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Safety, Tolerability and Pharmacokinetics of NYX-783 and Oxycodone DDI Study

Primary Purpose

Opioid Use Disorder

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
NYX-783
Placebo
Oxycodone
Sponsored by
Yale University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Opioid Use Disorder

Eligibility Criteria

21 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • BMI < 35 at screening.
  • Voluntary, written, informed consent.
  • Urine toxicology evidence of opiate use.
  • full scale and verbal IQs > 80 (Shipley Institute of Living IQ Screening Test).
  • Non-treatment seeking, non-dependent, opioid-experienced participants with low, non-weekly opioid use via smoking or oral pills routes and with no need for medical detoxification from opiates and without past 12 month history of overdoses or medical detoxification for opioid withdrawal.
  • Participants must agree to use dual contraceptive methods during the study and refrain from donating sperm or ova during study or for 28 days after final dose of drug for ova and for 90 days after final dose of drug for sperm. Dual contraceptive methods include the use of a barrier contraceptive (i.e., condoms) in addition to another effective method that can prevent pregnancy (i.e., oral or parenteral contraceptives, intrauterine devices, spermicide, etc.).
  • Ability to understand and comply with study requirements and restrictions and provide a secondary contact if they cannot be reached.

Exclusion Criteria:

  • Meet current DSM-5 criteria of moderate to severe Substance Use Disorder (SUD) on either sedative, hypnotics, cocaine, methamphetamine, opiates or alcohol.
  • Daily heroin, fentanyl use requiring opiate detoxification and treatment.
  • Regular daily prescribed use of anticonvulsants, sedatives/hypnotics, other antihypertensives, anti-arrhythmics, antiretroviral medications, naltrexone, antabuse, grapefruit juice and St. John's wort products, glucocorticoids, stimulants (amphetamine like compounds), central nervous system active medications, or other medications that in the opinion of the investigators interfere with the study.
  • Women who are pregnant or nursing (as assessed by pregnancy tests during initial intake and upon CNRU admission).
  • HIV seropositivity, hepatitis or other acute ongoing infectious disease considered clinically significant by the investigator.
  • Traumatic brain injury with loss of consciousness.
  • Individuals with current or past history of seizure disorders.
  • Current or recent diagnosis within past 6-months of Major Depressive Disorder (MDD), bipolar disorder, schizophrenia, and schizoaffective disorder.
  • History of a neurodegenerative or neuro-inflammatory disorder including Huntington's, Parkinson's, Alzheimer's disease, or multiple sclerosis.
  • Known familial history or known presence of long QT syndrome, or a known history of past or current clinically significant arrhythmias or ischemic heart disease.
  • History of gastrointestinal disease or surgery (except simply appendectomy or hernia repair), leading to impaired drug absorption.
  • Uncorrected hypothyroidism or hyperthyroidism. Participants with compensated hypothyroidism with normal thyroid-stimulating hormone levels may be enrolled.
  • Sensitivity, allergy, or intolerance to N-methyl-D-aspartate receptor (NMDAR) ligands including ketamine, dextromethorphan, memantine, methadone, dextropropoxyphene, or ketobemidone and magnesium. Use of NMDAR-binding drugs within 60 days prior to dosing or during the study.
  • Received an investigational product or device within 30 days of dosing (or 5 half-lives whichever is longer).
  • Previously received NYX-783.
  • Screening QT interval corrected for heart rate (HR) by Fridericia's formula (QTcF) > 450 (males) or 470 (females) milliseconds (msec) or an ECG that is not suitable for QT measurements (e.g., poorly defined termination of T-wave in the investigator's opinion.
  • Heart rate ≤45 or >90 bpm at screening
  • Creatinine clearance <60ml/min at screening or history of renal disease as assessed by Investigator.
  • Uncontrolled Type I or Type II diabetes or uncontrolled hypertension characterized by fasting blood glucose > 126 mg/dl or postprandial blood glucose > 200 mg/dl, resting systolic blood pressure >160 mm Hg or resting diastolic >100 mm Hg, or clinically significant hypotension in the judgement of the Investigator as characterized by resting systolic blood pressure <90 mm Hg or resting diastolic blood pressure <60 mm Hg.
  • Impaired hepatic function characterized by a previous known diagnosis of chronic liver disease and/or the presence of:

