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EMPOWER AUD Pivotal Trial

Primary Purpose

Alcoholism, Alcohol Abuse, Alcohol Use Disorder

Status
Not yet recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Empower Neuromodulation System
Sponsored by
Theranova, L.L.C.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcoholism focused on measuring Alcoholism, Alcohol Use Disorder

Eligibility Criteria

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

Inclusion Criteria: A candidate for this study must meet ALL of the following inclusion criteria: Women and men ≥21 years of age Individual has a current diagnosis of alcohol use disorder per DSM-5 via M.I.N.I. assessment by clinician Individual has a desire to reduce or quit alcohol use Based on the 28-day TLFB at enrollment, individual has an average daily alcohol consumption in the WHO risk levels of moderate, high, or very high (men: ≥2.91 drinks/day; women: ≥1.41 drinks/day) Individual has a breath alcohol concentration of 0.02% or less at enrollment Individual has a negative urine pregnancy test at screening (females of childbearing age only) Individual is able to provide informed consent Individual is capable and willing to follow all study-related procedures Exclusion Criteria: A candidate will be excluded from the study if ANY of the following conditions are met: Individual has a current, unstable psychiatric disorder per DSM-5 via M.I.N.I. assessment that is clinically significant enough to preclude study participation per the judgment of the study site PIs Individual has been diagnosed with a neurodegenerative disease, including Parkinson's disease, dementia, and Alzheimer's disease Individual has a current substance use disorder (SUD) diagnosis other than alcohol, nicotine, or cannabis per DSM-5 via M.I.N.I. assessment by clinician Individual requires acute medical detoxification from alcohol per based on a score of 12 or more on the Clinical Institute Withdrawal Assessment Alcohol Scale Revised (CIWA-Ar) Individual is taking or plans to start taking an AUD pharmacotherapy during the study Individual has had a change in AUD pharmacotherapy in the past 4 weeks Individual has initiated or discontinued SUD psychotherapy in the past 4 weeks, has had a change in SUD psychotherapy modality in the past 4 weeks, or expects to initiate, discontinue, or change psychotherapy modality during the study Individual has an active implant and/or an implanted electrical or neurostimulator device (e.g., pacemaker, defibrillator, vagal neurostimulator, deep brain stimulator, spinal stimulator, sacral stimulator, bone growth stimulator, or cochlear implant) Individual is currently using, or has used in the past 3 months, transcutaneous electrical nerve stimulation (TENS) in the upper extremities Individual is currently receiving, or has received in the past 3 months, acupuncture, or acupressure in the upper extremities Individual has an electrically conductive metal object (e.g., jewelry) that cannot be removed and will directly contact the gel electrodes of the Empower Neuromodulation System at either treatment location Individual has an open incision, wound, scar, active infection or otherwise compromised skin at the treatment locations and will directly contact the gel electrodes of the Empower Neuromodulation System at either anatomic location Individual has a history of epilepsy or a seizure disorder Individual has been clinically diagnosed with peripheral nerve damage of the upper limbs or has numbness or tingling in an upper limb at least weekly Individual is female and currently pregnant or breastfeeding, has been pregnant within the past 6 months, intends to become pregnant during participation in the study, or is unwilling to practice birth control during participation in the study Individual will not, for the duration of participation in the study, have a living situation that provides regular access to an electrical outlet for charging the study device and smartphone Individual has used an investigational drug, biologic, or medical device in the past 4 weeks Individual is deemed unsuitable for enrollment in the study by the investigator based on the subject's history or physical examination

Sites / Locations

  • University of California, San Francisco
  • Yale University

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

Active Treatment

Sham Treatment

Arm Description

The Active Treatment will use a functional Stimulator system.

The Sham Treatment (Placebo) will use a functional Stimulator system, but will provide a treatment in a location that is believed to have no benefit or harm to the subject.

