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HORIZANT (Gabapentin Enacarbil Extended-Release Tablets) for the Treatment of Alcohol Use Disorder

Primary Purpose

Alcohol Use Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
gabapentin enacarbil
Placebo
Sponsored by
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcohol Use Disorder focused on measuring alcohol use disorder, alcoholism, alcohol dependence, drinking alcohol

Eligibility Criteria

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

Inclusion Criteria:

Subjects must meet each one of the following inclusion criteria in order to be eligible for participation in the study:

  1. Be at least 21 years of age.
  2. Have a current (past 12 months) DSM-5 diagnosis of AUD.
  3. Have a BAC by breathalyzer equal to 0.000 when s/he signed the informed consent document (either just prior to or immediately after signing consent).
  4. Be seeking treatment for problems with alcohol.

Additional will be evaluated in clinic.

Exclusion Criteria:

Evaluations will be conducted in clinic.

Sites / Locations

  • University of California Los Angeles
  • Friends Research Institute
  • University of Miami, Miller School of Medicine
  • Johns Hopkins University School of Medicine
  • Boston University Medical Center
  • Dartmouth-Hitchcock Medical Center
  • Mount Sinai St. Luke's Hospital
  • University of Pennsylvania
  • The University of Texas Southwestern Medical Center
  • University of Virginia

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Sugar Pill

Gabapentin Enacarbil

Arm Description

Matching placebo, sugar pill

600 mg Gabapentin Enacarbil (Horizant)

Outcomes

Primary Outcome Measures

Percentage of Subjects With no Heavy Drinking Days (PSNHDD)
The primary objective of the study is to compare the efficacy of HORIZANT (gabapentin enacarbil) Extended-Release Tablets 600 mg twice daily (BID) with matched placebo on the primary alcohol consumption outcome endpoint, percentage of subjects with no heavy drinking days (PSNHDD) during the last 4 weeks of treatment, among patients with Alcohol Use Disorder (AUD).

