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Single Ascending Dose Study of ALA-1000

Primary Purpose

Opioid-use Disorder

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ALA-1000
buprenorphine sublingual film
Sponsored by
Alar Pharmaceuticals Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Opioid-use Disorder

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Competent to provide informed consent.
  2. Voluntarily provide informed consent and Health Insurance Portability and Accounting Act (HIPAA) Authorization prior to any procedures or evaluations performed specifically for the sole purpose of the study.
  3. Male or female between 18 to 65 years of age inclusive at the screening visit.
  4. Meets DSM-5 criteria for Opioid Use Disorder (OUD) and is seeking treatment of OUD.
  5. Body Mass Index (BMI) ≥ 18 and ≤ 35 kg/m2 at screening visit.
  6. Female subjects of childbearing potential must agree to use a reliable method of birth control (e.g., total abstinence, condom and spermicide, intrauterine device (IUD), oral contraception which has been stable for 30 days) and at least 120 days after stopping the investigational product.
  7. Agree to withdraw from opiates for at least 12 hours prior to admission to clinical unit.
  8. Agree not to take any buprenorphine product (other than ALA-1000 and buprenorphine sublingual films during tolerability/induction period) during the study.

Exclusion Criteria:

  1. History or presence of a significant medical disease or disorder which, in the opinion of the investigator, increases the risk of the study drug or may confound the interpretation of study measures, as confirmed by screening laboratory results.
  2. Clinically significant abnormal findings on physical examination, vital signs, or Electrocardiogram (ECG). Defined as having a QTc (Fridericia) interval > 470 msec or any other clinically significant abnormalities at screening, check-in, or prior to administration of ALA-1000.
  3. Pregnant or lactating.
  4. History of suicidal behavior in the past 1 year or current suicidal ideation as per investigator judgement.
  5. Currently meets Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for substance use disorder, moderate or severe for any substance other than opioids, caffeine, or nicotine.
  6. Currently meets criteria for any unstable psychiatric disorder, including schizophrenia, schizoaffective, bipolar disorder (depression and stable bipolar disorder are not excluded if condition has been stable for at least 60 days).
  7. Current diagnosis of Acquired Immune Deficiency Syndrome (AIDS) as confirmed by Western Blot and viral load laboratory results.
  8. Acute active Hepatitis B or C as evidenced by positive serology and Aspartate aminotransferase (AST)/ Alanine aminotransferase (ALT) >2 upper limit of normal (ULN)
  9. History of blood donation in excess of 450 mL within 30 days prior to Visit 1.
  10. Received treatment with an investigational drug or device within 90 days prior to Visit 1.
  11. Use of strong inhibitors or inducers of cytochrome P450 3A4 (CYP3A4) within 30 days prior to Visit 1.
  12. Use of any new medication, vitamins, or supplements within 7 days prior to Visit.
  13. Hypersensitivity or allergy to buprenorphine or other opioids which, in the opinion of the investigator, would compromise subject safety.

Sites / Locations

  • Innovative Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort1

Cohort2

Cohort3

Cohort4

Cohort5

Cohort6

Arm Description

Subjects receive a single subcutaneous injection of 1-fold ALA-1000 dose (first in human dose).

Subjects receive a single subcutaneous injection of 2-fold ALA-1000 dose

Subjects receive a single subcutaneous injection of 4.7-fold ALA-1000 dose

Subjects receive a single subcutaneous injection of 9.4-fold ALA-1000 dose

Subjects receive a single subcutaneous injection of 18.8-fold ALA-1000 dose

Subjects receive a single subcutaneous injection of 18.8-fold ALA-1000 dose after 7 days of buprenorphine sublingual film dosing

