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Tolerability, Safety, and Activity of SRX246 in Irritable Subjects With Huntington's Disease

Primary Purpose

Irritable Mood, Huntington's Disease

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
SRX246
Placebo
Sponsored by
Azevan Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Irritable Mood

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female Subjects aged 18 years or older
  2. Subjects must have clinical features of HD, which can include motor, cognitive, or behavioral symptoms
  3. A confirmatory family history of HD; OR CAG repeat expansion ≥ 37
  4. Total Functional Capacity (TFC) score of 5-13
  5. Evidence of irritability; a score of at least 2 or greater on the severity measure of either the UHDRS Irritability question (30b) or Aggression question (Disruptive or Aggressive Behavior, 31b)
  6. Women of childbearing potential (i.e., those not postmenopausal or surgically sterile) must have a negative pregnancy test, be non-lactating and use adequate contraception methods during the study. Adequate birth control includes: abstinence; oral, implanted or injected contraceptives, e.g., birth control pills; intra-uterine device; barrier (vaginal ring or diaphragm/cervical cap with spermicide); transdermal patch. Reliable contraception must have been in use 30 days prior to the Baseline Visit. Partner(s) contraception (e.g., male partner with vasectomy or other surgical contraception) is acceptable.
  7. Men must agree not to father a child during the study and one month after and to use contraception. Barrier with spermicide or surgical contraception is acceptable. Partner(s) contraception (e.g., female partner taking birth control pills or surgically sterile) is acceptable.
  8. Subjects must be able to swallow study drug capsules whole.
  9. Sufficient English skills to complete all assessments without assistance of an English language interpreter. Subjects with HD who cannot read or write might qualify for enrollment in the study. Site PIs will have to decide in each case whether the Subject can understand and fully participate with help from his/her Informant.
  10. Availability of a responsible Informant (referred to as a "study partner" in the consent document) who has good English skills, is familiar with the Subject, and is able and willing to comply with all required study procedures, ensuring that the patient attends all study visits and takes the study medicine as instructed. The study partner must spend time with the patient a minimum of 4 times per week on 4 separate days, and must monitor the patient's compliance and adverse events, participate in caregiver assessments, and use the eDiary.
  11. Subject has provided written, informed consent or, if Subject lacks the capacity to provide informed consent (as determined by an independent assessment by a qualified healthcare provider not directly involved in other study activities), a legally authorized representative (LAR) has provided written informed consent and the Subject has provided assent.

Exclusion Criteria:

  1. Any significant neurologic disease other than HD at Screening.
  2. Severe psychotic features or other severe psychiatric symptoms within the last three months which could lead to difficulty complying with the protocol.
  3. History of active alcohol or substance abuse within the past two years or Subject is unable to refrain from substance abuse throughout the study.
  4. Any chronic disability, significant systemic illness or unstable medical condition at Screening or Baseline that could lead to difficulty complying with the protocol.
  5. Use of any investigational drugs within 30 days of Screening.
  6. Subject has known allergy to any of the components of study medication.
  7. Subject is currently pregnant, breast-feeding and/or lactating.
  8. Subject acknowledges present use of illicit drugs at Screening.

Sites / Locations

  • University of Alabama
  • UCLA, Neurology Clinic
  • UC Davis Medical Center, Department of Neurology, CTSC Clinical Research Center
  • University of Colorado Hospital Translational Research Center
  • University of Miami, Miller School of Medicine, Jackson Behavioral Health Hospital
  • Emory University
  • Northwestern Out-Patient Neurology Clinic
  • University of Kansas Medical Center
  • Massachusetts General Hospital
  • Washington University School of Medicine
  • SUNY Stony Brook Clinical Research Center, Department of Neurology
  • Columbia University Medical Center, New York Presbyterian Hospital
  • University of Rochester Medical Center
  • University Medical Arts Building
  • Ohio State University, Wexner Medical Center, Department of Neurology
  • Oregon Health and Science University
  • University of Pittsburgh Medical Center, Department of Neurology
  • Vanderbilt Clinical Research Center
  • UT Southwestern Medical Center
  • University of Utah, Department of Neurology
  • University of Virginia Health System, Department of Neurology
  • Swedish Neuroscience Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

SRX246 120mg BID

SRX246 160mg BID

Placebo

Arm Description

SRX246 capsules, administered orally, in divided doses twice daily

SRX246 capsules, administered orally, in divided doses twice daily

Placebo capsules, administered orally, in divided doses twice daily

Outcomes

Primary Outcome Measures

Tolerability of SRX246
The primary endpoint, tolerability of SRX246, was assessed by the number of completers in each group.