Secondary Outcome Measures

Percentage of Subjects Abstinent From Alcohol (Key Secondary Endpoint)
Timeline Follow-back drinking data is used to calculate the % of subjects that report not drinking alcohol during weeks 22-25
Percentage of Subjects With a World Health Organization (WHO) Drinking Risk Category Decrease of at Least 1-level
Timeline Follow Back data is used to calculate the % of participants that decrease at least 1-level WHO drinking risk category. The WHO has developed a drinking risk categorical scale that can be used in a responder analysis approach to assess clinically relevant decreases in alcohol consumption (Aubin et al-2015). The WHO 1- and 2-level decrease endpoints are the percentage of subjects experiencing at least 1- and 2-level decrease in WHO levels of alcohol consumption, respectively, from the level at baseline (the period including the 28 days before screening) to the level during the last 4 weeks of the maintenance phase (Study Weeks 22-25). The WHO levels are as follows: Males Females Low Risk 1 to 40g 1 to 20g Medium Risk 41 to 60g 21 to 40g High Risk 61 to 100g 41 to 60g Very High Risk 101+g 61+g
Percentage of Subjects With a World Health Organization (WHO) Drinking Risk Category Decrease of at Least 2-levels
Timeline Follow Back data is used to calculate the % of participants that decrease at least 1-level WHO drinking risk category. The WHO has developed a drinking risk categorical scale that can be used in a responder analysis approach to assess clinically relevant decreases in alcohol consumption (Aubin et al-2015). The WHO 1- and 2-level decrease endpoints are the percentage of subjects experiencing at least 1- and 2-level decrease in WHO levels of alcohol consumption, respectively, from the level at baseline (the period including the 28 days before screening) to the level during the last 4 weeks of the maintenance phase (Study Weeks 22-25). The WHO levels are as follows: Males Females Low Risk 1 to 40g 1 to 20g Medium Risk 41 to 60g 21 to 40g High Risk 61 to 100g 41 to 60g Very High Risk 101+g 61+g
Percentage of Days Abstinent Per Week
Timeline Follow Back daily drinking data used to calculate the % of days abstinent per week.
Percentage of Heavy Drinking Days Per Week
Timeline Follow Back data used to calculate the % of heavy drinking days per week. Heavy drinking is 4+ drinks per day for females and 5+ drinks per day for males
Weekly Mean Number of Drinks Per Week
Timeline Follow Back data used to calculate the weekly mean number of drinks per week
Weekly Mean Drinks Per Drinking Day
Timeline Follow Back daily drinking data used to calculate the weekly mean drinks per drinking day
Cigarettes Per Week Among Smokers
A quantity frequency interview of three questions to assess cigarette smoking behavior and other tobacco/nicotine containing products use during the study: 1) "Over the past week, on how many days did you smoke cigarettes?", 2) "On the days you smoked during the past week, how many cigarettes did you smoke on average?", and 3) "Have you used any other tobacco or nicotine containing products besides cigarettes in the past week (e.g., cigars, cigarellos, pipes, bidis, or smokeless tobacco such as pan, chewing tobacco, or snuff, or nicotine replacement therapies such as patch or gum)?".
Alcohol Craving Score [Alcohol Craving Scale - Short Form (ACQ-SR-R)]
The ACQ-SR-R contains 12-items adapted from the 47-item ACQ-NOW developed by Singleton et al (1994) to assess craving for alcohol among alcohol users in the current context (right now). Each item has a 1 to 7 raw score (from strongly disagree to strongly agree). Items 3, 8, and 11 are reverse keyed. A general craving index is derived by summing all items and dividing by 12. Minimum score is 1 and maximum score is 7. Higher scores are indicative of higher craving. Mixed effects models as stated in Section 9.4.3 of the SAP will be generated for the total score and for the 4 subscales. Covariates for these models will be identified
Alcohol Related Consequences (ImBIBe) Score
ImBIBe is a 15-item questionnaire in which the subject responds on a 5-point scale (0-4) responses to questions on the consequences of alcohol use. This scale was adapted from the Drinker Inventory of Consequences questionnaire based on FDA recommendations on patient reported outcomes (Miller & Tonigen-1995). The potential range is 0-60. A higher score indicates a worse outcome. The questions are added together. A question that is missing is imputed with the average value of all other questions in the questionnaire.The total score is the sum of the individual item scores. Mixed effects models as stated in Section 9.4.3 will be generated for the total score. Covariates for these models will be identified
Pittsburgh Sleep Quality Index (PSQI) Score
The PSQI is a 19-item questionnaire assessing the subject's overall sleep experience in the past 30 days (Buysse et al-1989). The lower the overall score, the better the person sleeps. The tool has an adequate internal reliability, validity and consistency for clinical and community samples of the various populations. Range is (0-21); >6 indicative of "poor" sleep quality.
Beck Anxiety Inventory (BAI) Score
The BAI consists of 21 questions about how the subject has been feeling in the last week, expressed as common symptoms of anxiety (such as numbness and tingling, sweating not due to heat, and fear of the worst happening). This inventory was designed to minimize the overlap with depression scales (Beck et al-1988).The BAI has a maximum score of 63. The standardized cutoffs for anxiety severity are: 0-7: minimal level of anxiety 8-15: mild anxiety 16-25: moderate anxiety 26-63: severe anxiety
Beck Depression Inventory - II
The BDI-II is a 21-item multiple choice questionnaire that is used for measuring the severity of depression (Beck et al-1966). Each item is scored on a scale value of 0 to 3. The standardized cutoffs for depression severity are: 0-13: minimal depression 14-19: mild depression 20-28: moderate depression 29-63: severe depression

Full Information

First Posted
September 26, 2014
Last Updated
October 15, 2018
Sponsor
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Collaborators
Arbor Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02252536
Brief Title
HORIZANT (Gabapentin Enacarbil Extended-Release Tablets) for the Treatment of Alcohol Use Disorder
Official Title
Randomized, Double Blind, Placebo-Controlled Trial of the Safety and Efficacy of HORIZANT (Gabapentin Enacarbil) Extended-Release Tablets for the Treatment of Alcohol Use Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
March 2017 (Actual)
Study Completion Date
March 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Collaborators
Arbor Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether gabapentin enacarbil is effective in the treatment of problems with alcohol.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcohol Use Disorder
Keywords
alcohol use disorder, alcoholism, alcohol dependence, drinking alcohol

