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CompletedNCT03569631Updated Dec 19, 2024Results posted

A 2-Period Crossover Study of BPN14770 in Adults Males With Fragile X Syndrome

A Phase 2 interventional study of BPN14770 and Placebo in Fragile X Syndrome, FXS and Fra(X) Syndrome, sponsored by Tetra Discovery Partners. Completed at 1 site in United States. Open to male participants aged 18 Years to 45 Years. Per ClinicalTrials.gov, last updated 2024-12-19.

Sponsored by Tetra Discovery Partners · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Male
01

Study summary

This is a single-center, randomized, double-blind, 2-period crossover study to explore the effects of BPN14770 on cognitive function and behavior in subjects with Fragile X Syndrome. Subjects will receive both active treatment with BPN14770 capsules and matching placebo capsules in the course of the study. One treatment will be administered during each of the 12-week study periods.

Read the detailed description

A total of 30 subjects will be enrolled. The study consists of a screening period of up to 28 days prior to initial treatment, followed by two double-blind treatment periods, each 12 weeks long. A final follow-up visit or phone contact for safety is planned one week after the conclusion of Period 2.

Eligible subjects will be randomized in a blinded, balanced (1:1) fashion to receive either 25 mg BPN14770 capsules or matching placebo capsules during Period 1, followed by the opposite treatment during Period 2. One capsule will be taken twice daily during both double-blind periods.

Subjects will return to the clinic at the end of Weeks 2, 6, and 12 of each study period. Cognitive and behavioral evaluations will be repeated at Weeks 6 and 12 of each Period. Additionally, patients will be monitored for adverse events via a telephone call at the end of Week 1 of each Period, and one week following completion of Period 2 or following early discontinuation.

During clinic visits, adverse effects will be assessed, and laboratory measures, vital signs, and ECGs will be performed. Suicidality risk will also be evaluated at each clinic visit; if a concern is detected, the subject will be referred for further evaluation and treatment. Cognitive and behavioral assessments will be performed during each clinic visit. Pharmacodynamic measures of CNS function will be obtained to evaluated effects of the drug in the brain. Pharmacokinetic samples will be collected to confirm that study drug is present and to estimate plasma exposure at Week 12 of each Period.

02

Conditions studied

  • Fragile X Syndrome
  • FXS
  • Fra(X) Syndrome

Keywords

  • Phosphodiesterase Type 4D
  • PDE4D
  • Cognitive Dysfunction
  • Neurocognitive Disorders
  • Fragile X Syndrome
  • Fragile X
  • FXS
  • Brain Diseases
  • Central Nervous System Diseases
  • Nervous System Diseases
  • Mental Disorders
  • Cognition Disorders
  • Enzyme Inhibitors
  • Nootropic Agents
  • Developmental Disorder
  • Autism
  • Autistic Spectrum Disorder
  • Genetic Disease
  • Behavioral Disorder
  • Learning Disorder
03

In context

Fragile X Syndrome

110 studies on the registry are indexed under Fragile X Syndrome; 23 are open to participants now.

This study's enrollment of 30 is below the median of 58 across 88 interventional studies indexed under Fragile X Syndrome.

Browse Fragile X Syndrome studies →

Lead sponsor

Tetra Discovery Partners is the lead sponsor of 9 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  1. Subject is male aged 18 to 45 years, inclusive.
  2. Subject has Fragile X Syndrome with a molecular genetic confirmation of the full Fragile X Mental Retardation (FMR1) mutation (≥200 CGG repetitions).
  3. Current treatment with no more than 3 prescribed psychotropic medications. Anti- epileptic medications are permitted and are not counted as psychotropic medications if they are used for treatment of seizures. Anti-epileptics for other indications, such as the treatment of mood disorders, count towards the limit of permitted medications.
  4. Permitted concomitant psychotropic medications must be at a stable dose and dosing regimen for at least 2 weeks prior to Screening and must remain stable during the period between Screening and the commencement of study medication.
  5. Anti-epileptic medications must be at a stable dose and dosing regimen for 12 weeks prior to Screening and must remain stable during the period between Screening and the commencement of study medication.
  6. Subjects with a history of seizure disorder who are currently receiving treatment with anti-epileptics must have been seizure-free for 3 months preceding Screening, or must be seizure-free for 3 years if not currently receiving anti-epileptics.
  7. Behavioral and therapy treatments/interventions must be stable for 4 weeks prior to Screening and must remain stable during the period between Screening and the commencement of study medication, and throughout the study. Minor changes in hours or times of therapy that are not considered clinically significant will not be exclusionary. Changes in therapies provided through a school program, due to school vacations, are allowed.
  8. Subject must be willing to practice barrier methods of contraception while on study, if sexually active. Abstinence is also considered a reasonable form of birth control in this study population.
  9. Subject has a parent, legal authorized guardian or consistent caregiver.
  10. Subject and caregiver are able to attend the clinic regularly and reliably.
  11. Subject is able to swallow tablets and capsules.
  12. For subjects who are not their own legal guardian, subject's parent/legal authorized guardian is able to understand and sign an informed consent form to participate in the study.
  13. If subject is his/her own legal guardian, he/she can understand and sign informed consent to participate in the study.
  14. If subject is not their own legal guardian, the subject provides assent for participation in the study, if the subject has the cognitive ability to provide assent.

