NCT02649959

Brief Summary

This is a Phase III, open label extension study evaluating the continued safety and efficacy of CM-AT in pediatric patients with autism with all levels of fecal chymotrypsin.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
405

participants targeted

Target at P50-P75 for phase_3

Timeline
19mo left

Started Oct 2015

Longer than P75 for phase_3

Geographic Reach
1 country

31 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress87%
Oct 2015Jan 2028

Study Start

First participant enrolled

October 1, 2015

Completed
1 month until next milestone

First Submitted

Initial submission to the registry

November 12, 2015

Completed
2 months until next milestone

First Posted

Study publicly available on registry

January 8, 2016

Completed
12 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2028

Last Updated

March 18, 2026

Status Verified

March 1, 2026

Enrollment Period

12.3 years

First QC Date

November 12, 2015

Last Update Submit

March 16, 2026

Conditions

Keywords

AutismA long-term extension study in a pediatric population of children with autism.

Outcome Measures

Primary Outcomes (1)

  • Aberrant Behavioral Checklist: Subscale of Irritability / Agitation (ABC-I) at fecal chymotrypsin (FCT) levels less than or equal to 12.6

    Change from Baseline to each post-baseline visit, through study completion Week 72.

Secondary Outcomes (1)

  • Aberrant Behavior Checklist: Subscale of Lethargy / Social Withdrawal (ABC-L) at fecal chymotrypsin (FCT) levels less than or equal to 12.6

    Change from Baseline to each post-baseline visit, through study completion Week 72.

Study Arms (1)

Open Label

EXPERIMENTAL

CM-AT

Drug: CM-AT

Interventions

CM-ATDRUG

Single unit does powder of active substance (CM-AT) administered 3 times per day

Open Label

Eligibility Criteria

Age3 Years - 17 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Age between 3 and 8 years, inclusive, at the time of signing informed consent/assent in Sponsor 00103 Study
  • Completion of the Sponsor's 00103 Study who continue to meet eligibility requirements
  • Currently in the 00102 open label study and continue to meet eligibility requirements
  • Subjects who initially qualified for 00103 screening, who subsequently failed Baseline entrance criteria for randomization (@Visit 1) Baseline assessment of the ABC eligibility requirement who continue to meet eligibility requirements
  • Up to 20 subjects 9-17 years of age who directly enroll into this study, who meet the current Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR) diagnostic criteria for Autistic Disorder (AD), screened by the SCQ and confirmed by the ADI-R

You may not qualify if:

  • Patient weighing \< 13kg
  • Allergy to porcine products
  • Previous sensitization or allergy to trypsin, pancreatin, or pancrelipase
  • History of severe head trauma, as defined by loss of consciousness or hospitalization, skull fracture or stroke.
  • Seizure within the last year prior to enrollment, or the need for seizure medications either at present or in the past.
  • Evidence or history of severe, moderate or uncontrolled systemic disease
  • Ongoing dietary restriction for allergy or other reasons except nut allergies. Lactose free is allowable but not dairy free.
  • Inability to ingest the study drug / non-compliance with dosing schedule.
  • Inability to follow the prescribed dosing schedule.
  • Use of any stimulant or non-stimulant medication or medications given for attention deficit hyperactivity disorder (ADHD) must be discontinued 5 days prior to the initial randomized study period.
  • Subjects taking an selective serotonin reuptake inhibitor (SSRI) must be on a stable dose for a minimum of 30 days prior to entering the study.
  • History of premature birth \<35 weeks gestation.
  • Prior history of stroke in utero or other in utero insult.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (31)

Southwest Autism Research & Resource Center (S.A.R.R.C.)

Phoenix, Arizona, 85006, United States

Location

University of Arizona, Pediatrics Multidisciplinary Research Unit

Tucson, Arizona, 85724, United States

Location

Arkansas Children'S Hosp. Research Institute (A.C.H.R.I.)

Little Rock, Arkansas, 72202, United States

Location

N.R.C. Research Institute

Orange, California, 92868, United States

Location

M.I.N.D. Institute (Univ.of California, Davis)

Sacramento, California, 95817, United States

Location

University of California (U.C.S.F.)

