A pilot dose finding study of pioglitazone in autistic children

Lucia Capano, Annie Dupuis, Jessica Brian, Deepali Mankad, Lisa Genore, Rianne Hastie Adams, Sharon Smile, Toni Lui, Dina Odrobina, Jane A. Foster, Evdokia Anagnostou

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background: Pioglitazone is a promising compound for treatment of core autism spectrum disorder (ASD) symptoms as it targets multiple relevant pathways, including immune system alterations. Objective: This pilot study aimed to elucidate the maximum tolerated dose, safety, preliminary evidence of efficacy, and appropriate outcome measures in autistic children ages 5-12 years old. Methods: We conducted a 16-week prospective cohort, single blind, single arm, 2-week placebo run-in, dose-finding study of pioglitazone. Twenty-five participants completed treatment. A modified dose finding method was used to determine safety and dose response among three dose levels: 0.25 mg/kg, 0.5 mg/kg, and 0.75 mg/kg once daily. Results: Maximum tolerated dose: there were no serious adverse events (SAEs) and as such the maximum tolerated dose within the range tested was 0.75 mg/Kg once daily. Safety: overall, pioglitazone was well tolerated. Two participants discontinued intervention due to perceived non-efficacy and one due to the inability to tolerate interim blood work. Three participants experienced mild neutropenia. Early evidence of efficacy: statistically significant improvement was observed in social withdrawal, repetitive behaviors, and externalizing behaviors as measured by the Aberrant Behavior Checklist (ABC), Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Repetitive Behavior Scale-Revised (RBS-R). Forty-six percent of those enrolled were deemed to be global responders. Conclusions and relevance: Pioglitazone is well-tolerated and shows a potential signal in measures of social withdrawal, repetitive, and externalizing behaviors. Randomized controlled trials using the confirmed dose are warranted. Trial registration: ClinicalTrials.gov, NCT01205282. Registration date: September 20, 2010.

Original languageEnglish (US)
Article number59
JournalMolecular autism
Volume9
Issue number1
DOIs
StatePublished - Nov 26 2018
Externally publishedYes

Keywords

  • Autism spectrum disorder
  • Clinical trial
  • Cytokines
  • Drug therapy
  • Efficacy
  • Inflammation
  • Maximum tolerated dose (MTD)
  • Physiological effects of drugs
  • Pioglitazone
  • Safety profile
  • Treatment

ASJC Scopus subject areas

  • Molecular Biology
  • Developmental Neuroscience
  • Developmental Biology
  • Psychiatry and Mental health

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