Secondary Outcome Measures

Safety of SRX246
The Safety of SRX246 was assessed by the number of participants who experience an adverse event.

Full Information

First Posted
July 22, 2015
Last Updated
July 18, 2023
Sponsor
Azevan Pharmaceuticals
Collaborators
National Institute of Neurological Disorders and Stroke (NINDS), NeuroNEXT Network
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1. Study Identification

Unique Protocol Identification Number
NCT02507284
Brief Title
Tolerability, Safety, and Activity of SRX246 in Irritable Subjects With Huntington's Disease
Official Title
An Exploratory Phase II Study to Determine the Tolerability, Safety, and Activity of a Novel Vasopressin 1a Receptor Antagonist (SRX246) in Irritable Subjects With Huntington's Disease (HD)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
May 10, 2016 (Actual)
Primary Completion Date
September 10, 2018 (Actual)
Study Completion Date
December 21, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Azevan Pharmaceuticals
Collaborators
National Institute of Neurological Disorders and Stroke (NINDS), NeuroNEXT Network

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study evaluates the tolerability, safety and activity of SRX246 in the treatment of irritability in patients with Huntington's disease. Two-thirds of all participants will receive SRX246, while the other third will receive a placebo.
Detailed Description
SRX246 is a first-in-class vasopressin 1a (V1a) receptor antagonist that crosses the blood-brain barrier following oral administration. The molecule exhibits high affinity and high selectivity for its target receptor. Preclinical pharmacology studies have demonstrated significant CNS effects in models of irritability, including impulsive aggression, depression, and anxiety. In an experimental medicine fMRI study in healthy volunteers, SRX246 treatment significantly attenuated the effect of intranasal AVP in brain circuits known to modulate emotional responses to stimuli that elicit aggression/fear. Together, these findings suggest that SRX246 has potential as a novel therapeutic agent for major neuropsychiatric symptoms seen in HD patients. This is a 3-arm, multicenter, randomized, placebo-controlled, double-blind, 12 week, dose escalation study of SRX246 in irritable Subjects with early symptomatic HD. Following an initial screening visit, Subjects fulfilling the study inclusion and exclusion criteria will enter a pre-treatment screening phase to permit evaluations to confirm eligibility for inclusion into the study. This screening phase will be no longer than 30 days. At the completion of the screening period, eligible Subjects will be randomized at baseline visit to receive either placebo or final doses of SRX246 of 120 mg twice daily or 160 mg twice daily during the double-blind treatment phase. At baseline, Subjects in the active groups will receive 80 mg twice daily for 2 weeks, then escalate to 120 mg twice daily for 4 weeks. Then one group of Subjects will continue to take 120 mg of SRX246 twice daily for an additional 6 weeks, and the second group of Subjects will increase their dose to 160 mg of SRX246 twice daily for 6 weeks. Total dosing duration is 12 weeks. Subjects in the placebo group will receive a similar number of capsules that are identical in appearance to the capsules that contain SRX246 during the trial, in order to preserve the blind. In all groups, dose escalation will occur (stepwise) if patients have not experienced dose-limiting adverse effects. Patients who cannot tolerate their final dose of drug (or placebo) can have this dose reduced without compromising the blinding. Subjects will have periodic visits either "in-person" or by "telephone", to assess tolerability, safety, and several measures of irritability and other problem behaviors, and clinical assessments for activity signals.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Irritable Mood, Huntington's Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SRX246 120mg BID
Arm Type
Experimental
Arm Description
SRX246 capsules, administered orally, in divided doses twice daily
Arm Title
SRX246 160mg BID
Arm Type
Experimental
Arm Description
SRX246 capsules, administered orally, in divided doses twice daily
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo capsules, administered orally, in divided doses twice daily
Intervention Type
Drug
Intervention Name(s)
SRX246
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Tolerability of SRX246
Description
The primary endpoint, tolerability of SRX246, was assessed by the number of completers in each group.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Safety of SRX246
Description