    1. direct bilirubin > 1.5x the upper limit of normal at screening
    2. alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, or gamma-glutamyl transferase (GGT) > 2x the upper limit of normal at screening.
  • History of severe COVID-19 infection requiring hospitalization, treatment with oxygen or mechanical ventilation, that may interfere with study participation as assessment by the Investigator.
  • Any participant with a medical history of Covid-19 infection (positive test) within the last 2 months, or current symptoms consistent with Covid-19 infection, as assessed by the Investigator.
  • Donated blood during the past 8 weeks.
  • Participants who do not report an increase in subjective opioid effect, as measured by the Drug Effects Questionnaire (DEQ, see below) by minimum of 10% or more to initial challenge with oxycodone in Session 1 will be excluded from the DDI phase sessions 2-7.

Sites / Locations

  • Cmhc/CnruRecruiting
  • The Yale Stress Center: Yale UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Active Comparator

Active Comparator

Arm Label

Placebo + Oxycodone

NYX-783: 50 mg dose + Oxycodone

NYX-783: 150 mg dose + Oxycodone

Arm Description

Participants will receive placebo with + 15 mg oxycodone then placebo + 30 mg oxycodone in separate inpatient randomized sessions in this, cross-over study over 6 experimental sessions.

Participants will receive NYX-783 50 mg dose with + 15 mg oxycodone then NYX-783 50 mg + 30 mg oxycodone in separate inpatient randomized sessions in this, cross-over study over 6 experimental sessions.

Participants will receive NYX-783 150 mg dose with + 15 mg oxycodone then NYX-783 150 mg + 30 mg oxycodone in separate inpatient randomized sessions in this, cross-over study over 6 experimental sessions.

Outcomes

Primary Outcome Measures

Change in respiratory rate
Change in respiratory rate pre and post drug administration measured by counting breaths
Change in oxygenation saturation
Change in oxygenation saturation pre and post drug administration measured by pulse-oximeter
Change in blood pressure
Change in blood pressure pre and post drug administration measured by blood pressure monitor
Change in heart rate
Change in heart rate pre and post drug administration measured by blood pressure monitor
Change in body temperature
Change in body temperature pre and post drug administration measured by temperature monitor
Change in cardiac rate
Change in cardiac rate pre and post drug administration measured by EKG cardiac monitor
Change in cardiac rhythm
Change in cardiac rhythm pre and post drug administration measured by EKG cardiac monitor

Secondary Outcome Measures

treatment emergent adverse events (TEAES) from Systematic Assessment for Treatment Emergent Effects (SAFTEE)
The SAFTEE is a technique for the systematic assessment of side effects in clinical trials that rates the current severity of a wide range of somatic, behavioral and affective symptoms and tabulates occurrence of each TEAE symptom
Change in Clinical Opiate Withdrawal Scale (COWS)
COWS is an 11-item scale to rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed score determines the stage/severity of opiate withdrawal and assess the level of physical dependence on opioids. Score: 5- 12 = mild; 13-24 = moderate; 25-36 = moderately severe; more than 36 = severe withdrawal
Change in Subjective Opioid Withdrawal Scale (SOWS)
SOWS is a self-administered scale for opioid withdrawal symptoms. It has16 symptoms whose intensity is rated on a scale of 0 (not at all) to 4 (extremely). Mild Withdrawal = score of 1-10, Moderate withdrawal = 11-20, Severe withdrawal = 21-30
Change in Drug Effects Questionnaire (DEQ)
The DEQ measures Good Drug Effect and consists of 11 questions with total score range from 0-100. Higher scores indicate more positive effects.
Change in Visual Analog Scale (VAS)
The VAS scales are 5 item drug effect self report ratings The visual analog questions were "Do you feel any Drug Effect?" "Do you like the drug?" "How high are you?" "Does the drug have any Good Effects?" "Does the drug have any Bad Effects?" and "How much do you DESIRE opiates?" The subjects responded by positioning an arrow along a 100-point line labeled with "not at all" at one end and "extremely" at the other. High scores show drug effect and craving, low scores show low drug effect and low craving
Change in Opioid Symptom Checklist (OSC)
The OSC is a 13-item opioid symptom checklist consisting of true/false questions designed to measure opioid effects (e.g., "My skin is itchy"). True scores total up to acute opiate positive and negative symptoms and low true scores will mean not feeling any of the negative and positive symptoms.
Change in pupillary diameter
pupil diameter size using pupilometer

