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Phase 4 N=288 Randomized Triple-blind Treatment

A Study of TAK-503 in Children and Teenagers With Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder

Enrolled (actual)
288
Serious AEs
0.3%
Results posted
Apr 2026
Primary outcome: Primary: Part A: Change From Baseline in the Cambridge Neuropsychological Test Automated Battery (CANTAB) Reaction Time (RTI) Task at Week 18 — -7.1; -9.2; -5.1; 5.3 msec

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Guanfacine hydrochloride (TAK-503) (Drug); Atomoxetine hydrochloride (Drug); Placebo (Other)
Age
Pediatric · 6+ yrs
Sex
All
Sponsor
Shire
Primary completion
Sep 2025

Outcome Measures

OutcomeResultp-value
PRIMARY
Part A: Change From Baseline in the Cambridge Neuropsychological Test Automated Battery (CANTAB) Reaction Time (RTI) Task at Week 18
-7.1; -9.2; -5.1; 5.3; -10.6; -2.5
PRIMARY
Part A: Change From Baseline in the CANTAB RTI Task at Week 49
-41.6; 29.2; -18.6; 9.5
PRIMARY
Part B: Change From Baseline in the CANTAB RTI Task at Week 49
-10.43; 12.94; -18.81; -17.76; -8.08; -6.69
SECONDARY
Part A: Change From Baseline in the Rapid Visual Information Processing (RVP) Task of the CANTAB: Mean Response Latency
-21.8; 28.1; -21.0; 48.3; -27.1
SECONDARY
Part B: Change From Baseline in the RVP Task of the CANTAB: Mean Response Latency
89.91; -82.75; -11.49
SECONDARY
Part A: Change From Baseline in the RVP Task of the CANTAB: A'
0.014; 0.029; 0.028; 0.021; 0.019
SECONDARY
Part B: Change From Baseline in the RVP Task of the CANTAB: A'
-0.039; 0.030; 0.040
SECONDARY
Part A: Change From Baseline in the RVP Task of the CANTAB: Probability of Hit
-0.012; 0.035; -0.004; 0.019; 0.002
SECONDARY
Part B: Change From Baseline in the RVP Task of the CANTAB: Probability of Hit
0.003; 0.106; 0.035
SECONDARY
Part A: Change From Baseline in the Spatial Working Memory (SWM) Task of the CANTAB
-4.6; -2.4; -2.1; -1.0; -1.4; -1.0
SECONDARY
Part B: Change From Baseline in the SWM Task of the CANTAB
1.37; 5.45; -2.59; -0.06; 0.35; 0.45
SECONDARY
Part A: Change From Baseline in the Stop Signal Task (SST) Task of the CANTAB: Stop Signal Reaction Time and Median Reaction Time
-5.4; 6.9; -5.3; 13.5; 9.9; -14.7
SECONDARY
Part B: Change From Baseline in the SST Task of the CANTAB: Stop Signal Reaction Time and Median Reaction Time
22.87; 29.54; 49.52; 18.74; 41.68; -15.26
SECONDARY
Part A: Change From Baseline in the SST Task of the CANTAB: Direction Error (Go Trials), Direction Error (Stop Trials) and Missed Trials
3.5; 2.5; 2.5; 4.0; -3.9; 0.5
SECONDARY
Part B: Change From Baseline in the SST Task of the CANTAB: Direction Error (Go Trials), Direction Error (Stop Trials) and Missed Trials
-1.56; -1.05; -4.14; -1.21; -1.60; 3.71
SECONDARY
Part A: Change From Baseline in the Delayed Matching to Sample (DMS) Task of the CANTAB: Percentage of Correct Responses
-0.9; 3.3; 0.4; 1.3; -1.2
SECONDARY
Part B: Change From Baseline in the DMS Task of the CANTAB: Percentage of Correct Responses
7.42; -1.50; -1.36
SECONDARY
Part A: Change From Baseline in the DMS Task of the CANTAB: Mean Correct Latency
-1887.9; -1687.3; -1076.7; -1689.5; -1342.1
SECONDARY
Part B: Change From Baseline in the DMS Task of the CANTAB: Mean Correct Latency
54.16; 1216.36; -1724.85
SECONDARY