The Safety of SRX246 was assessed by the number of participants who experience an adverse event.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female Subjects aged 18 years or older Subjects must have clinical features of HD, which can include motor, cognitive, or behavioral symptoms A confirmatory family history of HD; OR CAG repeat expansion ≥ 37 Total Functional Capacity (TFC) score of 5-13 Evidence of irritability; a score of at least 2 or greater on the severity measure of either the UHDRS Irritability question (30b) or Aggression question (Disruptive or Aggressive Behavior, 31b) Women of childbearing potential (i.e., those not postmenopausal or surgically sterile) must have a negative pregnancy test, be non-lactating and use adequate contraception methods during the study. Adequate birth control includes: abstinence; oral, implanted or injected contraceptives, e.g., birth control pills; intra-uterine device; barrier (vaginal ring or diaphragm/cervical cap with spermicide); transdermal patch. Reliable contraception must have been in use 30 days prior to the Baseline Visit. Partner(s) contraception (e.g., male partner with vasectomy or other surgical contraception) is acceptable. Men must agree not to father a child during the study and one month after and to use contraception. Barrier with spermicide or surgical contraception is acceptable. Partner(s) contraception (e.g., female partner taking birth control pills or surgically sterile) is acceptable. Subjects must be able to swallow study drug capsules whole. Sufficient English skills to complete all assessments without assistance of an English language interpreter. Subjects with HD who cannot read or write might qualify for enrollment in the study. Site PIs will have to decide in each case whether the Subject can understand and fully participate with help from his/her Informant. Availability of a responsible Informant (referred to as a "study partner" in the consent document) who has good English skills, is familiar with the Subject, and is able and willing to comply with all required study procedures, ensuring that the patient attends all study visits and takes the study medicine as instructed. The study partner must spend time with the patient a minimum of 4 times per week on 4 separate days, and must monitor the patient's compliance and adverse events, participate in caregiver assessments, and use the eDiary. Subject has provided written, informed consent or, if Subject lacks the capacity to provide informed consent (as determined by an independent assessment by a qualified healthcare provider not directly involved in other study activities), a legally authorized representative (LAR) has provided written informed consent and the Subject has provided assent. Exclusion Criteria: Any significant neurologic disease other than HD at Screening. Severe psychotic features or other severe psychiatric symptoms within the last three months which could lead to difficulty complying with the protocol. History of active alcohol or substance abuse within the past two years or Subject is unable to refrain from substance abuse throughout the study. Any chronic disability, significant systemic illness or unstable medical condition at Screening or Baseline that could lead to difficulty complying with the protocol. Use of any investigational drugs within 30 days of Screening. Subject has known allergy to any of the components of study medication. Subject is currently pregnant, breast-feeding and/or lactating. Subject acknowledges present use of illicit drugs at Screening.
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
UCLA, Neurology Clinic
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
UC Davis Medical Center, Department of Neurology, CTSC Clinical Research Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
University of Colorado Hospital Translational Research Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Miami, Miller School of Medicine, Jackson Behavioral Health Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Northwestern Out-Patient Neurology Clinic
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Massachusetts General Hospital
City
Charlestown
State/Province
Massachusetts
ZIP/Postal Code
02129
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
SUNY Stony Brook Clinical Research Center, Department of Neurology
City
East Setauket
State/Province
New York
ZIP/Postal Code
11733
Country
United States
Facility Name
Columbia University Medical Center, New York Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
University of Rochester Medical Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14618
Country
United States
Facility Name
University Medical Arts Building
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Ohio State University, Wexner Medical Center, Department of Neurology
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43221
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pittsburgh Medical Center, Department of Neurology
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Vanderbilt Clinical Research Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
University of Utah, Department of Neurology
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
University of Virginia Health System, Department of Neurology
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
Swedish Neuroscience Institute
City
Seattle
State/Province
Washington
ZIP/Postal Code
98122
Country
United States

12. IPD Sharing Statement

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Tolerability, Safety, and Activity of SRX246 in Irritable Subjects With Huntington's Disease

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