Full Information

First Posted
June 21, 2022
Last Updated
October 9, 2023
Sponsor
Yale University
Collaborators
National Institute on Drug Abuse (NIDA), Aptinyx
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1. Study Identification

Unique Protocol Identification Number
NCT05447286
Brief Title
Safety, Tolerability and Pharmacokinetics of NYX-783 and Oxycodone DDI Study
Official Title
Clinical Evaluation of NMDA Modulator NYX-783 for OUD: Randomized, Double-blind, Placebo-Controlled Study to Assess Safety, Tolerability, and Pharmacokinetics of NYX-783 in Combination With Oxycodone (Study 1)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 15, 2023 (Actual)
Primary Completion Date
July 31, 2024 (Anticipated)
Study Completion Date
October 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Yale University
Collaborators
National Institute on Drug Abuse (NIDA), Aptinyx

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
This study proposes to examine the safety, tolerability, and pharmacokinetics (PK) of NYX-783 50 mg and 150 mg versus Placebo (PBO) in combination with acute Oxycodone 15 mg and 30 mg in an inpatient randomized, cross-over study in non-treatment seeking non-dependent, opioid experienced individuals with current recreational use.
Detailed Description
Outcomes will be cardiovascular (ECG monitoring, heart rate, blood pressure), respiratory, Clinical Opioid Withdrawal Scale (COWS), treatment emergent adverse events (TEAEs), and PK of NYX-783 levels in combination with Oxycodone. Secondary outcomes will be drug effects, subjective opiate withdrawal scale (SOWS), Drug Effects Questionnaire (DEQ), pupillary diameter, the Opioid Symptom Checklist (OSC), craving, stress and pain, and study drug levels during NYX-783 and Oxycodone combination challenge sessions.