Exclusion criteria

Exclusion Criteria:

  1. History of, or current cardiovascular, renal, hepatic, respiratory, gastrointestinal, psychiatric, neurologic, cerebrovascular, or other systemic disease that would place the subject at risk or potentially interfere with the interpretation of the safety, tolerability, or efficacy of the study medication. Common diseases such as mild hypertension, well-controlled type 2 diabetes mellitus (hemoglobin A1C [Hgb A1C] \<6.5%), etc. are allowed per the investigator's judgment as long as they are stable and controlled by medical therapy that is constant for at least 4 weeks before randomization.
  2. Renal impairment, defined as serum creatinine > 1.25 x ULN at screening
  3. Hepatic impairment, defined as ALT or AST elevation > 2 x ULN at screening. Note:

    LFTs may be repeated after 1 week to evaluate return to acceptable limits; if LFTs remain elevated, subject is ineligible to participate.

  4. Clinically significant abnormalities, in the investigator's judgment, in safety laboratory tests, vital signs, or ECG, as measured during Screening.
  5. History of substance abuse within the past year, according to investigator assessment.
  6. Significant hearing or visual impairment that may affect the subject's ability to complete the test procedures.
  7. Concurrent major psychiatric condition (e.g., Major Depressive Disorder, Schizophrenia or Bipolar Disorder) as diagnosed by the investigator. Subjects with additional diagnosis of Autism Spectrum Disorder or Anxiety Disorder will be allowed.
  8. Subject has active diseases that would interfere with participation, such as acquired immunodeficiency disorder, hepatitis C, hepatitis B, or tuberculosis.
  9. Subject is planning to commence psychotherapy or cognitive behavior therapy (CBT) during the period of the study or had begun psychotherapy or CBT within 4 weeks prior to Screening.
  10. Subject is related to anyone employed by the sponsor, investigator, or study staff.
  11. Subject has BMI less than 18 or greater than 36.
  12. Subject has participated in another clinical trial within the 30 days preceding Screening.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Investigator)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    BPN14770

    25mg BPN14770 capsules, one capsule taken twice daily for 12 weeks

    Drug: BPN14770

  • Placebo comparator
    Placebo

    Matching placebo capsules, one capsule taken twice daily for 12 weeks

    Drug: Placebo

Interventions

  • DrugBPN14770

    25 mg BPN14770 capsules

  • DrugPlacebo

    Placebo capsules to mimic 25 mg BPN14770 capsules

06

What researchers measure

Primary outcomes

  1. Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    A TEAE was any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. A Serious Adverse Event (SAE) was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

    Time frame: Up to 24 weeks

Secondary outcomes

  1. Change From Baseline in National Institute of Health Toolbox Cognitive Battery Modified for Intellectual Disabilities Crystallized Cognition Composite (NIH-TCB CCC) Score

    The NIH-TCB is a battery of extensively validated computer-administered cognitive tests administered on an iPad. The Crystallized Composite score assessment includes Picture Vocabulary and Oral Reading Recognition tests. The NIH toolbox standard score has a mean of 100 and standard deviation (SD) of 15. Higher scores indicate better intellectual abilities.

    Time frame: Baseline to Week 12

  2. Change From Baseline Between BPN14770 and Placebo Arm in Visual Analog Scale (VAS) Daily Functioning

    The VAS was used to measure the severity of Daily Functioning skills, which is a specific behavioral symptom targeted in this study. Parents or caregivers marked this behavior on a visual line on a score from 0 to 100, with higher scores indicating better quality of life.

    Time frame: Baseline to Week 12

  3. Change From Baseline Between BPN14770 and Placebo Arm in VAS Language

    The VAS was used to measure the severity of Language skills, which is a specific behavioral symptom targeted in this study. Parents or caregivers marked this behavior on a visual line on a score from 0 to 100, with higher scores indicating better quality of life.

    Time frame: Baseline to Week 12

07

Results

Posted Dec 19, 2024

Participant flow

Period 1 (12 Weeks)
Participant flow — Period 1 (12 Weeks)
MilestoneSequence A-BSequence B-A
Started1515
Received at least 1 dose of study drug1515
Completed1515
Not completed00
Period 2 (12 Weeks)
Participant flow — Period 2 (12 Weeks)
MilestoneSequence A-BSequence B-A
Started1515
Received at least 1 dose of study drug1515
Completed1515
Not completed00

Outcome measures

PrimaryNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)

A TEAE was any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. A Serious Adverse Event (SAE) was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

Time frame:
Up to 24 weeks
Reported as:
Count of participants · Participants
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
ParticipantsBPN14770Placebo
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)118
SecondaryChange From Baseline in National Institute of Health Toolbox Cognitive Battery Modified for Intellectual Disabilities Crystallized Cognition Composite (NIH-TCB CCC) Score

The NIH-TCB is a battery of extensively validated computer-administered cognitive tests administered on an iPad. The Crystallized Composite score assessment includes Picture Vocabulary and Oral Reading Recognition tests. The NIH toolbox standard score has a mean of 100 and standard deviation (SD) of 15. Higher scores indicate better intellectual abilities.