San Francisco, California, 94143-0984, United States

Location

IMMUNOe Research Centers

Centennial, Colorado, 80112, United States

Location

Yale Child Study Center

New Haven, Connecticut, 06519, United States

Location

Segal Institute For Clinical Research

North Miami, Florida, 33161, United States

Location

Advent Health -Lake Mary Pediatrics

Orange City, Florida, 32763, United States

Location

A.P.G. Research

Orlando, Florida, 32803, United States

Location

Research Institute of Deaconess Clinic

Newburgh, Indiana, 47630, United States

Location

Lake Charles Clinical Trials

Lake Charles, Louisiana, 70629, United States

Location

L.S.U. Health Sciences Center

Shreveport, Louisiana, 71103, United States

Location

Detroit Clinical Research Center, P.C.

Bingham Farms, Michigan, 48025, United States

Location

Children'S Specialized Hospital

Egg Harbor, New Jersey, 08234, United States

Location

Children's Specialized Hospital

Toms River, New Jersey, 08755, United States

Location

Clinical Research Center of Nj

Voorhees Township, New Jersey, 08043, United States

Location

Lovelace Scientific Resources

Albuquerque, New Mexico, 87108, United States

Location

Richmond Behavioral Associates

Staten Island, New York, 10312, United States

Location

Montefiore Med.Cneter, Autism & Obsessive Compulsive Spectrum Program

The Bronx, New York, 10467, United States

Location

Duke Center For Autism and Brain Development

Durham, North Carolina, 27705, United States

Location

Cleveland Clinic Autism Center

Cleveland, Ohio, 44104, United States

Location

Omega Medical Research

Warwick, Rhode Island, 02886, United States

Location

Carolina Clinical Trials, Inc.

Charleston, South Carolina, 29407, United States

Location

Vanderbilt Universtiy Med.Center-Treatment&Research Inst. For Asd

Nashville, Tennessee, 37232-2551, United States

Location

University of Texas, Houston-Behavioral & Biomedical Sciences

Houston, Texas, 77054, United States

Location

Focus Center of Clinical Research

Clinton, Utah, 84015, United States

Location

University of Virginia, Dept. of Psychiatry and Neurobehavioral Sciences

Charlottesville, Virginia, 22903, United States

Location

Neuroscience, Inc

Herndon, Virginia, 20170, United States

Location

Carilion Clinic-Virginia Tech, Carilion School of Medicine

Roanoke, Virginia, 24014, United States

Location

Related Publications (28)

  • McPheeters ML, Warren Z, Sathe N, Bruzek JL, Krishnaswami S, Jerome RN, Veenstra-Vanderweele J. A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics. 2011 May;127(5):e1312-21. doi: 10.1542/peds.2011-0427. Epub 2011 Apr 4.

    PMID: 21464191BACKGROUND
  • Autism and Developmental Disabilities Monitoring Network Surveillance Year 2008 Principal Investigators; Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ. 2012 Mar 30;61(3):1-19.

    PMID: 22456193BACKGROUND
  • Peacock G, Amendah D, Ouyang L, Grosse SD. Autism spectrum disorders and health care expenditures: the effects of co-occurring conditions. J Dev Behav Pediatr. 2012 Jan;33(1):2-8. doi: 10.1097/DBP.0b013e31823969de.

    PMID: 22157409BACKGROUND
  • Ganz ML. The lifetime distribution of the incremental societal costs of autism. Arch Pediatr Adolesc Med. 2007 Apr;161(4):343-9. doi: 10.1001/archpedi.161.4.343.

    PMID: 17404130BACKGROUND
  • McElhanon BO, McCracken C, Karpen S, Sharp WG. Gastrointestinal symptoms in autism spectrum disorder: a meta-analysis. Pediatrics. 2014 May;133(5):872-83. doi: 10.1542/peds.2013-3995.

