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Staccato Alprazolam in Panic Attack

Primary Purpose

Treatment of Induced Panic Attack

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Inhaled placebo
Inhaled alprazolam 1 mg
Inhaled alprazolam 2 mg
IV doxapram
Sponsored by
Alexza Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Treatment of Induced Panic Attack focused on measuring Staccato™ Alprazolam, Panic Attack, Inhaled alprazolam

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects who meet DSM-IV criteria for panic disorder, with or without agoraphobia.
  2. Subjects who have had at least one panic attack per week in each of the four weeks prior to the start of treatment and/or have a Mobility Inventory Score of 3.3 (alone) or 2.5 (accompanied).
  3. Male or female subjects who are English-speaking between 18 and 55 years of age.
  4. Female subjects who are not pregnant, or are surgically sterile or 2 years postmenopausal. If of childbearing potential, she must be using a medically-accepted method of birth control and agree to continue use of this method for at least 30 days after the study (i.e., barrier method with spermicide, steroidal contraceptive [oral, transdermal, and implanted, including Depo-Provera; contraceptives must be used in conjunction with a barrier method], or intrauterine device).
  5. Subjects who are medically healthy (i.e. without a clinically significant unstable medical condition such as asthma, coronary artery disease, renal insufficiency, etc.)
  6. Subjects who are able to give informed consent for participation.
  7. Subjects who are able to be withdrawn from current panic disorder medication because it is ineffective.

Exclusion Criteria:

  1. Subjects who have met DSM-IV criteria for substance abuse or dependence within six months of study entry must be excluded.
  2. Subjects with a baseline Acute Panic Inventory (22 item test) score of 41 or higher on the test day must be excluded.
  3. Subjects who are taking benzodiazepines, SSRIs, or medication that is effective for the prevention or treatment of the patient's panic disorder (i.e., no patient will be withdrawn for medication that is working for the purpose of entry into this study) must be excluded.
  4. Subjects who are clinically depressed must be excluded.
  5. Subjects who have received an investigational drug within 30 days (or within 5 half lives of the investigational drug) prior to test day must be excluded.
  6. Subjects with epilepsy or other convulsive disorders must be excluded.
  7. Subjects with a history of allergy or intolerance to benzodiazepines or related drugs (alprazolam, lorazepam, diazepam, etizolam, clonazepam, adinazolam) must be excluded.
  8. Subjects who test positive for alcohol or have a positive urine drug screen for illicit or disallowed drugs must be excluded. Subjects should refrain from consuming alcohol for at least 48 hours prior to dosing.
  9. Female subjects who are breastfeeding or have a positive pregnancy test must be excluded.
  10. Subjects who have any other disease or condition, by history, physical examination, or laboratory abnormalities that in the investigator's opinion, would present undue risk to the subject, or may confound the interpretation of study results must be excluded.

Sites / Locations

  • SUNY Downstate Medical Center
  • New York State Psychiatric Institute
  • Mt. Sinai School Of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Arm Label

RCT Placebo

RCT Alprazolam 1 mg

Open Label Inhaled Alprazolam 1 mg

Initial Inhaled Alprazolam 2 mg

Arm Description

Subjects received inhaled placebo after 0.5 mg/kg doxapram IV in the randomized controlled trial

Subjects received 1 mg inhaled Staccato alprazolam 10 s after 0.5 mg/kg doxapram IV in the randomized controlled trial

Subjects received 1 mg inhaled Staccato alprazolam 10 s after 0.5 mg/kg doxapram IV in the open label dose validation

Subjects received 2 mg inhaled Staccato alprazolam 10 s after 0.5 mg/kg doxapram IV in the initial open label dose assessment

Outcomes

Primary Outcome Measures

Number of Participants With Doxapram-induced Panic Attack
doxapram-induced panic attack of sufficient intensity (DIPASI) defined as a 10 or greater increase from baseline in the acute panic inventory (API)
Duration of the Doxapram-induced Panic Attack
Length of time from the doxapram injection to the time at which the acute panic inventory (API) value returns to within 10 points of the baseline API value. 0=never exceeded 0, 61=exceeded by more than 10 points still at end of assessment of 60 minutes. Thus each would have a duration whether or not they had a panic attack (DIPASI)

Secondary Outcome Measures

Borg Max Change From Baseline
Subjects asked to "Point to the number (0 to 10) which matches how breathless you feel now" where 0=nothing at all to 10=very, very strong

Full Information

First Posted
May 22, 2007
Last Updated
June 15, 2017
Sponsor
Alexza Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00477451
Brief Title
Staccato Alprazolam in Panic Attack
Official Title
Investigation of a Single Dose of Staccato™ Alprazolam for Inhalation on Doxapram-Induced Panic Attack in Patients With Panic Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
June 2008
Overall Recruitment Status
Completed
Study Start Date
May 2007 (Actual)
Primary Completion Date
April 2008 (Actual)
Study Completion Date
April 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alexza Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
We are developing Staccato™ Alprazolam for the treatment of Panic attacks associated with panic disorder. This study will provide an initial assessment of efficacy, and to continue to describe the tolerability and pharmacokinetics, of a single inhaled dose of Staccato Alprazolam on a doxapram-induced panic attack in patients with panic disorder.
Detailed Description
The study will be conducted at multiple centers. A total of 42 male and female panic disorder patients will be studied. The first 6 subjects will receive Staccato Alprazolam 1 mg open label to validate the dose selection. The remaining 36 subjects will be treated with either Staccato Alprazolam at the chosen dose; or with Staccato Placebo in a double blind, randomized order.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Treatment of Induced Panic Attack
Keywords
Staccato™ Alprazolam, Panic Attack, Inhaled alprazolam

