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A Trial of the Effect of CVL-865 on Panic Symptoms Induced by Carbon Dioxide Inhalation in Healthy Subjects

Primary Purpose

Panic Disorder

Status
Completed
Phase
Phase 1
Locations
Netherlands
Study Type
Interventional
Intervention
CVL-865 High dose
Alprazolam 1mg XR
Placebo
CVL-865 low dose
Sponsored by
Cerevel Therapeutics, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Panic Disorder focused on measuring Anxiety, Panic, CVL-865, PF-06372865, Hypercapnia, CO2 challenge, Healthy Subjects

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy male and female subjects, ages 18 to 55 years, inclusive, at the time of signing the ICF. Healthy is defined as no clinically relevant abnormalities identified by a detailed medical history, full physical examination, including blood pressure and heart rate measurement, 12-lead ECG, and clinical laboratory tests, as evaluated by the investigator.
  • Body mass index of 18.5 to 30.0 kg/m2, inclusive, and a total body weight >50 kg (110 lbs)
  • A female subject of childbearing potential who is sexually active with a nonsterilized male partner must agree to use a highly effective method of contraception from signing of informed consent and for 30 days post last dose. A male subject with a pregnant or a nonpregnant partner of childbearing potential must agree to use condom during treatment and until the end of relevant systemic exposure in the male subject for 94 days following the last dose with IMP.
  • Capable of giving signed informed consent
  • Ability, in the opinion of the investigator, to understand the nature of the trial and comply with protocol requirements, including the prescribed dosage regimens, scheduled visits, laboratory tests, and other trial procedures.
  • Defined as sensitive to the anxiogenic effects of double-breath CO2 inhalation

Exclusion Criteria:

  • Subjects with a current history of clinically significant cardiovascular pulmonary, gastrointestinal, renal, hepatic, metabolic, hematological, immunological, or neurological disease.
  • Subjects with a current or past history of clinically significant respiratory conditions
  • Subject with a personal or family history of sickle cell anemia
  • Subject with a personal or family history of cerebral aneurysm
  • Subjects with a clinically significant current or past personal or family history of any psychiatric disorder as classified by DSM-4 or DSM-5 criteria
  • Subjects with epilepsy or a history of seizures except for a single seizure episode
  • Subjects with a history of substance or alcohol-use disorder (DSM-5 criteria)
  • Subjects who answer "Yes" on the C-SSRS Suicidal Ideation Item 4, 5 and whose most recent episode meeting criteria for this C-SSRS Item 4, 5 occurred within the last 6 months
  • Subjects who, in the opinion of the investigator, present a serious risk of suicide
  • Subjects with human immunodeficiency virus seropositive status or acquired immunodeficiency syndrome, chronic hepatitis B or C (defined as positive serology and aspartate aminotransferase or alanine aminotransferase elevated to >2 × ULN)
  • Subject with a positive drug screen for illicit drugs
  • Subjects with a 12-lead ECG demonstrating either of the following:

    • QT interval corrected for heart rate using Fridericia's formula >450 msec (average of 3 ECGs obtained at the Screening Visit)
    • QRS interval >120 msec at the Screening Visit
  • Subjects with any of the following abnormalities in clinical laboratory tests at the Screening Visit, as assessed by the local laboratory and confirmed by a single repeat measurement, if deemed necessary:

    • AST or ALT ≥2 × ULN
    • Total bilirubin ≥1.5 × ULN. Subjects with a history of Gilbert's syndrome may be eligible provided the direct bilirubin is <ULN
    • Females: Hemoglobin <11 g/dL; Males: hemoglobin <12 g/dL
    • White blood cell count <3.0 × 109/L
    • Neutrophil count <2.0 × 109/L
    • Platelet count <150 × 109/L
  • Subjects with other abnormal laboratory test results, vital sign results, or ECG findings unless, based on the investigator's judgment, the findings are not medically significant
  • Systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg at Screening or Day -1
  • Subjects taking prohibited medication or who would be likely to require prohibited concomitant therapy
  • Subject has a current or past history of BZD abuse and/or dependence
  • Female subjects who are breastfeeding and/or who have a positive pregnancy test result prior to receiving IMP
  • Subjects who currently use or have used tobacco or nicotine-containing products within 30 days prior to signing the ICF. Subjects who test positive for urine cotinine
  • Subjects who has a history of consuming foods or beverages containing >8 units of methylxanthines per day and refuses to abstain from consumption of methylxanthine containing food and beverages while in the clinic.
  • Subjects with any condition possibly affecting drug absorption
  • Subjects with difficulty swallowing
  • Subjects who are known to be allergic or hypersensitive to the IMP or any of its components
  • Subjects with a known sensitivity or contraindication to alprazolam
  • Subjects who have participated in any clinical trial within 90 days prior to signing the ICF.
  • Subjects who have demonstrated a non-response to 35% CO2 double inhalation challenge in a previous trial.
  • Any subject who, in the opinion of the sponsor, investigator, or medical monitor, should not participate in the trial
  • Subjects with a positive SARS-CoV-2 quantitative PCR test result at Day -1, Period 1 are excluded. Results from subjects reporting a positive SARS-CoV-2 quantitative PCR test result prior to Day -1, Period need to be discussed with the sponsor/medical monitor prior to enrolment of the subject into the trial

Sites / Locations

  • Centre for Human Drug Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

CVL-865

Alprazolam

Placebo

Arm Description

High dose CVL-865 (25mg) Low dose CVL-865 (7.5mg)

Active Comparator Alprazolam with extended release oral tablets; 1 tablet BID

Placebo Comparator matching oral tablets for CVL-865, capsule for Alprazolam

Outcomes

Primary Outcome Measures

PSL-IV score
Change in Panic Symptom List -IV (PSL-IV), a questionnaire including 13 symptoms, each with intensity rating from 0 (not at all) to 4 (very intense), from pre-CO2 to Post CO2 challenge value

Secondary Outcome Measures

VAS Fear score
Change in Visual Analog Scale (VAS) value for fear, consisting of a horizontal line 100 mm in length with 0 corresponding to "no fear" and 100 corresponding to "the most fear possible", from pre-CO2 to Post CO2 challenge
CO2 challenge
Change from pre-CO2 to post-CO2 challenge values in Finapres NanoCore Physiological Measurements
Treatment-emergent AEs
Treatment-emergent AEs
Suicidality assessed using Columbia - Suicide Severity Rating Scale (C-SSRS)
Suicidality assessed using Columbia - Suicide Severity Rating Scale (C-SSRS) with no/yes (0/1) to each interview question on the occurrence of suicide events or ideation.
CVL-865 (and alprazolam, if appropriate) concentrations
Change From Baseline in NeuroCart test battery Score
Psychodynamic effects of CVL-865 will be assessed by means of the NeuroCart test battery (including saccadic eye movements, adaptive tracking, body sway, Quantitative EEG)
Change from Baseline in Bond & Lader Visual Analogue Scale (VAS)
Visual Analogue Scale (VAS) is made up of 16 pairs of alternative descriptors of mood and attention at either end. The Bond-Lader of a 10 cm line. Participants will rate their feelings at the time of assessment by indicating the point on the line which best represent their mood. Each item is scored by measuring the position relative to the left hand end of the line and levels of anxiety, sedation, and dysphoria are then calculated from the combined scores of selected items. The score ranges from 0 to 100, with a high score reflecting a high level of anxiety, sedation or dysphoria.

Full Information

First Posted
September 29, 2020
Last Updated
January 10, 2022
Sponsor
Cerevel Therapeutics, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04592536
Brief Title
A Trial of the Effect of CVL-865 on Panic Symptoms Induced by Carbon Dioxide Inhalation in Healthy Subjects
Official Title
A Randomized, Double-blind, Placebo- and Active Comparator-controlled, Crossover Trial to Examine the Effect of Multiple Doses of CVL-865 on Panic Symptoms Induced by Carbon Dioxide Inhalation in Healthy Subject
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
October 6, 2020 (Actual)
Primary Completion Date
November 14, 2021 (Actual)
Study Completion Date
December 13, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cerevel Therapeutics, LLC

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
The purpose of this study is to determine anxiolytic effect of multiple doses of CVL-865 using an experimental medicine model of carbon dioxide (CO2) inhalation in healthy volunteers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Panic Disorder
Keywords
Anxiety, Panic, CVL-865, PF-06372865, Hypercapnia, CO2 challenge, Healthy Subjects