    PMID: 24777214BACKGROUND
  • Buie T, Campbell DB, Fuchs GJ 3rd, Furuta GT, Levy J, Vandewater J, Whitaker AH, Atkins D, Bauman ML, Beaudet AL, Carr EG, Gershon MD, Hyman SL, Jirapinyo P, Jyonouchi H, Kooros K, Kushak R, Levitt P, Levy SE, Lewis JD, Murray KF, Natowicz MR, Sabra A, Wershil BK, Weston SC, Zeltzer L, Winter H. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010 Jan;125 Suppl 1:S1-18. doi: 10.1542/peds.2009-1878C.

    PMID: 20048083BACKGROUND
  • Samsam M, Ahangari R, Naser SA. Pathophysiology of autism spectrum disorders: revisiting gastrointestinal involvement and immune imbalance. World J Gastroenterol. 2014 Aug 7;20(29):9942-51. doi: 10.3748/wjg.v20.i29.9942.

    PMID: 25110424BACKGROUND
  • Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcin C, Montiel-Nava C, Patel V, Paula CS, Wang C, Yasamy MT, Fombonne E. Global prevalence of autism and other pervasive developmental disorders. Autism Res. 2012 Jun;5(3):160-79. doi: 10.1002/aur.239. Epub 2012 Apr 11.

    PMID: 22495912BACKGROUND
  • Wasfy M, Oyofo B, Elgindy A, Churilla A. Comparison of preservation media for storage of stool samples. J Clin Microbiol. 1995 Aug;33(8):2176-8. doi: 10.1128/jcm.33.8.2176-2178.1995.

    PMID: 7559972BACKGROUND
  • Cavallini G, Benini L, Brocco G, Riela A, Bovo P, Pederzoli P, Angelini G, Pelle C, Bertelli G, Scuro LA. The fecal chymotrypsin photometric assay in the evaluation of exocrine pancreatic capacity. Comparison with other direct and indirect pancreatic function tests. Pancreas. 1989;4(3):300-4. doi: 10.1097/00006676-198906000-00005.

    PMID: 2734275BACKGROUND
  • Matthews DM. Intestinal absorption of amino acids and peptides. Proc Nutr Soc. 1972 Sep;31(2):171-7. doi: 10.1079/pns19720033. No abstract available.

    PMID: 4563292BACKGROUND
  • Coutinho AM, Oliveira G, Morgadinho T, Fesel C, Macedo TR, Bento C, Marques C, Ataide A, Miguel T, Borges L, Vicente AM. Variants of the serotonin transporter gene (SLC6A4) significantly contribute to hyperserotonemia in autism. Mol Psychiatry. 2004 Mar;9(3):264-71. doi: 10.1038/sj.mp.4001409.

    PMID: 15094787BACKGROUND
  • Naushad SM, Jain JM, Prasad CK, Naik U, Akella RR. Autistic children exhibit distinct plasma amino acid profile. Indian J Biochem Biophys. 2013 Oct;50(5):474-8.

    PMID: 24772971BACKGROUND
  • Williams K, Wheeler DM, Silove N, Hazell P. Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2010 Aug 4;(8):CD004677. doi: 10.1002/14651858.CD004677.pub2.

    PMID: 20687077BACKGROUND
  • Tang G, Gudsnuk K, Kuo SH, Cotrina ML, Rosoklija G, Sosunov A, Sonders MS, Kanter E, Castagna C, Yamamoto A, Yue Z, Arancio O, Peterson BS, Champagne F, Dwork AJ, Goldman J, Sulzer D. Loss of mTOR-dependent macroautophagy causes autistic-like synaptic pruning deficits. Neuron. 2014 Sep 3;83(5):1131-43. doi: 10.1016/j.neuron.2014.07.040. Epub 2014 Aug 21.

    PMID: 25155956BACKGROUND
  • Balasubramanian MN, Butterworth EA, Kilberg MS. Asparagine synthetase: regulation by cell stress and involvement in tumor biology. Am J Physiol Endocrinol Metab. 2013 Apr 15;304(8):E789-99. doi: 10.1152/ajpendo.00015.2013. Epub 2013 Feb 12.

