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Trial registered on ANZCTR
Registration number
ACTRN12618000623291
Ethics application status
Approved
Date submitted
17/04/2018
Date registered
20/04/2018
Date last updated
17/07/2019
Date data sharing statement initially provided
17/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Neural mechanisms of lisdexamfetamine in binge eating disorder.
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Scientific title
Understanding the neural mechanisms of Lisdexamfetamine dimesylate (LDX) pharmacotherapy in binge-eating disorder.
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Secondary ID [1]
294610
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Binge-Eating Disorder
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Condition category
Condition code
Mental Health
306528
306528
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0
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Eating disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Drug name: Lisdexamfetamine dimesylate
Mode of administration: oral tablet
Dose and duration of administration: Intervention is planned to be titrated. All binge-eating disorder patients will commence with 30mg once daily for 2 weeks, then increase to 50mg once daily for the next 2 weeks following a blood pressure check. At 4-weeks, all participants will receive a safety and dose check by a study clinician. The clinician will assess whether those responsive to the medication should maintain their dose of 50mg once daily for the next 4 weeks, or whether those non-responsive should increase their dose to 70mg once daily for the next 4 weeks.
Strategies used to monitor adherence to the intervention will include:
- Participant diary to be completed daily, including a checkbox for medication compliance.
- Participants will be required to return all medication blister packs (used or unused) at the follow-up session, which will be counted for compliance rate. If less than 60% of tablets have been taken at this point, this will be viewed as non-compliant.
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Intervention code [1]
300913
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Treatment: Drugs
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Intervention code [2]
300914
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Behaviour
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Comparator / control treatment
The comparator/control group against which the study intervention is being compared will receive no treatment. This group will consist of healthy participants who are recruited separately from BED patients, and are matched with BED patients on age, gender and BMI.
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Control group
Active
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Outcomes
Primary outcome [1]
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Changes in resting-state functional connectivity between reward and inhibition networks in participants on LDX after 8 weeks of treatment, relative to pre-treatment, as assessed by MRI scans.
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Assessment method [1]
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Timepoint [1]
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Baseline; 8 weeks after LDX treatment commencement.
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Primary outcome [2]
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Changes in resting-state functional connectivity between reward and inhibition networks in participants on LDX after 8 weeks of treatment, relative to no-treatment controls, as assessed by MRI scans.
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Assessment method [2]
305563
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Timepoint [2]
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Baseline; 8 weeks after LDX treatment commencement.
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Secondary outcome [1]
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Changes in binge-eating symptoms, as assessed by the number of binge-eating events in the past week in a self-report diary.
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Assessment method [1]
345645
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Timepoint [1]
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Baseline; 8 weeks after LDX treatment commencement.
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Secondary outcome [2]
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Changes in functional connectivity between reward and inhibition networks.
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Assessment method [2]
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Timepoint [2]
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Baseline; 8 weeks after LDX treatment commencement.
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Eligibility
Key inclusion criteria
The key inclusion criteria for BED patients are:
- Age 18 – 40 years.
- Binge-eating disorder diagnosis, confirmed by the eating disorders module of the Structured Clinical Interview for DSM 5.
- Moderate to severe BED, defined as the presence of binge eating frequency of 3 days/week or greater in the month prior to the baseline assessment and a score of 4 or greater on the clinical global impressions severity scale.
- Body mass index of 20 – 45kg/m2.
- A study doctor has verified that it is medically and psychiatrically safe for their patient to commence LDX.
- Fluent in English.
- Have provided written informed consent.
The key inclusion criteria for control participants are:
- Age 18 – 40 years.
- Body Mass Index 20-45 kg/m2.
- Fluent in English.
- Have provided written informed consent.
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
The key exclusion criteria for BED patients are:
- Current anorexia or bulimia nervosa.
- History of psychosis or mania.
- Pregnant or breast-feeding women.
- Current therapy with antipsychotics or norepinephrine reuptake inhibitors.
- Cardiovascular disease, hypertension, use of monoamine oxidase inhibitors (MAOIs), or any other contraindications for psychostimulants.
- History of substance abuse/dependence (excluding nicotine).
- Previous suicide attempts or current suicidal ideation.
- Known medical condition, disease or neurological disorder which might, in the opinion of investigator/s, interfere with the assessments to be made in the study or put BED patients at increased risk when exposed to optimal doses of the drug treatment. For example, hypertension or a diagnosis of epilepsy would exclude a patient from this trial.
- Use of a psychostimulant in the 6 months prior to the study.
- Inability to tolerate the MRI scanner due to physical or psychological factors.
- History of physical brain injury or blow to the head that resulted in loss of consciousness for at least 10 minutes.
The key exclusion criteria for control participants are:
- Current or previous diagnosis of an eating disorder or any other psychiatric diagnosis, including substance dependence.
- Pregnant or breast-feeding women.
- Inability to tolerate the MRI scanner due to physical or psychological factors.
- Known medical condition, disease or neurological disorder which might, in the opinion of investigator/s, interfere with the assessments to be made in the study or put subjects at increased risk.
- History of physical brain injury or blow to the head that resulted in loss of consciousness for at least 10 minutes.
- Prior treatment with any stimulant medication.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/05/2018
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Actual
30/05/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
62
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Accrual to date
12
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
299226
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Commercial sector/Industry
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Name [1]
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Shire International GmbH
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Address [1]
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Zählerweg 10, CH-6300 Zug
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Country [1]
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Switzerland
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Primary sponsor type
University
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Name
University of Sydney
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Address
Camperdown, NSW, 2006
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Not applicable
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Address [1]
298496
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Not applicable
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Country [1]
298496
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300151
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Western Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
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PO Box 574 Wentworthville NSW 2145
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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17/10/2017
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Approval date [1]
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04/05/2018
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Ethics approval number [1]
300151
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AU RED HREC/17/WMEAD490
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Summary
Brief summary
While Lisdexamfetamine dimesylate (LDX) is indicated for moderate to severe binge-eating disorder (BED) in Australia, the exact mode of its therapeutic action in BED remains unknown. This study aims to provide a comprehensive understanding of the neural mechanisms by which LDX improves symptoms of BED. We hypothesise that: 1. LDX will act by altering connectivity within and between brain circuits responsible for reward and inhibition. 2. A reduction in binge-eating behaviours will correlate with increased activity and connectivity of brain regions within reward and inhibition circuits.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Michael Kohn
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Address
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Department of Adolescent and Young Adult Medicine
Level 2, Westmead Hospital
Hawkesbury Road, Westmead NSW 2137
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Country
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Australia
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Phone
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+61288906788
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Fax
82710
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Email
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[email protected]
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Contact person for public queries
Name
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Jenny Yang
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Address
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Westmead Institute for Medical Research
176 Hawkesbury Road, Westmead NSW 2145
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Country
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Australia
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Phone
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+61286273321
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Kristi Griffiths
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Address
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Westmead Institute for Medical Research
176 Hawkesbury Road, Westmead NSW 2145
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Country
82712
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Australia
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Phone
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+61286273318
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Fax
82712
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Email
82712
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
There is no plan to make individual participant data (IPD) publicly available for this trial.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Functional Connectivity Mechanisms Underlying Symptom Reduction Following Lisdexamfetamine Treatment in Binge-Eating Disorder: A Clinical Trial.
2024
https://dx.doi.org/10.1016/j.bpsgos.2023.08.016
N.B. These documents automatically identified may not have been verified by the study sponsor.
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