Game developer Akili Interactive’s EndeavorRX is the first video game to be approved by the Food and Drug Administration (FDA) as a prescriptive medicine for kids with ADHD in the United States (via The Verge). Formerly known as ProjectEVO, EndeavorRX can now be suggested to kids between the age of 8-12 years who are suffering from the disorder.
Attention deficit hyperactivity disorder, or ADHD for short, is a mental health disorder that can cause hyperactivity and impulsive behavior amongst both adults in children. This often leads to an inability to maintain focus on a subject for long periods of time.
After undergoing a testing phase involving clinical trials that studied over 600 children, the game exhibited some positive results in dealing with the disorder. A third of the kids treated “no longer had a measurable attention deficit on at least one measure of objective attention” after playing the game for 25 minutes a day, over a period of five days a week for a total of four weeks. Improvements in the impairments caused by ADHD due to EndeavorRX were sustained for a month and the only disclosed side-effects of the game include frustration and headaches.
Despite this, the doctors working in conjunction with the game developers stated that the game is certainly not the alternative to existing recommendations and treatments for ADHD. Details of the complete study conducted by the doctors on EndeavorRX can be found on The Lancet. If you are interested in checking it out, you may join the program here.
Akili Announces FDA Clearance of EndeavorRx™ for Children with ADHD, the First Prescription Treatment Delivered Through a Video Game
Shown to improve attention function, EndeavorRx is backed by data from five clinical studies, including a prospective, randomized controlled trial
Akili announced that the U.S. Food and Drug Administration (FDA) has granted clearance for EndeavorRxTM (AKL-T01) as a prescription treatment for children with attention-deficit/hyperactivity disorder (ADHD). Delivered through a captivating video game experience, EndeavorRx is indicated to improve attention function as measured by computer-based testing in children ages 8-12 years old with primarily inattentive or combined-type ADHD, who have a demonstrated attention issue. See full indication below. Persistent attention issues have a significant impact on the daily lives of millions of people. Attention impairments are a key component of ADHD for many children yet are often overshadowed by more overt symptoms of ADHD.
EndeavorRx was reviewed through FDA’s de novo pathway and its clearance creates a new class of digital therapeutics. EndeavorRx is designed to directly target and activate neural systems through the presentation of sensory stimuli and motor challenges to improve cognitive functioning.
“We’re proud to make history with FDA’s decision”, said Eddie Martucci, Ph.D., chief executive officer of Akili. “With EndeavorRx, we’re using technology to help treat a condition in an entirely new way as we directly target neurological function through medicine that feels like entertainment. Families are looking for new ways to help their children with ADHD. With the decision by FDA, we’re excited to offer families a first-of-its-kind non-drug treatment option and take an important first step toward our goal to help all people living with cognitive issues.”
EndeavorRx was granted clearance based on data from five clinical studies in more than 600 children diagnosed with ADHD, including a prospective, randomized, controlled study published in The Lancet Digital Health journal, which showed EndeavorRx improved objective measures of attention in children with ADHD. After four weeks of EndeavorRx treatment, one-third of children no longer had a measurable attention deficit on at least one measure of objective attention. Further, about half of parents saw a clinically meaningful change in their child’s day-to-day impairments after one month of treatment with EndeavorRx; this increased to 68% after the second month of treatment. Improvements in ADHD impairments following a month of treatment with EndeavorRx were maintained for up to a month.
“For children living with ADHD, improving their ability to focus and resist distraction is critical to their daily functioning and performance in school,” said Elysa Marco, M.D., cognitive and behavioral child neurologist, and Clinical Executive for Neurodevelopmental Medicine at Cortica Healthcare. “Unlike traditional ADHD medications, EndeavorRx is designed to specifically target inattention. Based on the benefits my research participants and patients have experienced, I am thrilled that EndeavorRx is moving from the lab to the clinic to play an essential role as part of a comprehensive treatment plan for children with ADHD.”