Outcomes

Primary Outcome Measures

Primary Safety Endpoint: Frequency of device-related Serious AEs (SAEs)
The primary safety endpoint will be comparing the frequency of device-related Serious AEs (SAEs) between the Active and Sham Treatment groups, where device-related SAEs include probably and possibly device-related serious adverse events
Primary Effectiveness Endpoint: Change in WHO risk level via 28-day TLFB
The primary effectiveness endpoint is the responder rate at Week 12, where a responder is a study subject who experiences ≥1 level reduction in the WHO risk level from Baseline to Week 12 via the 28-day Timeline Follow-back (TLFB), and responder rate is the percentage of participants in a treatment group who are responders

Secondary Outcome Measures

Change in Alcohol Craving Intensity via the Penn Alcohol Craving Survey (PACS)
Change in alcohol craving intensity. The change in alcohol craving intensity as assessed via the Penn Alcohol Craving Survey (PACS) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The scale has a range of 0-30 where a higher score indicates more severe cravings.
Change in Heavy Drinking Days (HDD) via 28-day TLFB
Change in heavy drinking days (HDD). The change in HDD as assessed via the 28-day Timeline Follow-Back (TLFB) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups, where a HDD is defined as 5 or more drinks for men and 4 or more drinks for women in one calendar day
Change in Alcohol Related Problems via SIP
Change in alcohol-related problems. The change in alcohol-related problems as assessed via the Short Index of Problems (SIP) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The total score has a range of 0-15 where a higher total indicates more problems.
Change in Alcohol Consumption via PEth analysis
Change in phosphatidylethanol (PEth)-based evaluation of alcohol consumption. The change in alcohol consumption as assessed via PEth analysis from Baseline to Week 12 will be compared between the Active and Sham Treatment groups.
Change in Alcohol Craving Intensity via daily self reports
Change in daily alcohol craving intensity. The change in daily alcohol craving intensity as assessed via daily self-reports on the Empower app (100-point Visual Analog Scale (VAS)) from Week 1 to Week 12 will be compared between the Active and Sham Treatment groups. The scale range is 0-100, where the higher rating indicates higher level of alcohol cravings.
Improvement in Clinician Assessment of Illness via CGI
Improvement in clinician assessment of illness. The clinician assessment of improvement in illness as assessed via Clinical Global Impression (CGI) at Week 12 will be compared between the Active and Sham Treatment groups.

Full Information

First Posted
May 12, 2023
Last Updated
July 26, 2023
Sponsor
Theranova, L.L.C.
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1. Study Identification