    PMID: 23403946BACKGROUND
  • Fairclough PD, Hegarty JE, Silk DB, Clark ML. Comparison of the absorption of two protein hydrolysates and their effects on water and electrolyte movements in the human jejunum. Gut. 1980 Oct;21(10):829-34. doi: 10.1136/gut.21.10.829.

    PMID: 7192244BACKGROUND
  • Arnold GL, Hyman SL, Mooney RA, Kirby RS. Plasma amino acids profiles in children with autism: potential risk of nutritional deficiencies. J Autism Dev Disord. 2003 Aug;33(4):449-54. doi: 10.1023/a:1025071014191.

    PMID: 12959424BACKGROUND
  • Munasinghe SA, Oliff C, Finn J, Wray JA. Digestive enzyme supplementation for autism spectrum disorders: a double-blind randomized controlled trial. J Autism Dev Disord. 2010 Sep;40(9):1131-8. doi: 10.1007/s10803-010-0974-2.

    PMID: 20204691BACKGROUND
  • Schreck KA, Williams K, Smith AF. A comparison of eating behaviors between children with and without autism. J Autism Dev Disord. 2004 Aug;34(4):433-8. doi: 10.1023/b:jadd.0000037419.78531.86.

    PMID: 15449518BACKGROUND
  • Bailey DB Jr, Raspa M, Olmsted M, Holiday DB. Co-occurring conditions associated with FMR1 gene variations: findings from a national parent survey. Am J Med Genet A. 2008 Aug 15;146A(16):2060-9. doi: 10.1002/ajmg.a.32439.

    PMID: 18570292BACKGROUND
  • Lecavalier L. An evaluation of the Gilliam Autism Rating Scale. J Autism Dev Disord. 2005 Dec;35(6):795-805. doi: 10.1007/s10803-005-0025-6.

    PMID: 16283084BACKGROUND
  • Marcus RN, Owen R, Kamen L, Manos G, McQuade RD, Carson WH, Aman MG. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. J Am Acad Child Adolesc Psychiatry. 2009 Nov;48(11):1110-1119. doi: 10.1097/CHI.0b013e3181b76658.

    PMID: 19797985BACKGROUND
  • Yerys BE, Wallace GL, Sokoloff JL, Shook DA, James JD, Kenworthy L. Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders. Autism Res. 2009 Dec;2(6):322-33. doi: 10.1002/aur.103.

    PMID: 19998356BACKGROUND
  • Schreck KA, Williams K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Res Dev Disabil. 2006 Jul-Aug;27(4):353-63. doi: 10.1016/j.ridd.2005.03.005. Epub 2005 Jul 25.

    PMID: 16043324BACKGROUND
  • Borowitz D. Update on the evaluation of pancreatic exocrine status in cystic fibrosis. Curr Opin Pulm Med. 2005 Nov;11(6):524-7. doi: 10.1097/01.mcp.0000181474.08058.b3.

    PMID: 16217179BACKGROUND
  • Penn AH, Hugli TE, Schmid-Schonbein GW. Pancreatic enzymes generate cytotoxic mediators in the intestine. Shock. 2007 Mar;27(3):296-304. doi: 10.1097/01.shk.0000235139.20775.7f.

    PMID: 17304111BACKGROUND
  • Pearson DA, Hendren RL, Heil MF, McIntyre WR, Raines SR. Pancreatic Replacement Therapy for Maladaptive Behaviors in Preschool Children With Autism Spectrum Disorder. JAMA Netw Open. 2023 Nov 1;6(11):e2344136. doi: 10.1001/jamanetworkopen.2023.44136.

MeSH Terms

Conditions

Autistic Disorder

Condition Hierarchy (Ancestors)

Autism Spectrum DisorderChild Development Disorders, PervasiveNeurodevelopmental DisordersMental Disorders

Study Officials

  • Deborah Pearson, PhD

    The University of Texas Health Science Center, Houston

    PRINCIPAL INVESTIGATOR
  • Robert Hendren, DO

    University of California, San Francisco

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 12, 2015

First Posted

January 8, 2016

Study Start

October 1, 2015

Primary Completion (Estimated)

January 1, 2028

Study Completion (Estimated)

January 1, 2028

Last Updated

March 18, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will not share

Locations