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
Other
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double blind, placebo controlled.
Allocation
Randomized
Enrollment
9 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo + Oxycodone
Arm Type
Placebo Comparator
Arm Description
Participants will receive placebo with + 15 mg oxycodone then placebo + 30 mg oxycodone in separate inpatient randomized sessions in this, cross-over study over 6 experimental sessions.
Arm Title
NYX-783: 50 mg dose + Oxycodone
Arm Type
Active Comparator
Arm Description
Participants will receive NYX-783 50 mg dose with + 15 mg oxycodone then NYX-783 50 mg + 30 mg oxycodone in separate inpatient randomized sessions in this, cross-over study over 6 experimental sessions.
Arm Title
NYX-783: 150 mg dose + Oxycodone
Arm Type
Active Comparator
Arm Description
Participants will receive NYX-783 150 mg dose with + 15 mg oxycodone then NYX-783 150 mg + 30 mg oxycodone in separate inpatient randomized sessions in this, cross-over study over 6 experimental sessions.
Intervention Type
Drug
Intervention Name(s)
NYX-783
Other Intervention Name(s)
((2S, 3R)-3-hydroxy-2-((S)-5-isobutyryl-1-oxo-2,5-diazaspiro[3.4]octan-2-yl)butanamide)
Intervention Description
This study proposes to examine the safety, tolerability, and pharmacokinetics (PK) of NYX-783 at 50 mg and 150 mg doses versus Placebo (PBO) in combination with acute Oxycodone 15 mg and 30 mg in an inpatient randomized, cross-over study over 6 experimental sessions.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
This study proposes to examine the safety, tolerability, and pharmacokinetics (PK) of NYX-783 at 50 mg and 150 mg doses versus Placebo (PBO) in combination with acute Oxycodone 15 mg and 30 mg in an inpatient randomized, cross-over study over 6 experimental sessions.
Intervention Type
Drug
Intervention Name(s)
Oxycodone
Intervention Description
This study proposes to examine the safety, tolerability, and pharmacokinetics (PK) of NYX-783 at 50 mg and 150 mg doses versus Placebo (PBO) in combination with acute Oxycodone 15 mg and 30 mg in an inpatient randomized, cross-over study over 6 experimental sessions.
Primary Outcome Measure Information:
Title
Change in respiratory rate
Description
Change in respiratory rate pre and post drug administration measured by counting breaths
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in oxygenation saturation
Description
Change in oxygenation saturation pre and post drug administration measured by pulse-oximeter
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in blood pressure
Description
Change in blood pressure pre and post drug administration measured by blood pressure monitor
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in heart rate
Description
Change in heart rate pre and post drug administration measured by blood pressure monitor
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in body temperature
Description
Change in body temperature pre and post drug administration measured by temperature monitor
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in cardiac rate
Description
Change in cardiac rate pre and post drug administration measured by EKG cardiac monitor
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in cardiac rhythm
Description
Change in cardiac rhythm pre and post drug administration measured by EKG cardiac monitor
Time Frame
over 6 sessions from baseline up to 3 weeks
Secondary Outcome Measure Information:
Title
treatment emergent adverse events (TEAES) from Systematic Assessment for Treatment Emergent Effects (SAFTEE)
Description
The SAFTEE is a technique for the systematic assessment of side effects in clinical trials that rates the current severity of a wide range of somatic, behavioral and affective symptoms and tabulates occurrence of each TEAE symptom
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in Clinical Opiate Withdrawal Scale (COWS)
Description
COWS is an 11-item scale to rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed score determines the stage/severity of opiate withdrawal and assess the level of physical dependence on opioids. Score: 5- 12 = mild; 13-24 = moderate; 25-36 = moderately severe; more than 36 = severe withdrawal
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in Subjective Opioid Withdrawal Scale (SOWS)
Description
SOWS is a self-administered scale for opioid withdrawal symptoms. It has16 symptoms whose intensity is rated on a scale of 0 (not at all) to 4 (extremely). Mild Withdrawal = score of 1-10, Moderate withdrawal = 11-20, Severe withdrawal = 21-30
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in Drug Effects Questionnaire (DEQ)
Description
The DEQ measures Good Drug Effect and consists of 11 questions with total score range from 0-100. Higher scores indicate more positive effects.
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in Visual Analog Scale (VAS)
Description
The VAS scales are 5 item drug effect self report ratings The visual analog questions were "Do you feel any Drug Effect?" "Do you like the drug?" "How high are you?" "Does the drug have any Good Effects?" "Does the drug have any Bad Effects?" and "How much do you DESIRE opiates?" The subjects responded by positioning an arrow along a 100-point line labeled with "not at all" at one end and "extremely" at the other. High scores show drug effect and craving, low scores show low drug effect and low craving
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in Opioid Symptom Checklist (OSC)
Description
The OSC is a 13-item opioid symptom checklist consisting of true/false questions designed to measure opioid effects (e.g., "My skin is itchy"). True scores total up to acute opiate positive and negative symptoms and low true scores will mean not feeling any of the negative and positive symptoms.
Time Frame
over 6 sessions from baseline up to 3 weeks
Title
Change in pupillary diameter
Description
pupil diameter size using pupilometer
Time Frame
over 6 sessions from baseline up to 3 weeks
Other Pre-specified Outcome Measures:
Title
Pharmacokinetic (PK) levels of study medication
Description
plasma levels drawn repeatedly in 3 experimental sessions
Time Frame