Unique Protocol Identification Number
NCT05948605
Brief Title
EMPOWER AUD Pivotal Trial
Official Title
Evaluation of the Empower Neuromodulation System for the Treatment of Alcohol Use Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
August 1, 2023 (Anticipated)
Primary Completion Date
May 1, 2024 (Anticipated)
Study Completion Date
May 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Theranova, L.L.C.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Multi-site, double-blinded, prospective, randomized, sham-controlled study
Detailed Description
To evaluate the safety and effectiveness of the Empower Neuromodulation System in alcohol use disorder (AUD) patients. The primary safety endpoint will be device-related serious adverse events. The primary effectiveness endpoint will be responder rate at 12 weeks, where a responder is defined as a subject who experiences at least a one level reduction in the WHO risk level for daily alcohol consumption from Baseline to Week 12 as measured via the 28-day Timeline Follow-back (TLFB). Responder rate will be compared between subjects randomized to the active treatment vs. the sham treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcoholism, Alcohol Abuse, Alcohol Use Disorder
Keywords
Alcoholism, Alcohol Use Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Multi-center, double-blinded, prospective, randomized, sham-controlled study
Masking
ParticipantCare ProviderInvestigator
Masking Description
Site staff are blinded to the subject's assigned Arm.
Allocation
Randomized
Enrollment
128 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active Treatment
Arm Type
Active Comparator
Arm Description
The Active Treatment will use a functional Stimulator system.
Arm Title
Sham Treatment
Arm Type
Sham Comparator
Arm Description
The Sham Treatment (Placebo) will use a functional Stimulator system, but will provide a treatment in a location that is believed to have no benefit or harm to the subject.
Intervention Type
Device
Intervention Name(s)
Empower Neuromodulation System
Intervention Description
The Empower Neuromodulation System is designed to provide transcutaneous stimulation to the branches of a spinal nerve. The system comprised of three key components: (A) The Stimulator, (B) the Empower smartphone app, and (C) the Gel Patch. The smartphone application is used to coordinate treatment and record participant responses.
Primary Outcome Measure Information:
Title
Primary Safety Endpoint: Frequency of device-related Serious AEs (SAEs)
Description
The primary safety endpoint will be comparing the frequency of device-related Serious AEs (SAEs) between the Active and Sham Treatment groups, where device-related SAEs include probably and possibly device-related serious adverse events
Time Frame
Week 12
Title
Primary Effectiveness Endpoint: Change in WHO risk level via 28-day TLFB
Description
The primary effectiveness endpoint is the responder rate at Week 12, where a responder is a study subject who experiences ≥1 level reduction in the WHO risk level from Baseline to Week 12 via the 28-day Timeline Follow-back (TLFB), and responder rate is the percentage of participants in a treatment group who are responders
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
Change in Alcohol Craving Intensity via the Penn Alcohol Craving Survey (PACS)
Description
Change in alcohol craving intensity. The change in alcohol craving intensity as assessed via the Penn Alcohol Craving Survey (PACS) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The scale has a range of 0-30 where a higher score indicates more severe cravings.
Time Frame
Week 12
Title
Change in Heavy Drinking Days (HDD) via 28-day TLFB
Description
Change in heavy drinking days (HDD). The change in HDD as assessed via the 28-day Timeline Follow-Back (TLFB) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups, where a HDD is defined as 5 or more drinks for men and 4 or more drinks for women in one calendar day
Time Frame
Week 12
Title
Change in Alcohol Related Problems via SIP
Description
Change in alcohol-related problems. The change in alcohol-related problems as assessed via the Short Index of Problems (SIP) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The total score has a range of 0-15 where a higher total indicates more problems.
Time Frame
Week 12
Title
Change in Alcohol Consumption via PEth analysis
Description
Change in phosphatidylethanol (PEth)-based evaluation of alcohol consumption. The change in alcohol consumption as assessed via PEth analysis from Baseline to Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Title
Change in Alcohol Craving Intensity via daily self reports
Description
Change in daily alcohol craving intensity. The change in daily alcohol craving intensity as assessed via daily self-reports on the Empower app (100-point Visual Analog Scale (VAS)) from Week 1 to Week 12 will be compared between the Active and Sham Treatment groups. The scale range is 0-100, where the higher rating indicates higher level of alcohol cravings.
Time Frame
Week 12
Title
Improvement in Clinician Assessment of Illness via CGI
Description
Improvement in clinician assessment of illness. The clinician assessment of improvement in illness as assessed via Clinical Global Impression (CGI) at Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Other Pre-specified Outcome Measures:
Title
Exploratory Effectiveness - Responder Rate Week 6
Description
Responder rate at Week 6. The percentage of responders at 6 weeks will be compared between the Active and Sham Treatment groups.
