학술논문

Randomized placebo-controlled study of lovastatin in children with neurofibromatosis type 1
Document Type
article
Source
Neurology. 87(24)
Subject
Biomedical and Clinical Sciences
Neurosciences
Clinical Sciences
Pediatric
Behavioral and Social Science
Clinical Trials and Supportive Activities
Mental Health
Neurofibromatosis
Clinical Research
Rehabilitation
Rare Diseases
Basic Behavioral and Social Science
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Attention
Attention Deficit Disorder with Hyperactivity
Double-Blind Method
Executive Function
Female
Humans
Learning
Lovastatin
Male
Neurofibromatosis 1
Neuropsychological Tests
Quality of Life
NF Clinical Trials Consortium
Cognitive Sciences
Neurology & Neurosurgery
Clinical sciences
Language
Abstract
ObjectiveTo assess the efficacy of lovastatin on visuospatial learning and attention for treating cognitive and behavioral deficits in children with neurofibromatosis type 1 (NF1).MethodsA multicenter, international, randomized, double-blind, placebo-controlled trial was conducted between July 2009 and May 2014 as part of the NF Clinical Trials Consortium. Children with NF1 aged 8-15 years were screened for visuospatial learning or attention deficits (n = 272); 146 children demonstrated deficits at baseline and were randomly assigned to lovastatin (n = 74; 40 mg/d) or placebo (n = 70). Treatment was administered once daily for 16 weeks. Primary outcomes were total errors on the Cambridge Neuropsychological Test Automated Battery Paired Associate Learning task (visuospatial learning) and the Score subtest from the Test of Everyday Attention for Children (sustained attention). Secondary outcomes measured executive function, attention, visuospatial skills, behavior, and quality of life. Primary analyses were performed on the intention-to-treat population.ResultsLovastatin had no significant effect on primary outcomes after 16 weeks of treatment: visuospatial learning (Cohen d = -0.15, 95% confidence interval -0.47 to 0.18) or sustained attention (Cohen d = 0.19, 95% confidence interval -0.14 to 0.53). Lovastatin was well tolerated, with no increase in reported adverse events compared to placebo.ConclusionsLovastatin administered once daily for 16 weeks did not improve visuospatial learning or attention in children with NF1 and is not recommended for amelioration of cognitive deficits in this population.Clinicaltrialsgov identifierThis study was registered at ClinicalTrials.gov (NCT00853580) and Australian New Zealand Clinical Trials Registry (ACTRN12607000560493).Classification of evidenceThis study provides Class I evidence that for children with NF1, lovastatin does not improve visuospatial learning or attention deficits.