Part A: Change From Baseline in the DMS Task of the CANTAB: Mean Choices to Correct
0.036; -0.051; 0.005; -0.019; 0.050
SECONDARY
Part B: Change From Baseline in the DMS Task of the CANTAB: Mean Choices to Correct
-0.168; 0.020; 0.028
SECONDARY
Parts A and B: Sexual Maturation Assessed Using Tanner Stage
15; 12; 17; 7; 0; 4
SECONDARY
Parts A and B: Change From Baseline in Weight
46.87; 46.35; 46.09; 47.06; 47.79; 51.17
SECONDARY
Parts A and B: Change From Baseline in Height
151.09; 150.77; 149.69; 151.39; 151.98; 153.62
SECONDARY
Parts A and B: Change From Baseline in Body Mass Index (BMI)
19.90; 19.78; 19.90; 19.91; 20.41; 21.07
SECONDARY
Parts A and B: Number of Participants With Clinically Significant Changes in Vital Signs: Pulse Rate, Blood Pressure (BP), Temperature, and Respiratory Rate
2; 10; 0; 2; 1; 2
SECONDARY
Parts A and B: Number of Participants With Clinically Significant Changes in Electrocardiogram (ECG)
1; 1; 0; 0; 0; 0
SECONDARY
Parts A and B: Number of Participants With Treatment-emergent Adverse Events (TEAEs)
36; 60; 58; 30; 8; 13
SECONDARY
Part A: Psychiatric Symptoms Assessed Using Brief Psychiatric Rating Scale for Children (BPRS-C): Total Score
-3.0; -3.1; -3.1; -6.0; -4.4
SECONDARY
Part B: Psychiatric Symptoms Assessed Using BPRS-C: Total Score
11.7; 10.6; 9.9; 13.2; 5.1; 8.5
SECONDARY
Parts A and B: Number of Participants With Suicidal Ideation (SI) or Behavior Assessed Using Columbia- Suicide Severity Rating Scale (CSSRS)
0; 1; 0; 0; 0; 0
SECONDARY
Parts A and B: Number of Participants With Side Effects Assessed Using Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale: Asthenia or Lassitude or Increased Fatigability
83; 85; 83; 54; 28; 30
SECONDARY
Parts A and B: Number of Participants With Side Effects Assessed Using UKU Side Effect Rating Scale: Sleepiness or Sedation
84; 82; 83; 56; 26; 28
SECONDARY
Parts A and B: Number of Participants With Side Effects Assessed Using UKU Side Effect Rating Scale: Increased Duration of Sleep
89; 87; 86; 54; 28; 30
SECONDARY
Parts A and B: Number of Participants With Side Effects Assessed Using UKU Side Effect Rating Scale: Orthostatic Dizziness
88; 92; 89; 61; 28; 30
SECONDARY
Part A: Sedative Effects Assessed Using Pediatric Daytime Sleepiness Scale (PDSS): Total Score
-2.0; -1.8; -0.8; -2.0; -1.7
SECONDARY
Part B: Sedative Effects Assessed Using PDSS: Total Score
13.2; 15.5; 15.1; 13.5; 13.3; 14.6
SECONDARY
Parts A and B: Symptoms Assessed Using ADHD-Rating Scale-5 (ADHD-RS-5): Total Score
39.8; 39.4; 40.0; 31.6; 24.1; 24.6
SECONDARY
Parts A and B: Symptoms Assessed Using ADHD-RS-5: Inattention Subscale Score
21.6; 21.5; 21.9; 17.0; 13.0; 13.7
SECONDARY
Parts A and B: Symptoms Assessed Using ADHD-RS-5: Hyperactivity-Impulsivity Subscale Score
18.2; 17.9; 18.1; 14.6; 11.1; 10.9
SECONDARY
Parts A and B: Number of Participants Assessed for Severity of Mental Illness Using Clinical Global Impression-Improvement (CGI-I)
0; 2; 0; 0; 5; 5
SECONDARY
Parts A and B: Participants Functioning and Well-being Assessed Using Child Health and Illness Profile - Child Edition: Parent Report Form (CHIP-CE:PRF): Global Score
3.49; 3.58; 3.56; 3.53; 3.78; 3.87
SECONDARY
Parts A and B: Behavioral, Social, and Academic Issues Assessed Using Conners 3 Parent Short Form (C3PS): Total Score
66.3; 63.7; 66.0; 58.9; 40.9; 48.9