The EndeavorRx treatment will be available with a prescription to families soon. Akili believes that cognitive impairments require the same constant attention and care as with any other chronic condition. EndeavorRx will be released as the centerpiece of the Endeavor Care Program, which includes the EndeavorRx treatment and Akili Care,TM a mobile tracking app, and personal support services for caregivers. Easily accessible from home, EndeavorRx is downloaded from the App Store by families on their mobile devices and does not require any additional equipment.
“The clearance of EndeavorRx marks the culmination of nearly a decade of research and development and was fueled by the commitment of our team and collaborators to challenge the status quo of medicine. This would not have been possible without the dedication of our clinical research partners and hundreds of families who gave their time and energy to participate in our clinical trials,” said Scott Kellogg, senior vice president of medical devices at Akili.
For families who have accessed EndeavorRx through FDA’s COVID-19 enforcement discretion guidance, Akili is committed to a seamless transition for them to the prescription program as appropriate.
EndeavorRx is built on the Akili Selective Stimulus Management engine (SSMETM) core technology, a proprietary technology designed for the targeted activation of specific neural systems in the brain to treat diseases with associated cognitive dysfunction. SSME presents specific sensory stimuli and simultaneous motor challenges designed to target and activate the neural systems that play a key role in attention function while using adaptive algorithms to personalize the treatment experience for each individual patient. This enables second by second monitoring of patient progress completing the treatment sessions, and continuously challenges each patient to an optimized level, encouraging patients to improve their performance. Driven by the core belief at Akili that effective medicine can also be fun and engaging, EndeavorRx is delivered through an action video game experience. The captivating experience of EndeavorRx is designed to drive engagement and compliance.
Clinical Evidence Supporting EndeavorRx
The EndeavorRx research program includes three studies in ADHD (STARS-ADHD, STARS-Adjunct and ADHD-POC) and two pilot studies in ADHD with different comorbidities (Sensory Processing Disorderand Autism Spectrum Disorder). The pivotal STARS-ADHD study was a multi-center, randomized, blinded, controlled study in 348 children diagnosed with ADHD, and results were recently published in The Lancet Digital Health journal. In the pivotal study, EndeavorRx showed a statistically significant improvement compared to an educational-style video game control (p=0.006) on a change in the Attention Performance Index (API) of the Test of Variables of Attention (TOVA®), a computerized test cleared by FDA to evaluate the effects of interventions in ADHD. In the STARS-Adjunct open-label study, statistically significant improvement was seen in the IRS (a parent-reported clinician-administered scale of ADHD impairments) from baseline to after 4-weeks of treatment in both children on stimulants and off any ADHD medication. No, serious adverse events have been associated with EndeavorRx in any study to date. Some study participants (9.3%) experienced non-serious treatment-related adverse events with EndeavorRx, including frustration, headache, dizziness, emotional reaction, nausea, or aggression.
EndeavorRx Indication for Use
EndeavorRx is indicated to improve attention function as measured by computer-based testing in children ages 8-12 years old with primarily inattentive or combined-type ADHD, who have a demonstrated attention issue. Patients who engage with EndeavorRx demonstrate improvements in a digitally assessed measure Tests of Variables of Attention (TOVA) of sustained and selective attention and may not display benefits in typical behavioral symptoms, such as hyperactivity. EndeavorRx should be considered for use as part of a therapeutic program that may include: clinician-directed therapy, medication, and/or educational programs, which further address symptoms of the disorder. EndeavorRx is not intended to be used as a stand-alone therapeutic and is not a substitution for a child’s medication.
Akili is combining scientific and clinical rigor with the ingenuity of the tech and entertainment industries to challenge the status quo of medicine. Akili has pioneered the development of video game-based digital medicine to improve cognitive function. Akili’s flagship product, EndeavorRx, is a prescription digital treatment to address inattention in children with attention deficit hyperactivity disorder (ADHD). Akili’s patented technology serves as the foundation of its products and is designed to directly activate the networks in the brain responsible for cognitive function. Driven by Akili’s belief that effective medicine can also be fun and engaging, Akili’s treatments are delivered through captivating action video game experiences that drive engagement and compliance. For more information, please visit AkiliInteractive.com.