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
346 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sugar Pill
Arm Type
Placebo Comparator
Arm Description
Matching placebo, sugar pill
Arm Title
Gabapentin Enacarbil
Arm Type
Active Comparator
Arm Description
600 mg Gabapentin Enacarbil (Horizant)
Intervention Type
Drug
Intervention Name(s)
gabapentin enacarbil
Other Intervention Name(s)
Horizant Extended Release Tablets
Intervention Description
Horizant Extended Release Tablets, 600 mg, white to off-white, oval shaped tablets, taken 2 times per day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablet, white to off-white, oval shaped tablets, taken 2 times per day
Primary Outcome Measure Information:
Title
Percentage of Subjects With no Heavy Drinking Days (PSNHDD)
Description
The primary objective of the study is to compare the efficacy of HORIZANT (gabapentin enacarbil) Extended-Release Tablets 600 mg twice daily (BID) with matched placebo on the primary alcohol consumption outcome endpoint, percentage of subjects with no heavy drinking days (PSNHDD) during the last 4 weeks of treatment, among patients with Alcohol Use Disorder (AUD).
Time Frame
Weeks 22-25
Secondary Outcome Measure Information:
Title
Percentage of Subjects Abstinent From Alcohol (Key Secondary Endpoint)
Description
Timeline Follow-back drinking data is used to calculate the % of subjects that report not drinking alcohol during weeks 22-25
Time Frame
Weeks 22-25
Title
Percentage of Subjects With a World Health Organization (WHO) Drinking Risk Category Decrease of at Least 1-level
Description
Timeline Follow Back data is used to calculate the % of participants that decrease at least 1-level WHO drinking risk category. The WHO has developed a drinking risk categorical scale that can be used in a responder analysis approach to assess clinically relevant decreases in alcohol consumption (Aubin et al-2015). The WHO 1- and 2-level decrease endpoints are the percentage of subjects experiencing at least 1- and 2-level decrease in WHO levels of alcohol consumption, respectively, from the level at baseline (the period including the 28 days before screening) to the level during the last 4 weeks of the maintenance phase (Study Weeks 22-25). The WHO levels are as follows: Males Females Low Risk 1 to 40g 1 to 20g Medium Risk 41 to 60g 21 to 40g High Risk 61 to 100g 41 to 60g Very High Risk 101+g 61+g
Time Frame
Weeks 22-25
Title
Percentage of Subjects With a World Health Organization (WHO) Drinking Risk Category Decrease of at Least 2-levels
Description
Timeline Follow Back data is used to calculate the % of participants that decrease at least 1-level WHO drinking risk category. The WHO has developed a drinking risk categorical scale that can be used in a responder analysis approach to assess clinically relevant decreases in alcohol consumption (Aubin et al-2015). The WHO 1- and 2-level decrease endpoints are the percentage of subjects experiencing at least 1- and 2-level decrease in WHO levels of alcohol consumption, respectively, from the level at baseline (the period including the 28 days before screening) to the level during the last 4 weeks of the maintenance phase (Study Weeks 22-25). The WHO levels are as follows: Males Females Low Risk 1 to 40g 1 to 20g Medium Risk 41 to 60g 21 to 40g High Risk 61 to 100g 41 to 60g Very High Risk 101+g 61+g
Time Frame
Weeks 22-25
Title
Percentage of Days Abstinent Per Week
Description
Timeline Follow Back daily drinking data used to calculate the % of days abstinent per week.
Time Frame
Weeks 22-25
Title
Percentage of Heavy Drinking Days Per Week
Description
Timeline Follow Back data used to calculate the % of heavy drinking days per week. Heavy drinking is 4+ drinks per day for females and 5+ drinks per day for males
Time Frame
Weeks 22-25
Title
Weekly Mean Number of Drinks Per Week
Description
Timeline Follow Back data used to calculate the weekly mean number of drinks per week
Time Frame
Weeks 22-25
Title
Weekly Mean Drinks Per Drinking Day
Description
Timeline Follow Back daily drinking data used to calculate the weekly mean drinks per drinking day
Time Frame
Weeks 22-25
Title
Cigarettes Per Week Among Smokers
Description
A quantity frequency interview of three questions to assess cigarette smoking behavior and other tobacco/nicotine containing products use during the study: 1) "Over the past week, on how many days did you smoke cigarettes?", 2) "On the days you smoked during the past week, how many cigarettes did you smoke on average?", and 3) "Have you used any other tobacco or nicotine containing products besides cigarettes in the past week (e.g., cigars, cigarellos, pipes, bidis, or smokeless tobacco such as pan, chewing tobacco, or snuff, or nicotine replacement therapies such as patch or gum)?".
