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The Zonisamide and Reinforcement for Reducing Alcohol Use (ZARRA) Study

Primary Purpose

Alcohol Use Disorder (AUD)

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Zonisamide
Placebo
Sponsored by
Washington State University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcohol Use Disorder (AUD) focused on measuring Alcohol Use Disorder, Zonisamide, Contingency Management, Incentives for Sobriety

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Four or more standard drinks on four or more occasions in the prior 30 days.
  2. Seeking AUD treatment.
  3. Aged 18-65 years.
  4. DSM-5 diagnosis of AUD.
  5. Ability to read and speak English.
  6. Ability to provide written informed consent.
  7. Breath alcohol of 0.00 during informed consent.
  8. Provision of at least 1 EtG-positive urine test at any time during the induction period.
  9. Non-lactating women of childbearing age using reliable form of birth control with a negative urine pregnancy test at baseline, and
  10. Attended at least 4 of 6 visits during the induction period.

Exclusion Criteria:

  1. Significant risk of dangerous alcohol withdrawal, defined as a history of alcohol detoxification or seizure in the last 12 months and expression of concern by the participant about dangerous withdrawal;
  2. Currently receiving any pharmacotherapy for alcohol or in the past 30 days.
  3. Current DSM-5 diagnosis of severe substance use disorder other than nicotine.
  4. Suicide attempt in the last 20 years.
  5. History of hypersensitivity to sulfonamide medication, Stevens-Johnson Syndrome, penicillin allergy or allergic reaction to any drug
  6. Systemic autoimmune disease.
  7. History of current seizure disorder (e.g., are they receiving medication currently for their seizures, have they ever been told by their provider that they have epilepsy, or do they have a history of recurring seizures in the last 5 years?).
  8. Current clinically significant blood dyscrasia.
  9. History of clinically significant renal calculi or renal failure; renal compromise (defined by an elevation of serum creatinine above our laboratory's limit of normal).
  10. History of traumatic brain injury (TBI; e.g., ever been told by a provider that they had a moderate or severe TBI, lost consciousness for 30 minutes or longer or had a post-traumatic amnesia lasting a day or longer).
  11. Any other current, clinically significant physical disease [i.e., neurologic, renal, rheumatologic, gastrointestinal, hematologic, pulmonary, endocrine, cardiovascular, hepatic, or autoimmune disease] on the basis of medical history, physical examination, or routine laboratory evaluation that, in the context of the study would represent a risk to the subject, or significant laboratory abnormalities related to hepatic function such as marked elevations of hepatic aminotransferase levels (i.e., AST and ALT) or direct bilirubin, and
  12. Any other medical or psychiatric condition that Dr. Rodin determines would compromise safe participation.

Sites / Locations

  • Washington State UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

ZON+ST

PLO+ST

Arm Description

Zonisamide (ZON) plus standard treatment (ST)

Placebo (PLO) plus standard treatment (ST)

Outcomes

Primary Outcome Measures

Change in Self Reported Alcohol Consumption
Consumption of alcohol between participants randomized to ZON+ST vs PLO+ST assessed by participant self report (collected 1x weekly from weeks 1-14 and once at weeks 18, 38, and 54).

Secondary Outcome Measures

Change in Biochemically Verified Alcohol Consumption
Consumption of alcohol between participants randomized to ZON+ST vs PLO+ST assessed by alcohol breathalyzer and biochemical EtG values (collected 3x weekly from weeks 1-6, 1x weekly at weeks 7-14, and once at weeks 18, 38, and 54).

Full Information

First Posted
October 14, 2021
Last Updated
April 25, 2023
Sponsor
Washington State University
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1. Study Identification

Unique Protocol Identification Number
NCT05134857
Brief Title
The Zonisamide and Reinforcement for Reducing Alcohol Use (ZARRA) Study
Official Title
Zonisamide for the Treatment of Alcohol Use Disorder in the Addiction Neuroclinical Assessment Framework
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 7, 2022 (Actual)
Primary Completion Date
August 2025 (Anticipated)
Study Completion Date
August 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Washington State University

4. Oversight

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

5. Study Description

Brief Summary
A phase II randomized, double-blind, placebo-controlled clinical trial (RCT) to evaluate the ability of zonisamide (ZON) to decrease alcohol use among treatment-seeking adults with an alcohol use disorder (AUD).
Detailed Description
This project focuses on the efficacy of a promising pharmacotherapy (ZON) for AUDs using a placebo-controlled design that will rigorously measure alcohol use and medication adherence. Results will guide novel mechanistic targets to better capture the heterogeneity within AUDs. This project will evaluate the ability of ZON to treat the alcohol use disorder. The investigators hypothesize that the group assigned to ZON associated with the standard treatment (ZON+ST) will yield lower rates of biochemically verified alcohol use, fewer self-reported drinks per day, and fewer heavy drinking days during the 12-week treatment and 1-year follow-up periods, relative to the placebo associated with the standard treatment (PLO+ST) group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcohol Use Disorder (AUD)
Keywords
Alcohol Use Disorder, Zonisamide, Contingency Management, Incentives for Sobriety