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
56 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CVL-865
Arm Type
Experimental
Arm Description
High dose CVL-865 (25mg) Low dose CVL-865 (7.5mg)
Arm Title
Alprazolam
Arm Type
Active Comparator
Arm Description
Active Comparator Alprazolam with extended release oral tablets; 1 tablet BID
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo Comparator matching oral tablets for CVL-865, capsule for Alprazolam
Intervention Type
Drug
Intervention Name(s)
CVL-865 High dose
Intervention Description
High dose CVL-865: Will be administered as 5mg BID for 2 days followed by 12.5mg BID for another 2 days during the Titration Phase. 25mg will be administered during the Maintenance Phase (3 days of BID and morning dose only on the 4th day)
Intervention Type
Drug
Intervention Name(s)
Alprazolam 1mg XR
Intervention Description
Alprazolam 1mg XR will be administered for 8 days BID (morning dose only on 8th day)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo, oral tablet/capsule will be administered for 8 days BID (morning dose only on 8th day)
Intervention Type
Drug
Intervention Name(s)
CVL-865 low dose
Intervention Description
Low dose CVL-865, oral tablets. Will be administered as 2.5mg BID for 2 days followed by 5mg BID for another 2 days during the Titration Phase. 7.5mg BID will be administered during the Maintenance Phase (3 days of BID and morning dose only on 4th day)
Primary Outcome Measure Information:
Title
PSL-IV score
Description
Change in Panic Symptom List -IV (PSL-IV), a questionnaire including 13 symptoms, each with intensity rating from 0 (not at all) to 4 (very intense), from pre-CO2 to Post CO2 challenge value
Time Frame
up to Day 8
Secondary Outcome Measure Information:
Title
VAS Fear score
Description
Change in Visual Analog Scale (VAS) value for fear, consisting of a horizontal line 100 mm in length with 0 corresponding to "no fear" and 100 corresponding to "the most fear possible", from pre-CO2 to Post CO2 challenge
Time Frame
up to Day 8
Title
CO2 challenge
Description
Change from pre-CO2 to post-CO2 challenge values in Finapres NanoCore Physiological Measurements
Time Frame
Screening, Day 1, Day 8
Title
Treatment-emergent AEs
Description
Treatment-emergent AEs
Time Frame
From screening to Follow-up Visit
Title
Suicidality assessed using Columbia - Suicide Severity Rating Scale (C-SSRS)
Description
Suicidality assessed using Columbia - Suicide Severity Rating Scale (C-SSRS) with no/yes (0/1) to each interview question on the occurrence of suicide events or ideation.
Time Frame
Screening, Day -1, Day 8
Title
CVL-865 (and alprazolam, if appropriate) concentrations
Time Frame
Day 8
Title
Change From Baseline in NeuroCart test battery Score
Description
Psychodynamic effects of CVL-865 will be assessed by means of the NeuroCart test battery (including saccadic eye movements, adaptive tracking, body sway, Quantitative EEG)
Time Frame
Screening, Day 1, Day 8
Title
Change from Baseline in Bond & Lader Visual Analogue Scale (VAS)
Description
Visual Analogue Scale (VAS) is made up of 16 pairs of alternative descriptors of mood and attention at either end. The Bond-Lader of a 10 cm line. Participants will rate their feelings at the time of assessment by indicating the point on the line which best represent their mood. Each item is scored by measuring the position relative to the left hand end of the line and levels of anxiety, sedation, and dysphoria are then calculated from the combined scores of selected items. The score ranges from 0 to 100, with a high score reflecting a high level of anxiety, sedation or dysphoria.
Time Frame
Day 1, Day 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy male and female subjects, ages 18 to 55 years, inclusive, at the time of signing the ICF. Healthy is defined as no clinically relevant abnormalities identified by a detailed medical history, full physical examination, including blood pressure and heart rate measurement, 12-lead ECG, and clinical laboratory tests, as evaluated by the investigator. Body mass index of 18.5 to 30.0 kg/m2, inclusive, and a total body weight >50 kg (110 lbs) A female subject of childbearing potential who is sexually active with a nonsterilized male partner must agree to use a highly effective method of contraception from signing of informed consent and for 30 days post last dose. A male subject with a pregnant or a nonpregnant partner of childbearing potential must agree to use condom during treatment and until the end of relevant systemic exposure in the male subject for 94 days following the last dose with IMP. Capable of giving signed informed consent