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RCT Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects received inhaled placebo after 0.5 mg/kg doxapram IV in the randomized controlled trial
Arm Title
RCT Alprazolam 1 mg
Arm Type
Experimental
Arm Description
Subjects received 1 mg inhaled Staccato alprazolam 10 s after 0.5 mg/kg doxapram IV in the randomized controlled trial
Arm Title
Open Label Inhaled Alprazolam 1 mg
Arm Type
Experimental
Arm Description
Subjects received 1 mg inhaled Staccato alprazolam 10 s after 0.5 mg/kg doxapram IV in the open label dose validation
Arm Title
Initial Inhaled Alprazolam 2 mg
Arm Type
Experimental
Arm Description
Subjects received 2 mg inhaled Staccato alprazolam 10 s after 0.5 mg/kg doxapram IV in the initial open label dose assessment
Intervention Type
Drug
Intervention Name(s)
Inhaled placebo
Intervention Description
Inhaled Staccato Alprazolam Placebo
Intervention Type
Drug
Intervention Name(s)
Inhaled alprazolam 1 mg
Intervention Description
Inhaled Staccato Alprazolam 1 mg
Intervention Type
Drug
Intervention Name(s)
Inhaled alprazolam 2 mg
Intervention Description
Inhaled Staccato Alprazolam 2 mg
Intervention Type
Drug
Intervention Name(s)
IV doxapram
Intervention Description
0.5 mg/kg doxapram IV approximately 10s after receiving inhaled alprazolam or placebo
Primary Outcome Measure Information:
Title
Number of Participants With Doxapram-induced Panic Attack
Description
doxapram-induced panic attack of sufficient intensity (DIPASI) defined as a 10 or greater increase from baseline in the acute panic inventory (API)
Time Frame
0 to 2 hours
Title
Duration of the Doxapram-induced Panic Attack
Description
Length of time from the doxapram injection to the time at which the acute panic inventory (API) value returns to within 10 points of the baseline API value. 0=never exceeded 0, 61=exceeded by more than 10 points still at end of assessment of 60 minutes. Thus each would have a duration whether or not they had a panic attack (DIPASI)
Time Frame
1 hr post-dose
Secondary Outcome Measure Information:
Title
Borg Max Change From Baseline
Description
Subjects asked to "Point to the number (0 to 10) which matches how breathless you feel now" where 0=nothing at all to 10=very, very strong
Time Frame
45 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who meet DSM-IV criteria for panic disorder, with or without agoraphobia. Subjects who have had at least one panic attack per week in each of the four weeks prior to the start of treatment and/or have a Mobility Inventory Score of 3.3 (alone) or 2.5 (accompanied). Male or female subjects who are English-speaking between 18 and 55 years of age. Female subjects who are not pregnant, or are surgically sterile or 2 years postmenopausal. If of childbearing potential, she must be using a medically-accepted method of birth control and agree to continue use of this method for at least 30 days after the study (i.e., barrier method with spermicide, steroidal contraceptive [oral, transdermal, and implanted, including Depo-Provera; contraceptives must be used in conjunction with a barrier method], or intrauterine device). Subjects who are medically healthy (i.e. without a clinically significant unstable medical condition such as asthma, coronary artery disease, renal insufficiency, etc.) Subjects who are able to give informed consent for participation. Subjects who are able to be withdrawn from current panic disorder medication because it is ineffective. Exclusion Criteria: Subjects who have met DSM-IV criteria for substance abuse or dependence within six months of study entry must be excluded. Subjects with a baseline Acute Panic Inventory (22 item test) score of 41 or higher on the test day must be excluded. Subjects who are taking benzodiazepines, SSRIs, or medication that is effective for the prevention or treatment of the patient's panic disorder (i.e., no patient will be withdrawn for medication that is working for the purpose of entry into this study) must be excluded. Subjects who are clinically depressed must be excluded. Subjects who have received an investigational drug within 30 days (or within 5 half lives of the investigational drug) prior to test day must be excluded. Subjects with epilepsy or other convulsive disorders must be excluded. Subjects with a history of allergy or intolerance to benzodiazepines or related drugs (alprazolam, lorazepam, diazepam, etizolam, clonazepam, adinazolam) must be excluded. Subjects who test positive for alcohol or have a positive urine drug screen for illicit or disallowed drugs must be excluded. Subjects should refrain from consuming alcohol for at least 48 hours prior to dosing. Female subjects who are breastfeeding or have a positive pregnancy test must be excluded. Subjects who have any other disease or condition, by history, physical examination, or laboratory abnormalities that in the investigator's opinion, would present undue risk to the subject, or may confound the interpretation of study results must be excluded.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sanjay Mathew, MD
Organizational Affiliation
Mt. Sinai School of Medicine
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jeremy Coplan, MD
Organizational Affiliation
State University of New York - Downstate Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Laszlo Papp, MD
Organizational Affiliation
New York State Psychiatric Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
SUNY Downstate Medical Center
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11203-2056
Country
United States
Facility Name
New York State Psychiatric Institute
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Mt. Sinai School Of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD submitted to regulatory authorities. Others may contact Alexza Pharmaceuticals, Inc. Please send your request to ClinicalTrialsInfo@alexza.com

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Staccato Alprazolam in Panic Attack

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