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Fasoracetam in adolescents with ADHD and glutamatergic gene network variants disrupting mGluR neurotransmitter signaling

  • Josephine Elia
  • , Grace Ungal
  • , Charlly Kao
  • , Alexander Ambrosini
  • , Nilsa De Jesus-Rosario
  • , Lene Larsen
  • , Rosetta Chiavacci
  • , Tiancheng Wang
  • , Christine Kurian
  • , Kanani Titchen
  • , Brian Sykes
  • , Sharon Hwang
  • , Bhumi Kumar
  • , Jacqueline Potts
  • , Joshua Davis
  • , Jeffrey Malatack
  • , Emma Slattery
  • , Ganesh Moorthy
  • , Athena Zuppa
  • , Andrew Weller
  • Enda Byrne, Yun R. Li, Walter K. Kraft, Hakon Hakonarson
  • Drexel University
  • The Children's Hospital of Philadelphia
  • University of Pennsylvania
  • Thomas Jefferson University
  • Alfred I. duPont Hospital for Children
  • University of California at San Francisco

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

The glutamatergic neurotransmitter system may play an important role in attention-deficit hyperactivity disorder (ADHD). This 5-week, open-label, single-blind, placebo-controlled study reports the safety, pharmacokinetics and responsiveness of the metabotropic glutamate receptor (mGluR) activator fasoracetam (NFC-1), in 30 adolescents, age 12-17 years with ADHD, harboring mutations in mGluR network genes. Mutation status was double-blinded. A single-dose pharmacokinetic profiling from 50-800 mg was followed by a single-blind placebo at week 1 and subsequent symptom-driven dose advancement up to 400 mg BID for 4 weeks. NFC-1 treatment resulted in significant improvement. Mean Clinical Global Impressions-Improvement (CGI-I) and Severity (CGI-S) scores were, respectively, 3.79 at baseline vs. 2.33 at week 5 (P < 0.001) and 4.83 at baseline vs. 3.86 at week 5 (P < 0.001). Parental Vanderbilt scores showed significant improvement for subjects with mGluR Tier 1 variants (P < 0.035). There were no differences in the incidence of adverse events between placebo week and weeks on active drug. The trial is registered at https://clinicaltrials.gov/ct2/show/study/NCT02286817.

Original languageEnglish
Article number4
JournalNature Communications
Volume9
Issue number1
DOIs
StatePublished - 1 Dec 2018

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