Ability, in the opinion of the investigator, to understand the nature of the trial and comply with protocol requirements, including the prescribed dosage regimens, scheduled visits, laboratory tests, and other trial procedures. Defined as sensitive to the anxiogenic effects of double-breath CO2 inhalation Exclusion Criteria: Subjects with a current history of clinically significant cardiovascular pulmonary, gastrointestinal, renal, hepatic, metabolic, hematological, immunological, or neurological disease. Subjects with a current or past history of clinically significant respiratory conditions Subject with a personal or family history of sickle cell anemia Subject with a personal or family history of cerebral aneurysm Subjects with a clinically significant current or past personal or family history of any psychiatric disorder as classified by DSM-4 or DSM-5 criteria Subjects with epilepsy or a history of seizures except for a single seizure episode Subjects with a history of substance or alcohol-use disorder (DSM-5 criteria) Subjects who answer "Yes" on the C-SSRS Suicidal Ideation Item 4, 5 and whose most recent episode meeting criteria for this C-SSRS Item 4, 5 occurred within the last 6 months Subjects who, in the opinion of the investigator, present a serious risk of suicide Subjects with human immunodeficiency virus seropositive status or acquired immunodeficiency syndrome, chronic hepatitis B or C (defined as positive serology and aspartate aminotransferase or alanine aminotransferase elevated to >2 × ULN) Subject with a positive drug screen for illicit drugs Subjects with a 12-lead ECG demonstrating either of the following: QT interval corrected for heart rate using Fridericia's formula >450 msec (average of 3 ECGs obtained at the Screening Visit) QRS interval >120 msec at the Screening Visit Subjects with any of the following abnormalities in clinical laboratory tests at the Screening Visit, as assessed by the local laboratory and confirmed by a single repeat measurement, if deemed necessary: AST or ALT ≥2 × ULN Total bilirubin ≥1.5 × ULN. Subjects with a history of Gilbert's syndrome may be eligible provided the direct bilirubin is <ULN Females: Hemoglobin <11 g/dL; Males: hemoglobin <12 g/dL White blood cell count <3.0 × 109/L Neutrophil count <2.0 × 109/L Platelet count <150 × 109/L Subjects with other abnormal laboratory test results, vital sign results, or ECG findings unless, based on the investigator's judgment, the findings are not medically significant Systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg at Screening or Day -1 Subjects taking prohibited medication or who would be likely to require prohibited concomitant therapy Subject has a current or past history of BZD abuse and/or dependence Female subjects who are breastfeeding and/or who have a positive pregnancy test result prior to receiving IMP Subjects who currently use or have used tobacco or nicotine-containing products within 30 days prior to signing the ICF. Subjects who test positive for urine cotinine Subjects who has a history of consuming foods or beverages containing >8 units of methylxanthines per day and refuses to abstain from consumption of methylxanthine containing food and beverages while in the clinic. Subjects with any condition possibly affecting drug absorption Subjects with difficulty swallowing Subjects who are known to be allergic or hypersensitive to the IMP or any of its components Subjects with a known sensitivity or contraindication to alprazolam Subjects who have participated in any clinical trial within 90 days prior to signing the ICF. Subjects who have demonstrated a non-response to 35% CO2 double inhalation challenge in a previous trial. Any subject who, in the opinion of the sponsor, investigator, or medical monitor, should not participate in the trial Subjects with a positive SARS-CoV-2 quantitative PCR test result at Day -1, Period 1 are excluded. Results from subjects reporting a positive SARS-CoV-2 quantitative PCR test result prior to Day -1, Period need to be discussed with the sponsor/medical monitor prior to enrolment of the subject into the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gabriel Etienne Jacobs, PhD, MD
Organizational Affiliation
Centre for Human Drug Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre for Human Drug Research
City
Leiden
State/Province
Zernikedreef 8
ZIP/Postal Code
2333 CL
Country
Netherlands

12. IPD Sharing Statement

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A Trial of the Effect of CVL-865 on Panic Symptoms Induced by Carbon Dioxide Inhalation in Healthy Subjects

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