Time Frame
Week 6
Title
Exploratory Effectiveness - Drink reduction Week 12 via TLFB
Description
Change in alcoholic drinks consumed at Week 12. The change in average alcoholic drinks consumed per day as assessed via the 28-day TLFB from Baseline to Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Title
Exploratory Effectiveness - % Drink change Week 12 via TLFB
Description
Percent reduction in alcoholic drinks consumed at Week 12. The percent change in average alcoholic drinks consumed per day as assessed via the 28-day TLFB from Baseline to Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Title
Exploratory Effectiveness - Drinks change at Week 6
Description
Change in alcoholic drinks consumed at Week 6. The change in average alcoholic drinks consumed per day as assessed via the 28-day TLFB from Baseline to Week 6 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 6
Title
Exploratory Effectiveness - Drink change Week 12 via App
Description
Change in alcoholic drinks consumed at Week 12. The change in average alcoholic drinks consumed per day as assessed via the daily self-reports on the Empower app from Baseline to Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Title
Exploratory Effectiveness - % Drink change Week 12 via App
Description
Percent change in alcoholic drinks consumed at Week 12. The percent change in average alcoholic drinks consumed per day as assessed via the daily self-reports on the Empower app from Baseline to Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Title
Exploratory Effectiveness - Drink change Week 6 via App
Description
Change in alcoholic drinks consumed at Week 6. The change in average alcoholic drinks consumed per day as assessed via the daily self-reports on the Empower app from Baseline to Week 6 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 6
Title
Exploratory Effectiveness - Change in HDD at Week 6 via TLFB
Description
Change in HDD at Week 6. The change in HDD as assessed via the 28-day TLFB from Baseline to Week 6 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 6
Title
Exploratory Effectiveness - Abstinence at Week 12 via TLFB
Description
Abstinence at Week 12. The percent of subjects who are abstinent at Week 12 as assessed via the 28-day TLFB at Week 12 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 12
Title
Exploratory Effectiveness - Alcohol consumption at Week 6 via PEth
Description
Change in PEth-based evaluation of alcohol consumption at Week 6. The change in alcohol consumption as assessed via PEth analysis from Baseline to Week 6 will be compared between the Active and Sham Treatment groups.
Time Frame
Week 6
Title
Exploratory Effectiveness - Alcohol craving reduction at Week 6 via PACS
Description
Change in alcohol craving intensity at Week 6. The change in alcohol craving intensity as assessed via the Penn Alcohol Craving Scale (PACS) from Baseline to Week 6 will be compared between the Active and Sham Treatment groups. The scale has a range of 0-30 where a higher score indicates more severe cravings.
Time Frame
Week 6
Title
Exploratory Effectiveness - Alcohol craving at Week 12 via PACS
Description
Percent change in alcohol craving intensity at Week 12. The percent change in alcohol craving intensity as assessed via the PACS from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The scale has a range of 0-30 where a higher score indicates more severe cravings.
Time Frame
Week 12
Title
Exploratory Effectiveness - Alcohol craving change at Week 6 via VAS
Description
Change in daily alcohol craving intensity at Week 6. The change in daily alcohol craving intensity as assessed via daily self-reports on the Empower app (100-point Visual Analog Scale (VAS)) from Week 1 to Week 6 will be compared between the Active and Sham Treatment groups. For each subject, the average craving score per day will be calculated for each study week from the daily surveys, and the average score for Week 1 will be compared against the average score for Week 6. The scale range is 0-100, where the higher rating indicates higher level of alcohol cravings.
Time Frame
Week 6
Title
Exploratory Effectiveness - Alcohol craving % change at Week 12 via VAS
Description
Percent reduction in daily alcohol craving intensity at Week 12. The percent change in daily alcohol craving intensity as assessed via daily self-reports on the Empower app (100-point Visual Analog Scale (VAS)) from Week 1 to Week 12 will be compared between the Active and Sham Treatment groups. For each subject, the average craving score per day will be calculated for each study week from the daily surveys. The scale range is 0-100, where the higher rating indicates higher level of alcohol cravings.
Time Frame
Week 12
Title
Exploratory Effectiveness - Change in alcohol-related problems at Week 6 via SIP
Description
Change in alcohol-related problems at Week 6. The change in alcohol-related problems as assessed via the SIP from Baseline to Week 6 will be compared between the Active and Sham Treatment groups. The total score has a range of 0-15 where a higher total indicates more problems.
Time Frame
Week 6
Title
Exploratory Effectiveness - Change in anxiety at Week 12 via BAI
Description
Change in anxiety at Week 12. The change in anxiety as assessed via the Beck Anxiety Inventory (BAI) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The total score has a range of 0-63 where a higher total indicates more severe anxiety.
Time Frame
Week 12
Title
Exploratory Effectiveness - Change in depression at Week 12 via PHQ-9
Description
