Title

Trial of Minocycline to Treat Children With Fragile X Syndrome
Randomized Double-Blind Controlled Cross Over Trial of Minocycline in Children With Fragile X Syndrome
  • Phase

    N/A
  • Study Type

    Interventional
  • Intervention/Treatment

    minocycline ...
  • Study Participants

    66
This is a single center study at the UC Davis MIND Institute in patients age 3.5-16 years of age with fragile X syndrome (FXS), funded by a National Fragile X Foundation Grant. It is a controlled trial of minocycline, an antibiotic commonly used in children for infection or for treatment of neurodegenerative disorders. We are investigating its use in FXS because it lowers matrix metalloproteinase 9 (MMP9) levels, which are high in FXS, and it also strengthens brain connections in the animal models of FXS. We hypothesize that minocycline will likely be helpful for language, behavior and/or cognition in fragile X patients.
This is a single center study at the UC Davis MIND Institute in patients age 3.5-16 years of age with fragile X syndrome (FXS), funded by a National Fragile X Foundation Grant. It is a controlled trial of minocycline, an antibiotic commonly used in children for infection or for treatment of neurodegenerative disorders. We are investigating its use in FXS because it lowers matrix metalloproteinase 9 (MMP9) levels, which are high in FXS, and it also strengthens brain connections in the animal models of FXS. We hypothesize that minocycline will likely be helpful for language, behavior and/or cognition in fragile X patients.

The aim of this study is to carry out a double-blind placebo controlled trial of minocycline treatment in children with FXS who are 3.5 to 16 years of age. At baseline, we will assess behavior and perceptual and cognitive development. After the children have been treated for 3 months with either minocycline or placebo, they undergo the same baseline testing. They will then cross over and be treated for a second 3 months. We will carry out testing again at the end of the second 3 month period. We will also assess the side effects of minocycline treatment throughout the study.
Study Started
Jan 31
2010
Primary Completion
Dec 31
2011
Study Completion
Dec 31
2011
Results Posted
Jul 30
2014
Estimate
Last Update
May 30
2017

Drug minocycline hydrochloride

Minocycline hydrochloride dosed orally once a day for 3 months.

Drug Placebo

Placebo will be given daily for 3 months.

Placebo pill Placebo Comparator

All patients will be on placebo for 3 months in this crossover study.

Minocycline Experimental

All patients will be on minocycline for 3 months in this crossover trial.

Criteria

Inclusion Criteria:

Must have fragile X syndrome with molecular documentation
Current pharmacological treatment regimen has been stable for at least 4 weeks

Exclusion Criteria:

Subjects who plan to initiate or change pharmacologic or non-pharmacologic interventions during the course of the study
subjects who are unable to take oral medication
subjects who have been on minocycline previously
subjects who are allergic to minocycline or tetracyclines
subjects who are pregnant
subjects with history of lupus or hepatic dysfunction

Summary

Minocycline

Placebo

All Events

Event Type Organ System Event Term Minocycline Placebo

Clinical Global Impression Scale (CGI)

The CGI-I utilizes history from primary caregivers and incorporates it into a seven step clinical rating for follow up throughout treatment, from 1 "very much improved" to 7 "very much worse". Lower scores indicate more improvement. Scores were obtained post treatments. Scores from when the patients were on minocycline either first or second were combined and averaged to determine a least squares mean and placebo scores were obtained in the same manner.

Minocycline

2.49
units on a scale (Least Squares Mean)
Standard Error: 0.13

Placebo

2.97
units on a scale (Least Squares Mean)
Standard Error: 0.13

Visual Analogue Scale- Behavior 1

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the first behavior that the caregivers noted, out of three.

Baseline

2.28
units on a scale (Least Squares Mean)
Standard Error: 0.21

Minocycline

4.6
units on a scale (Least Squares Mean)
Standard Error: 0.31

Placebo

4.44
units on a scale (Least Squares Mean)
Standard Error: 0.30

Visual Analogue Scale- Behaviors 2

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the second behavior that the caregivers noted, out of three.

Baseline

2.62
units on a scale (Least Squares Mean)
Standard Error: 0.23

Minocycline

4.91
units on a scale (Least Squares Mean)
Standard Error: 0.31

Placebo

4.16
units on a scale (Least Squares Mean)
Standard Error: 0.29

Expressive Vocabulary Test-2

The EVT-2 standard score assesses language development through a participant's one word synonym response to visual stimuli. Standard scores range from 20-160. A standard score of 100 is average, with a 15 point standard deviation. Higher values represent a better outcome.