Summary

The main aim of this study is learn more about long-term TAK-503 treatment in children and teenagers with ADHD for whom earlier stimulant treatment did not work. The study has two parts (A and B). In Part A, participants will take tablets of TAK-503, atomoxetine or placebo and in Part B TAK-503 tablets.

Eligibility Criteria

Inclusion Criteria

Study Part A:

  • Participant is a male or female aged 6 to 17 years inclusive at the time of consent/assent.
  • Participant must meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for a primary diagnosis of ADHD based on a detailed psychiatric evaluation using the Kiddie-Schedule for Affective Disorders-Present and Lifetime Version (K-SADS-PL) by a trained child and adolescent psychiatrist at screening (Visit 1A).
  • Participant for whom prior stimulant therapy is not suitable, not tolerated, or shown to be ineffective as determined by investigator clinical assessment and review of the Prior Stimulant Medication Questionnaire (PSMQ) administered during screening (Visit 1A).
  • Participant has an ADHD-RS-5 total score greater than or equal to (> =) 28 at baseline (Visit 2A).
  • Participant has a baseline (Visit 2A) CGI-S score > = 4.
  • Participant who is a female of childbearing potential (FOCP) and postmenarchal must have a negative serum beta-human chorionic gonadotropin (β-hCG) pregnancy test at screening (Visit 1A) and a negative urine pregnancy test at baseline (Visit 2A), be nonlactating, and agree to comply with any applicable contraceptive requirements described in the protocol. Female of child bearing potential is defined as any female participant who is at least aged 9 years or younger than 9 years and postmenarchal.
  • Participants parent or legally authorized representative (LAR) must provide signature of informed consent. Documentation of assent (if applicable) must be provided by the participant indicating that the participant is aware of the investigational nature of the study and the required procedures and restrictions in accordance with the International Council for Harmonisation (ICH) Good Clinical Practice (GCP) Guideline E6[R2] and applicable regulations, before completing any study-related procedures.
  • Participant and parent/LAR are willing and able to comply with all the testing and requirements defined in this protocol, including oversight of morning dosing. Specifically, the parent/LAR must be available for the duration of the study to administer the investigational medicinal product (IMP) dose each morning when the participant awakens.
  • Participant has supine and standing blood pressure (BP) measurements less than the 95th percentile for age, sex, and height at both screening (Visit 1A) and baseline (Visit 2A).
  • Participant is functioning at an age-appropriate level intellectually, as judged by the investigator.
  • Participant is able to swallow intact tablets and capsules.

Study Part B:

  • Female participants of child-bearing potential must have a negative serum β-hCG pregnancy test if a screening visit is conducted and/or a negative urine pregnancy test at baseline and agree to comply with any applicable contraceptive requirements of the protocol. An FOCP is defined as any female participant who is at least aged 9 years or younger than 9 years and postmenarchal.
  • Participant has a supine and standing BP measurement less than the 95th percentile for age, sex, and height.

Exclusion Criteria

Study Part A:

  • Participant has a current, controlled (requiring medication or therapy) or uncontrolled, comorbid psychiatric disorder (except oppositional defiant disorder), including but not limited to any of the following comorbid Axis I and Axis II disorders (the K-SADS-PL should be reviewed to confirm diagnosis, if necessary):
  • Post-traumatic stress disorder (PTSD)
  • Bipolar illness, psychosis, or family history in either biological parent
  • Pervasive developmental disorder
  • Obsessive-compulsive disorder (OCD)
  • Psychosis/schizophrenia
  • Serious tic disorder or a family history of Tourette's disorder
  • Participant is currently considered to be a suicide risk by the investigator; has made a previous suicide attempt; has a history of, or currently demonstrating, active suicidal ideation.
  • Participant has a substance abuse disorder as define
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04085172). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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