Time Frame
Weeks 22-25
Title
Alcohol Craving Score [Alcohol Craving Scale - Short Form (ACQ-SR-R)]
Description
The ACQ-SR-R contains 12-items adapted from the 47-item ACQ-NOW developed by Singleton et al (1994) to assess craving for alcohol among alcohol users in the current context (right now). Each item has a 1 to 7 raw score (from strongly disagree to strongly agree). Items 3, 8, and 11 are reverse keyed. A general craving index is derived by summing all items and dividing by 12. Minimum score is 1 and maximum score is 7. Higher scores are indicative of higher craving. Mixed effects models as stated in Section 9.4.3 of the SAP will be generated for the total score and for the 4 subscales. Covariates for these models will be identified
Time Frame
Weeks 24 and 26
Title
Alcohol Related Consequences (ImBIBe) Score
Description
ImBIBe is a 15-item questionnaire in which the subject responds on a 5-point scale (0-4) responses to questions on the consequences of alcohol use. This scale was adapted from the Drinker Inventory of Consequences questionnaire based on FDA recommendations on patient reported outcomes (Miller & Tonigen-1995). The potential range is 0-60. A higher score indicates a worse outcome. The questions are added together. A question that is missing is imputed with the average value of all other questions in the questionnaire.The total score is the sum of the individual item scores. Mixed effects models as stated in Section 9.4.3 will be generated for the total score. Covariates for these models will be identified
Time Frame
Weeks 24 and 26
Title
Pittsburgh Sleep Quality Index (PSQI) Score
Description
The PSQI is a 19-item questionnaire assessing the subject's overall sleep experience in the past 30 days (Buysse et al-1989). The lower the overall score, the better the person sleeps. The tool has an adequate internal reliability, validity and consistency for clinical and community samples of the various populations. Range is (0-21); >6 indicative of "poor" sleep quality.
Time Frame
Week 26
Title
Beck Anxiety Inventory (BAI) Score
Description
The BAI consists of 21 questions about how the subject has been feeling in the last week, expressed as common symptoms of anxiety (such as numbness and tingling, sweating not due to heat, and fear of the worst happening). This inventory was designed to minimize the overlap with depression scales (Beck et al-1988).The BAI has a maximum score of 63. The standardized cutoffs for anxiety severity are: 0-7: minimal level of anxiety 8-15: mild anxiety 16-25: moderate anxiety 26-63: severe anxiety
Time Frame
Week 26
Title
Beck Depression Inventory - II
Description
The BDI-II is a 21-item multiple choice questionnaire that is used for measuring the severity of depression (Beck et al-1966). Each item is scored on a scale value of 0 to 3. The standardized cutoffs for depression severity are: 0-13: minimal depression 14-19: mild depression 20-28: moderate depression 29-63: severe depression
Time Frame
Week 26

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must meet each one of the following inclusion criteria in order to be eligible for participation in the study: Be at least 21 years of age. Have a current (past 12 months) DSM-5 diagnosis of AUD. Have a BAC by breathalyzer equal to 0.000 when s/he signed the informed consent document (either just prior to or immediately after signing consent). Be seeking treatment for problems with alcohol. Additional will be evaluated in clinic. Exclusion Criteria: Evaluations will be conducted in clinic.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Raye Z. Litten, Ph.D.
Organizational Affiliation
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Official's Role
Study Chair
Facility Information:
Facility Name
University of California Los Angeles
City
Los Angeles
State/Province
California
Country
United States
Facility Name
Friends Research Institute
City
San Francisco
State/Province
California
ZIP/Postal Code
94103
Country
United States
Facility Name
University of Miami, Miller School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Johns Hopkins University School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Facility Name
Boston University Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Mount Sinai St. Luke's Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10025
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
The University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22911
Country
United States

12. IPD Sharing Statement

Learn more about this trial

HORIZANT (Gabapentin Enacarbil Extended-Release Tablets) for the Treatment of Alcohol Use Disorder

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