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
A phase II randomized, double-blind, placebo-controlled clinical trial
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
205 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ZON+ST
Arm Type
Experimental
Arm Description
Zonisamide (ZON) plus standard treatment (ST)
Arm Title
PLO+ST
Arm Type
Placebo Comparator
Arm Description
Placebo (PLO) plus standard treatment (ST)
Intervention Type
Drug
Intervention Name(s)
Zonisamide
Intervention Description
The ZON will be supplied in 100 mg capsules and deposited directly into the TAD device by research staff every 2 weeks. All participants will be told to take 100 mg/day for the first three weeks (Week 1-2 single-blind, placebo-only, induction; end of Week 2, active treatment begins) and increasing by 100 mg/day every other week (Week 4: 200 mg/day; Week 6: 300 mg/day; Week 8: 400 mg/day) up to the target dose of 500 mg/day by Week 10. The participants will be maintained on this dose through Week 14 of active treatment and then tapered off ZON (2 weeks). This dosing schedule is consistent with best practices for ZON. All TAD devices will only dispense the prescribed medication between 4pm and 11pm each night. Participants will be instructed to take the medication at or near bedtime.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The PLO will be supplied at the same schedule and in the same manner (TAD device) as the ZON.
Primary Outcome Measure Information:
Title
Change in Self Reported Alcohol Consumption
Description
Consumption of alcohol between participants randomized to ZON+ST vs PLO+ST assessed by participant self report (collected 1x weekly from weeks 1-14 and once at weeks 18, 38, and 54).
Time Frame
12-week treatment and 1-year follow-up period
Secondary Outcome Measure Information:
Title
Change in Biochemically Verified Alcohol Consumption
Description
Consumption of alcohol between participants randomized to ZON+ST vs PLO+ST assessed by alcohol breathalyzer and biochemical EtG values (collected 3x weekly from weeks 1-6, 1x weekly at weeks 7-14, and once at weeks 18, 38, and 54).
Time Frame
12-week treatment and 1-year follow-up period
Other Pre-specified Outcome Measures:
Title
Adverse Events
Description
Occurrence of adverse events assessed by SAFETEE (collected 3x weekly at weeks 1-6, 1x weekly at weeks 7-14, and once at weeks 18, 38, and 54).
Time Frame
12-week treatment and 1-year follow-up period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Four or more standard drinks on four or more occasions in the prior 30 days. Seeking AUD treatment. Aged 18-65 years. DSM-5 diagnosis of AUD. Ability to read and speak English. Ability to provide written informed consent. Breath alcohol of 0.00 during informed consent. Provision of at least 1 EtG-positive urine test at any time during the induction period. Non-lactating women of childbearing age using reliable form of birth control with a negative urine pregnancy test at baseline, and Attended at least 4 of 6 visits during the induction period. Exclusion Criteria: Significant risk of dangerous alcohol withdrawal, defined as a history of alcohol detoxification or seizure in the last 12 months and expression of concern by the participant about dangerous withdrawal; Currently receiving any pharmacotherapy for alcohol or in the past 30 days. Current DSM-5 diagnosis of severe substance use disorder other than nicotine. Suicide attempt in the last 20 years. History of hypersensitivity to sulfonamide medication, Stevens-Johnson Syndrome, penicillin allergy or allergic reaction to any drug Systemic autoimmune disease. History of current seizure disorder (e.g., are they receiving medication currently for their seizures, have they ever been told by their provider that they have epilepsy, or do they have a history of recurring seizures in the last 5 years?). Current clinically significant blood dyscrasia. History of clinically significant renal calculi or renal failure; renal compromise (defined by an elevation of serum creatinine above our laboratory's limit of normal). History of traumatic brain injury (TBI; e.g., ever been told by a provider that they had a moderate or severe TBI, lost consciousness for 30 minutes or longer or had a post-traumatic amnesia lasting a day or longer). Any other current, clinically significant physical disease [i.e., neurologic, renal, rheumatologic, gastrointestinal, hematologic, pulmonary, endocrine, cardiovascular, hepatic, or autoimmune disease] on the basis of medical history, physical examination, or routine laboratory evaluation that, in the context of the study would represent a risk to the subject, or significant laboratory abnormalities related to hepatic function such as marked elevations of hepatic aminotransferase levels (i.e., AST and ALT) or direct bilirubin, and Any other medical or psychiatric condition that Dr. Rodin determines would compromise safe participation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Abigail L Bowen, MS
Phone
(425) 736-1354
Email
abigail.bowen@wsu.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Sterling McPherson, PhD
Phone
(509) 324-7459
Email
sterling.mcpherson@wsu.edu
Facility Information:
Facility Name
Washington State University
City
Spokane
State/Province
Washington
ZIP/Postal Code
99202
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Abigail L Bowen, MS
Phone
425-736-1354
Email
abigail.bowen@wsu.edu
First Name & Middle Initial & Last Name & Degree
Serena McPherson, BA
Phone
(509) 590-7689
Email
s.mcpherson@wsu.edu

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Data is to be shared with NIAAA under their required data archiving procedures.
IPD Sharing Time Frame
5-6 years
IPD Sharing Access Criteria
Determined by NIAAA data archive policy
IPD Sharing URL
https://www.niaaa.nih.gov/research/niaaa-data-archive

Learn more about this trial

The Zonisamide and Reinforcement for Reducing Alcohol Use (ZARRA) Study

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