across 3 sessions during the 3 weeks assessment period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: BMI < 35 at screening. Voluntary, written, informed consent. Urine toxicology evidence of opiate use. full scale and verbal IQs > 80 (Shipley Institute of Living IQ Screening Test). Non-treatment seeking, non-dependent, opioid-experienced participants with low, non-weekly opioid use via smoking or oral pills routes and with no need for medical detoxification from opiates and without past 12 month history of overdoses or medical detoxification for opioid withdrawal. Participants must agree to use dual contraceptive methods during the study and refrain from donating sperm or ova during study or for 28 days after final dose of drug for ova and for 90 days after final dose of drug for sperm. Dual contraceptive methods include the use of a barrier contraceptive (i.e., condoms) in addition to another effective method that can prevent pregnancy (i.e., oral or parenteral contraceptives, intrauterine devices, spermicide, etc.). Ability to understand and comply with study requirements and restrictions and provide a secondary contact if they cannot be reached. Exclusion Criteria: Meet current DSM-5 criteria of moderate to severe Substance Use Disorder (SUD) on either sedative, hypnotics, cocaine, methamphetamine, opiates or alcohol. Daily heroin, fentanyl use requiring opiate detoxification and treatment. Regular daily prescribed use of anticonvulsants, sedatives/hypnotics, other antihypertensives, anti-arrhythmics, antiretroviral medications, naltrexone, antabuse, grapefruit juice and St. John's wort products, glucocorticoids, stimulants (amphetamine like compounds), central nervous system active medications, or other medications that in the opinion of the investigators interfere with the study. Women who are pregnant or nursing (as assessed by pregnancy tests during initial intake and upon CNRU admission). HIV seropositivity, hepatitis or other acute ongoing infectious disease considered clinically significant by the investigator. Traumatic brain injury with loss of consciousness. Individuals with current or past history of seizure disorders. Current or recent diagnosis within past 6-months of Major Depressive Disorder (MDD), bipolar disorder, schizophrenia, and schizoaffective disorder. History of a neurodegenerative or neuro-inflammatory disorder including Huntington's, Parkinson's, Alzheimer's disease, or multiple sclerosis. Known familial history or known presence of long QT syndrome, or a known history of past or current clinically significant arrhythmias or ischemic heart disease. History of gastrointestinal disease or surgery (except simply appendectomy or hernia repair), leading to impaired drug absorption. Uncorrected hypothyroidism or hyperthyroidism. Participants with compensated hypothyroidism with normal thyroid-stimulating hormone levels may be enrolled. Sensitivity, allergy, or intolerance to N-methyl-D-aspartate receptor (NMDAR) ligands including ketamine, dextromethorphan, memantine, methadone, dextropropoxyphene, or ketobemidone and magnesium. Use of NMDAR-binding drugs within 60 days prior to dosing or during the study. Received an investigational product or device within 30 days of dosing (or 5 half-lives whichever is longer). Previously received NYX-783. Screening QT interval corrected for heart rate (HR) by Fridericia's formula (QTcF) > 450 (males) or 470 (females) milliseconds (msec) or an ECG that is not suitable for QT measurements (e.g., poorly defined termination of T-wave in the investigator's opinion. Heart rate ≤45 or >90 bpm at screening Creatinine clearance <60ml/min at screening or history of renal disease as assessed by Investigator. Uncontrolled Type I or Type II diabetes or uncontrolled hypertension characterized by fasting blood glucose > 126 mg/dl or postprandial blood glucose > 200 mg/dl, resting systolic blood pressure >160 mm Hg or resting diastolic >100 mm Hg, or clinically significant hypotension in the judgement of the Investigator as characterized by resting systolic blood pressure <90 mm Hg or resting diastolic blood pressure <60 mm Hg. Impaired hepatic function characterized by a previous known diagnosis of chronic liver disease and/or the presence of: direct bilirubin > 1.5x the upper limit of normal at screening alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, or gamma-glutamyl transferase (GGT) > 2x the upper limit of normal at screening. History of severe COVID-19 infection requiring hospitalization, treatment with oxygen or mechanical ventilation, that may interfere with study participation as assessment by the Investigator. Any participant with a medical history of Covid-19 infection (positive test) within the last 2 months, or current symptoms consistent with Covid-19 infection, as assessed by the Investigator. Donated blood during the past 8 weeks. Participants who do not report an increase in subjective opioid effect, as measured by the Drug Effects Questionnaire (DEQ, see below) by minimum of 10% or more to initial challenge with oxycodone in Session 1 will be excluded from the DDI phase sessions 2-7.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Rajita Sinha, PhD
Phone
203-737-5805
Email
rajita.sinha@yale.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Gustavo Angarita
Phone
203-974-7536
Email
Gustavo.angarita@yale.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rajita Sinha, PhD
Organizational Affiliation
Yale University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cmhc/Cnru
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06519
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Talia Mayerson, BS
Email
talia.mayerson@yale.edu
First Name & Middle Initial & Last Name & Degree
Gustavo Angarita, MD
Email
gustavo.angarita@yale.edu
Facility Name
The Yale Stress Center: Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06519
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Emalee Dauginikas, MA
Email
emalee.dauginikas@yale.edu
First Name & Middle Initial & Last Name & Degree
Rachel Hart, MA
Email
rachel.hart@yale.edu
First Name & Middle Initial & Last Name & Degree
Rajita Sinha, PhD

12. IPD Sharing Statement

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Safety, Tolerability and Pharmacokinetics of NYX-783 and Oxycodone DDI Study

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