Outcomes

Primary Outcome Measures

Incidence of AEs will be summarized by treatment overall, by severity, and by relationship to ALA-1000. Serious AEs and AEs leading to discontinuation of study drug will also be presented.
Change of vital signs will be assessed in subjects receiving ALA-1000.
Vital signs including blood pressure, pulse rate, respiration rate, pulse oximetry and temperature. Systolic and diastolic blood pressure will be assessed while supine and standing. Pulse oximetry will be monitored continuously for 24 hours post injection to assess for any signs/symptoms of respiratory depression.
Chang of clinical laboratory assessments (biochemistry, hematology and urinalysis) will be assessed in subjects receiving ALA-1000.
Samples will be collected for laboratory tests, including hematology, serum chemistry, urinalysis, serum/urine pregnancy test (conducted for females of childbearing potential only), and urine drug screen, to assess the safety of subjects.
Change of ECG parameter of QTcF interval will be assessed in subjects receiving ALA-1000
A standard physical examination will be performed to monitor the safety in subjects receiving ALA-1000
The examination will include assessment of skin, head, ears, eyes, nose, throat, neck, thyroid, lungs, heart, cardiovascular, abdomen, lymph nodes, and musculoskeletal system/extremities.
Injection site assessment will be conducted to monitor the safety in subjects receiving ALA-1000
Injection site assessment including pain, tenderness, induration, erythema/redness, and swelling. If an infection develops at the injection site, the subject will be withdrawn from the study.
Concomitant medications will be reviewed and documented to monitor the safety in subjects receiving ALA-1000
The medication name, dose, frequency, date, and indication for use must be recorded
AUC (area under the plasma concentration-time curve) for subjects receive ALA-1000 injection
Cmax (maximum observed plasma concentration) for subjects receive ALA-1000 injection
Tmax (time to maximum concentration) for subjects receive ALA-1000 injection
t1/2 (time to half plasma concentration) for subjects receive ALA-1000 injection

Secondary Outcome Measures

Change of opioid withdrawal symptoms will be assessed using Clinical Opiate Withdrawal Scale (COWS) for subjects receive ALA-1000 injection
Opioid withdrawal symptoms will be measured using COWS scores. Score: 5- 1 2 = mild; 1 3-24 = moderate; 25-36 = moderately severe; more than 36 = severe withdrawal
Change of suicidal ideation will be assessed using Columbia-Suicide Severity Rating Scale (C-SSRS) for subjects receive ALA-1000 injection
Suicidal ideation scores will be reported using C-SSRS. The suicidal ideation scale identifies behaviors and thoughts that are associated with an increased risk of suicidal actions in the future. Score: 5- 1 2 = mild; 1 3-24 = moderate; 25-36 = moderately severe; more than 36 = severe suicidal ideation.
Assessment of the abstinence by urine toxicology results negative for opioids in subjects received ALA-1000 injection.

Full Information

First Posted
October 8, 2019
Last Updated
December 28, 2021
Sponsor
Alar Pharmaceuticals Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04122755
Brief Title
Single Ascending Dose Study of ALA-1000
Official Title
A Single Ascending Dose, Open-Label Study Evaluating the Safety, Tolerability, And Pharmacokinetics of ALA-1000 in Opioid-Dependent Individuals
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
September 16, 2019 (Actual)
Primary Completion Date
May 3, 2021 (Actual)
Study Completion Date
May 3, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alar 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
Yes