Change in depression at Week 12. The change in depression as assessed via the Patient Health Questionnaire (PHQ-9) from Baseline to Week 12 will be compared between the Active and Sham Treatment groups. The questionnaire scoring ranges from 0-27 where the higher number indicates higher level of depression.
Time Frame
Week 12
Title
Exploratory Effectiveness - Satisfaction with treatment at Week 12 via VAS
Description
Satisfaction with treatment. Satisfaction with treatment as assessed via 100-mm Visual Analog Scale (VAS) at Week 12 will be compared between the Active and Sham Treatment groups. The scale range is 0-100, where the higher rating indicates higher level of satisfaction with the device and phone app.
Time Frame
Week 12
Title
Exploratory Effectiveness - System Usability at Week 12 via SUS
Description
Usability. System usability as assessed via the SUS at Week 12 will be compared between the Active and Sham Treatment groups. Scores from the Active Treatment group will also be compared against benchmarks for average score (SUS=68) and excellent score (SUS=80).
Time Frame
Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A candidate for this study must meet ALL of the following inclusion criteria: Women and men ≥21 years of age Individual has a current diagnosis of alcohol use disorder per DSM-5 via M.I.N.I. assessment by clinician Individual has a desire to reduce or quit alcohol use Based on the 28-day TLFB at enrollment, individual has an average daily alcohol consumption in the WHO risk levels of moderate, high, or very high (men: ≥2.91 drinks/day; women: ≥1.41 drinks/day) Individual has a breath alcohol concentration of 0.02% or less at enrollment Individual has a negative urine pregnancy test at screening (females of childbearing age only) Individual is able to provide informed consent Individual is capable and willing to follow all study-related procedures Exclusion Criteria: A candidate will be excluded from the study if ANY of the following conditions are met: Individual has a current, unstable psychiatric disorder per DSM-5 via M.I.N.I. assessment that is clinically significant enough to preclude study participation per the judgment of the study site PIs Individual has been diagnosed with a neurodegenerative disease, including Parkinson's disease, dementia, and Alzheimer's disease Individual has a current substance use disorder (SUD) diagnosis other than alcohol, nicotine, or cannabis per DSM-5 via M.I.N.I. assessment by clinician Individual requires acute medical detoxification from alcohol per based on a score of 12 or more on the Clinical Institute Withdrawal Assessment Alcohol Scale Revised (CIWA-Ar) Individual is taking or plans to start taking an AUD pharmacotherapy during the study Individual has had a change in AUD pharmacotherapy in the past 4 weeks Individual has initiated or discontinued SUD psychotherapy in the past 4 weeks, has had a change in SUD psychotherapy modality in the past 4 weeks, or expects to initiate, discontinue, or change psychotherapy modality during the study Individual has an active implant and/or an implanted electrical or neurostimulator device (e.g., pacemaker, defibrillator, vagal neurostimulator, deep brain stimulator, spinal stimulator, sacral stimulator, bone growth stimulator, or cochlear implant) Individual is currently using, or has used in the past 3 months, transcutaneous electrical nerve stimulation (TENS) in the upper extremities Individual is currently receiving, or has received in the past 3 months, acupuncture, or acupressure in the upper extremities Individual has an electrically conductive metal object (e.g., jewelry) that cannot be removed and will directly contact the gel electrodes of the Empower Neuromodulation System at either treatment location Individual has an open incision, wound, scar, active infection or otherwise compromised skin at the treatment locations and will directly contact the gel electrodes of the Empower Neuromodulation System at either anatomic location Individual has a history of epilepsy or a seizure disorder Individual has been clinically diagnosed with peripheral nerve damage of the upper limbs or has numbness or tingling in an upper limb at least weekly Individual is female and currently pregnant or breastfeeding, has been pregnant within the past 6 months, intends to become pregnant during participation in the study, or is unwilling to practice birth control during participation in the study Individual will not, for the duration of participation in the study, have a living situation that provides regular access to an electrical outlet for charging the study device and smartphone Individual has used an investigational drug, biologic, or medical device in the past 4 weeks Individual is deemed unsuitable for enrollment in the study by the investigator based on the subject's history or physical examination
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Aaron Miller
Phone
4159268616
Email
ClinicalStudy@TheraNova.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Burnett, MD
Organizational Affiliation
TheraNova, LLC
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Steven L Batki, MD
First Name & Middle Initial & Last Name & Degree
David Pennington, PhD
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06516
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ismene Petrakis, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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EMPOWER AUD Pivotal Trial

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