Time frame:
Baseline to Week 12
Reported as:
Mean · units on a scale
Change From Baseline in National Institute of Health Toolbox Cognitive Battery Modified for Intellectual Disabilities Crystallized Cognition Composite (NIH-TCB CCC) Score
units on a scaleBPN14770Placebo
Change From Baseline in National Institute of Health Toolbox Cognitive Battery Modified for Intellectual Disabilities Crystallized Cognition Composite (NIH-TCB CCC) Score0.1 ± 3.45-0.9 ± 7.18
SecondaryChange From Baseline Between BPN14770 and Placebo Arm in Visual Analog Scale (VAS) Daily Functioning

The VAS was used to measure the severity of Daily Functioning skills, which is a specific behavioral symptom targeted in this study. Parents or caregivers marked this behavior on a visual line on a score from 0 to 100, with higher scores indicating better quality of life.

Time frame:
Baseline to Week 12
Reported as:
Mean · millimeters (mm)
Change From Baseline Between BPN14770 and Placebo Arm in Visual Analog Scale (VAS) Daily Functioning
millimeters (mm)BPN41770Placebo
Change From Baseline Between BPN14770 and Placebo Arm in Visual Analog Scale (VAS) Daily Functioning9.4 ± 27.916.8 ± 22.77
SecondaryChange From Baseline Between BPN14770 and Placebo Arm in VAS Language

The VAS was used to measure the severity of Language skills, which is a specific behavioral symptom targeted in this study. Parents or caregivers marked this behavior on a visual line on a score from 0 to 100, with higher scores indicating better quality of life.

Time frame:
Baseline to Week 12
Reported as:
Mean · millimeters (mm)
Change From Baseline Between BPN14770 and Placebo Arm in VAS Language
millimeters (mm)BPN41770Placebo
Change From Baseline Between BPN14770 and Placebo Arm in VAS Language18.2 ± 21.4715.4 ± 22.07

Adverse events

Collected over First dose of study drug up to 24 weeks. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
BPN147700/30 (0%)1/30 (3.3%)5/30 (16.7%)
Placebo0/30 (0%)0/30 (0%)6/30 (20%)
Most frequent serious events
Most frequent serious events
EventBPN14770Placebo
Bursitis infectiveInfections and infestations1/300/30
Most frequent other events
Most frequent other events
EventBPN14770Placebo
VomitingGastrointestinal disorders3/302/30
Upper respiratory tract infectionInfections and infestations2/303/30
DiarrhoeaGastrointestinal disorders0/302/30

Baseline characteristics

Safety Population included all participants who were randomized and receive at least one dose of study drug.

Age, Continuous
Age, Continuous(years)Sequence A-BSequence B-ATotal
Mean31.2 ± 6.8232.1 ± 8.0031.6 ± 7.32
Sex: Female, Male
Sex: Female, Male(Participants)Sequence A-BSequence B-ATotal
Female000
Male151530
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Sequence A-BSequence B-ATotal
Hispanic or Latino112
Not Hispanic or Latino141428
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Sequence A-BSequence B-ATotal
American Indian or Alaska Native011
Asian000
Native Hawaiian or Other Pacific Islander123
Black or African American000
White141226
More than one race000
Unknown or Not Reported000
08

Study locations

1 site
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
09

References and documents

Publications

  • Gurney ME, Cogram P, Deacon RM, Rex C, Tranfaglia M. Multiple Behavior Phenotypes of the Fragile-X Syndrome Mouse Model Respond to Chronic Inhibition of Phosphodiesterase-4D (PDE4D). Sci Rep. 2017 Nov 7;7(1):14653. doi: 10.1038/s41598-017-15028-x. PubMed 29116166 ↗
  • Berry-Kravis EM, Harnett MD, Reines SA, Reese MA, Ethridge LE, Outterson AH, Michalak C, Furman J, Gurney ME. Inhibition of phosphodiesterase-4D in adults with fragile X syndrome: a randomized, placebo-controlled, phase 2 clinical trial. Nat Med. 2021 May;27(5):862-870. doi: 10.1038/s41591-021-01321-w. Epub 2021 Apr 29. PubMed 33927413 ↗

Study documents

  • Study protocol · Jun 25, 2018
  • Statistical analysis plan · Jul 16, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03569631
Lead sponsor
Tetra Discovery Partners
Responsible party
Sponsor
First posted
Jun 26, 2018
Start date
Jul 9, 2018
Primary completion
Jul 31, 2020
Completion
Jul 31, 2020
Results posted
Dec 19, 2024
Last update
Dec 19, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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