5. Study Description

Brief Summary
An open-label study designed to evaluate the safety, tolerability, and pharmacokinetics of ALA-1000 in opioid-dependent subjects. To characterize the PK profile of ALA-1000 in 5 single ascending dose cohorts and a sixth cohort of single ALA-1000 after receiving buprenorphine sublingual films for 7 days.
Detailed Description
The study will include opioid-dependent subjects who have been receiving stable, orally administered buprenorphine for at least 2 weeks or buprenorphine naïve subjects who will be stabilized on orally administered buprenorphine for 3 days prior to ALA-1000 administration. All subjects will be washed off of oral buprenorphine for 7 days prior to ALA-1000 administration except Cohort 6 which will receive ALA-1000 administration after 7 days of buprenorphine sublingual film dosing. The subsequent cohorts will be initiated after safety and PK information from the preceding cohorts is available. The expected maximum duration of participation for each subject is 192 days approximately, consisting of up to a 7-day screening period, up to a 31-day residential phase, and up to a 154-day nonresidential period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Opioid-use Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
59 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort1
Arm Type
Experimental
Arm Description
Subjects receive a single subcutaneous injection of 1-fold ALA-1000 dose (first in human dose).
Arm Title
Cohort2
Arm Type
Experimental
Arm Description
Subjects receive a single subcutaneous injection of 2-fold ALA-1000 dose
Arm Title
Cohort3
Arm Type
Experimental
Arm Description
Subjects receive a single subcutaneous injection of 4.7-fold ALA-1000 dose
Arm Title
Cohort4
Arm Type
Experimental
Arm Description
Subjects receive a single subcutaneous injection of 9.4-fold ALA-1000 dose
Arm Title
Cohort5
Arm Type
Experimental
Arm Description
Subjects receive a single subcutaneous injection of 18.8-fold ALA-1000 dose
Arm Title
Cohort6
Arm Type
Experimental
Arm Description
Subjects receive a single subcutaneous injection of 18.8-fold ALA-1000 dose after 7 days of buprenorphine sublingual film dosing
Intervention Type
Drug
Intervention Name(s)
ALA-1000
Other Intervention Name(s)
Depot Buprenorphine Formulation
Intervention Description
Blood sample for PK analysis are collected before and post single injection of ALA-1000 (Day1) according to the schedule of procedures. Subjects remain in the residential phase through Day21 for safety assessment.
Intervention Type
Drug
Intervention Name(s)
buprenorphine sublingual film
Intervention Description
ALA-1000 injection after 7 days of buprenorphine sublingual film dosing. Blood sample for PK analysis are collected before and post sublingual buprenorphine dosing on Day-1
Primary Outcome Measure Information:
Title
Incidence of AEs will be summarized by treatment overall, by severity, and by relationship to ALA-1000. Serious AEs and AEs leading to discontinuation of study drug will also be presented.
Time Frame
Baseline (prior to dosing) through the End of Study (Day175), or Early termination
Title
Change of vital signs will be assessed in subjects receiving ALA-1000.
Description
Vital signs including blood pressure, pulse rate, respiration rate, pulse oximetry and temperature. Systolic and diastolic blood pressure will be assessed while supine and standing. Pulse oximetry will be monitored continuously for 24 hours post injection to assess for any signs/symptoms of respiratory depression.
Time Frame
Baseline (prior to dosing) through the End of Study (Day175), or Early termination
Title
Chang of clinical laboratory assessments (biochemistry, hematology and urinalysis) will be assessed in subjects receiving ALA-1000.
Description
Samples will be collected for laboratory tests, including hematology, serum chemistry, urinalysis, serum/urine pregnancy test (conducted for females of childbearing potential only), and urine drug screen, to assess the safety of subjects.
Time Frame
Baseline (prior to dosing) through the End of Study (Day175), or Early termination
Title
Change of ECG parameter of QTcF interval will be assessed in subjects receiving ALA-1000
Time Frame
Baseline (prior to dosing) through the End of Study (Day175), or Early termination
Title
A standard physical examination will be performed to monitor the safety in subjects receiving ALA-1000
Description
The examination will include assessment of skin, head, ears, eyes, nose, throat, neck, thyroid, lungs, heart, cardiovascular, abdomen, lymph nodes, and musculoskeletal system/extremities.
Time Frame
Baseline (prior to dosing) to the End of Study (Day175), or Early termination
Title
Injection site assessment will be conducted to monitor the safety in subjects receiving ALA-1000
Description
Injection site assessment including pain, tenderness, induration, erythema/redness, and swelling. If an infection develops at the injection site, the subject will be withdrawn from the study.
Time Frame
From the end of ALA-1000 injection through the End of Study (Day175), or Early termination
Title
Concomitant medications will be reviewed and documented to monitor the safety in subjects receiving ALA-1000
Description
The medication name, dose, frequency, date, and indication for use must be recorded
Time Frame
