A Proof-of-Concept Study of Minocycline in Autism

Overview

The purpose of the study is to determine if Minocycline shows initial evidence of efficacy, safety, and tolerability in youth with Autism Spectrum Disorder ages 12 to 22 years.

Full Title of Study: “Comparison of the Pharmacodynamic and Tolerability Profiles of Minocycline Versus Placebo in Autism Spectrum Disorder: a Double-blind, Placebo-controlled, Crossover, Proof-of-concept Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Treatment
    • Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: October 30, 2020

Detailed Description

This is a double-blind, placebo-controlled, crossover, proof-of-concept study that compares the pharmacodynamic and tolerability profiles of minocycline versus placebo in autism spectrum disorder.

Interventions

  • Drug: Minocycline
    • Minocycline 100 mg capsules or matching placebo will be prepared by the central investigational pharmacy at Cincinnati Children’s Hospital Medical Center. Drug identity will be masked by over encapsulation of the study drug.
  • Drug: Placebos
    • Minocycline 100 mg capsules or matching placebo will be prepared by the central investigational pharmacy at Cincinnati Children’s Hospital Medical Center. Drug identity will be masked by over encapsulation of the study drug.

Arms, Groups and Cohorts

  • Experimental: Minocycline versus Placebo
    • Phase 1: 4 weeks of daily minocycline 100mg BID dosing 2-week washout period Phase 2: 4 weeks of daily placebo dosing
  • Experimental: Placebo versus Minocycline
    • Phase 1: 4 weeks of daily placebo dosing 2-week washout period Phase 2: 4 weeks of daily minocycline 100mg BID dosing

Clinical Trial Outcome Measures

Primary Measures

  • Subject weight will be compared pre- and post-treatment in the drug versus placebo conditions
    • Time Frame: Through study completion, an average of 2 years
    • Subject weight will be measured in kilograms
  • Aberrant Behavior will be evaluated pre- and post-treatment in the drug versus placebo conditions
    • Time Frame: Through study completion, an average of 2 years
    • Aberrant behavior will be measured by the Aberrant Behavior Checklist total score
  • Incidence of liver toxicity will be evaluated in the pre- and post-treatment setting in the drug versus placebo conditions
    • Time Frame: Through study completion, an average of 2 years
    • Liver toxicity will be defined as the development of an ALT or AST value greater than twice the upper limit of normal during a treatment period

Participating in This Clinical Trial

Inclusion Criteria

1. 22 ≥ Age ≥12 years. Males and females included in study. 2. Diagnostic confirmation of Autism Spectrum Disorder as confirmed by gold standard clinical interview using DSM 5 criteria and administration of the Autism Diagnostic Observation Schedule-2, Module 3 or 4. 3. General good health as determined by physical exam, medical and psychiatric history and safety labs as defined by the PI or designee. 4. Male study participants who are sexually active with a female partner of childbearing potential must be surgically sterilized, practicing abstinence, or agree to use highly effective methods of birth control (defined below), and not rely on barrier methods and spermicide alone, from the time of screening until 1 week after final dose of study drug. 5. Female participants of childbearing potential may be included in the study provided they are practicing abstinence or are using a double barrier method from the time of screening until 1 week after the final dose of study drug. Participants using hormonal methods of birth control (oral, intravaginal, transdermal, injectable, or implantable) must be on a stable dose for at least three months prior to screening. 6. Whole brain absolute cumulative gamma power (30 to 80 Hz) with median cut off at 2.5 (upward adjusted) Exclusion Criteria:

1. Allergy or hypersensitivity to any of the tetracyclines antibiotics. 2. Inability to swallow study drug. 3. Concomitant use of scheduled anti-inflammatory drugs with the exception of as needed ibuprofen or acetaminophen use. 4. Unstable dosing of any mood, anxiety or behavior medications in the 5 half-lives prior to Phase 1 baseline visit. 5. Concomitant use of scheduled benzodiazepines, baclofen, gabapentin, pregabalin, or supplements with impact on the GABA system. 6. Concomitant daily use of antacids 7. Concomitant use of oral acne medications (isotretinoin), not including lotions or creams applied to the skin 8. Concomitant use of any cannabinoid or related product. 9. Unstable seizure disorder as defined by any seizure in the 6 months prior to baseline visit and/or a change in any anti-convulsant drug dosing in the 60 days prior to study screen. 10. Abnormal baseline safety lab assessments including, but not limited to ALT or AST greater than 1.5x the upper limit of normal, elevated ANA, total bilirubin or creatinine greater than 1x the upper limit of normal, other clinically relevant lab abnormality, or abnormality in ECG, HR or BP at screening as determined by the investigator or designee. 11. History of autoimmune disorder 12. History of or current abuse of drugs or alcohol including prescription medication. 13. Women who are pregnant (i.e. have a positive pregnancy test), intending to become pregnant, breast feeding, or women of child-bearing potential who are unwilling to use contraception as required in the study inclusion criteria or maintain abstinence during the course of the study 14. Inability to attend scheduled study visits, plans for family relocation during the study, or any other criteria that the investigator may determine to be associated with inability to complete the study

Gender Eligibility: All

Minimum Age: 12 Years

Maximum Age: 22 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Children’s Hospital Medical Center, Cincinnati
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Craig Erickson, Principal Investigator, Children’s Hospital Medical Center, Cincinnati

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