Baseline

65.92
units on a scale (Least Squares Mean)
Standard Error: 3.61

Minocycline

68.86
units on a scale (Least Squares Mean)
Standard Error: 1.28

Placebo

67.91
units on a scale (Least Squares Mean)
Standard Error: 1.20

Vineland Adaptive Behavior Scale-II (VABS-II)Adaptive Behavior Composite Score

The VABS-II Adaptive Behavior Composite Score was used to assess adaptive skills. An Adaptive Behavior Composite Score may range from 20-160 with an average of 100 with a standard deviation of 15. Higher scores show improvement.

Baseline

69.88
units on a scale (Least Squares Mean)
Standard Error: 2.00

Minocycline

70.85
units on a scale (Least Squares Mean)
Standard Error: 0.92

Placebo

71.43
units on a scale (Least Squares Mean)
Standard Error: 0.90

Aberrant Behavior Checklist-Community Edition (ABC-C)Composite Score

The ABC-C composite scores were used to quantify the severity of a patient's behaviors. A composite score consists of subscale scores including Irritability and Agitation, Lethargy and Social Withdrawal, Stereotypic Behavior, Hyperactivity and Noncompliance, and Inappropriate Speech. The composite score may range from 0-174. Lower scores indicate improvement.

Baseline

41.22
units on a scale (Least Squares Mean)
Standard Error: 3.44

Minocycline

44.22
units on a scale (Least Squares Mean)
Standard Error: 3.02

Placebo

41.81
units on a scale (Least Squares Mean)
Standard Error: 2.94

Visual Analogue Scale Behavior 3- VAS3

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the third behavior that caregivers noted, out of three.

Baseline

2.8
units on a scale (Least Squares Mean)
Standard Error: 0.27

Minocycline

4.88
units on a scale (Least Squares Mean)
Standard Error: 0.36

Placebo

4.13
units on a scale (Least Squares Mean)
Standard Error: 0.35

VAS Categorized by Behavior: Aggression/ ADHD

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the least squares mean of all behaviors having to do with aggression or ADHD behaviors.

Baseline

2.38
units on a scale (Least Squares Mean)
Standard Error: 0.20

Minocycline

4.49
units on a scale (Least Squares Mean)
Standard Error: 0.32

Placebo

4.26
units on a scale (Least Squares Mean)
Standard Error: 0.32

VAS Categorized by Behavior:Anxiety/ Mood

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the least squares mean of all behaviors having to do with anxiety or mood related behaviors.

Baseline

2.47
units on a scale (Least Squares Mean)
Standard Error: 0.25

Minocycline

5.26
units on a scale (Least Squares Mean)
Standard Error: 0.46

Placebo

4.05
units on a scale (Least Squares Mean)
Standard Error: 0.46

VAS Categorized by Behavior:Language/ Cognition

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the least squares mean of all behaviors having to do with language or cognitive symptoms.

Baseline

2.58
units on a scale (Least Squares Mean)
Standard Error: 0.30

Minocycline

4.99
units on a scale (Least Squares Mean)
Standard Error: 0.37

Placebo

4.67
units on a scale (Least Squares Mean)
Standard Error: 0.34

VAS Categorized by Behavior: Other

A VAS is used to represent a caregiver's assessment of given behaviors, which were chosen by the parents. Caregivers marked a 10 cm horizontal line representing a visual continuum of each behavior from "worst behavior" to "behavior not a problem." Greater values indicate greater improvement. This measure represents the least squares mean of all behaviors having to do with other behaviors that were not able to be categorized.

Baseline

3.49
units on a scale (Least Squares Mean)
Standard Error: 0.66

Minocycline

5.84
units on a scale (Least Squares Mean)
Standard Error: 0.54

Placebo

3.41
units on a scale (Least Squares Mean)
Standard Error: 0.54

Total

55
Participants

Age, Continuous

9.21
years (Mean)
Standard Deviation: 3.57

Age, Categorical

Region of Enrollment

Sex: Female, Male

First Intervention (Week 1-12)

Minocycline First, Then Placebo Second

Placebo First, Minocycline Second

Second Intervention (Week 13-24)

Minocycline First, Then Placebo Second

Placebo First, Minocycline Second