Prior to dosing through the End of Study (Day175), or Early termination
Title
AUC (area under the plasma concentration-time curve) for subjects receive ALA-1000 injection
Time Frame
Prior to ALA-1000 injection through the End of Study (Day175), or Early termination
Title
Cmax (maximum observed plasma concentration) for subjects receive ALA-1000 injection
Time Frame
Prior to ALA-1000 injection through the End of Study (Day175), or Early termination
Title
Tmax (time to maximum concentration) for subjects receive ALA-1000 injection
Time Frame
Prior to ALA-1000 injection through the End of Study (Day175), or Early termination
Title
t1/2 (time to half plasma concentration) for subjects receive ALA-1000 injection
Time Frame
Prior to ALA-1000 injection through the End of Study (Day175), or Early termination
Secondary Outcome Measure Information:
Title
Change of opioid withdrawal symptoms will be assessed using Clinical Opiate Withdrawal Scale (COWS) for subjects receive ALA-1000 injection
Description
Opioid withdrawal symptoms will be measured using COWS scores. Score: 5- 1 2 = mild; 1 3-24 = moderate; 25-36 = moderately severe; more than 36 = severe withdrawal
Time Frame
Baseline (prior to dosing) through the End of Study (Day175), or Early termination
Title
Change of suicidal ideation will be assessed using Columbia-Suicide Severity Rating Scale (C-SSRS) for subjects receive ALA-1000 injection
Description
Suicidal ideation scores will be reported using C-SSRS. The suicidal ideation scale identifies behaviors and thoughts that are associated with an increased risk of suicidal actions in the future. Score: 5- 1 2 = mild; 1 3-24 = moderate; 25-36 = moderately severe; more than 36 = severe suicidal ideation.
Time Frame
Screening through the End of Study (Day175), or Early termination
Title
Assessment of the abstinence by urine toxicology results negative for opioids in subjects received ALA-1000 injection.
Time Frame
Screening through the End of Study (Day175), or Early termination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Competent to provide informed consent. Voluntarily provide informed consent and Health Insurance Portability and Accounting Act (HIPAA) Authorization prior to any procedures or evaluations performed specifically for the sole purpose of the study. Male or female between 18 to 65 years of age inclusive at the screening visit. Meets DSM-5 criteria for Opioid Use Disorder (OUD) and is seeking treatment of OUD. Body Mass Index (BMI) ≥ 18 and ≤ 35 kg/m2 at screening visit. Female subjects of childbearing potential must agree to use a reliable method of birth control (e.g., total abstinence, condom and spermicide, intrauterine device (IUD), oral contraception which has been stable for 30 days) and at least 120 days after stopping the investigational product. Agree to withdraw from opiates for at least 12 hours prior to admission to clinical unit. Agree not to take any buprenorphine product (other than ALA-1000 and buprenorphine sublingual films during tolerability/induction period) during the study. Exclusion Criteria: History or presence of a significant medical disease or disorder which, in the opinion of the investigator, increases the risk of the study drug or may confound the interpretation of study measures, as confirmed by screening laboratory results. Clinically significant abnormal findings on physical examination, vital signs, or Electrocardiogram (ECG). Defined as having a QTc (Fridericia) interval > 470 msec or any other clinically significant abnormalities at screening, check-in, or prior to administration of ALA-1000. Pregnant or lactating. History of suicidal behavior in the past 1 year or current suicidal ideation as per investigator judgement. Currently meets Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for substance use disorder, moderate or severe for any substance other than opioids, caffeine, or nicotine. Currently meets criteria for any unstable psychiatric disorder, including schizophrenia, schizoaffective, bipolar disorder (depression and stable bipolar disorder are not excluded if condition has been stable for at least 60 days). Current diagnosis of Acquired Immune Deficiency Syndrome (AIDS) as confirmed by Western Blot and viral load laboratory results. Acute active Hepatitis B or C as evidenced by positive serology and Aspartate aminotransferase (AST)/ Alanine aminotransferase (ALT) >2 upper limit of normal (ULN) History of blood donation in excess of 450 mL within 30 days prior to Visit 1. Received treatment with an investigational drug or device within 90 days prior to Visit 1. Use of strong inhibitors or inducers of cytochrome P450 3A4 (CYP3A4) within 30 days prior to Visit 1. Use of any new medication, vitamins, or supplements within 7 days prior to Visit. Hypersensitivity or allergy to buprenorphine or other opioids which, in the opinion of the investigator, would compromise subject safety.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Erin Tireman
Organizational Affiliation
Innovative Clinical Research
Official's Role
Study Director
Facility Information:
Facility Name
Innovative Clinical Research
City
Miami
State/Province
Florida
ZIP/Postal Code
33016
Country
United States

12. IPD Sharing Statement

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Single Ascending Dose Study of ALA-1000

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