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Multisite Controlled Trial of Cocaine Vaccine (TA-CD)

Primary Purpose

Cocaine Dependence

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
TA-CD Vaccination
Placebo Injection
Sponsored by
Baylor College of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cocaine Dependence focused on measuring Cocaine Vaccine, TA-CD 09

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA:

  1. Male or female. Females either must be of non-child bearing potential (i.e., surgically sterilized or postmenopausal) or must be using adequate contraception, have a negative pregnancy test, and must agree to continue to use such precautions for 3 months after the last vaccination;
  2. Meets DSM-IV-TR criteria for a principal diagnosis of cocaine dependence as confirmed by the MINI;
  3. Motivated to discontinue or reduce cocaine use during the period of the study as evidenced both by the judgment of the Investigator or designee and by the subject providing at least 2 urine samples in each of the 2 baseline weeks;
  4. In good general health as determined by medical history, general clinical examination, laboratory tests;
  5. Has provided written informed consent. Subjects should be cooperative, willing and able to participate and adhere to the Protocol requirements.

EXCLUSION CRITERIA:

  1. Subject is cocaine-free (i.e., negative urine results [BE level]) during the 2-week screening period;
  2. Subject has known immunodeficiency or has a history of autoimmune disease or hypersensitivity to other vaccines. A human immunodeficiency virus (HIV) test must be performed at Screening and reported as negative for HIV-1 and HIV-2;
  3. Currently taking medication known to have significant immunosuppressive effects such as systemic glucocorticoids (topical and inhaled formulations are permitted) or oral systemic corticosteroids, within 30 days prior to randomization;
  4. Currently taking a dopaminergic, dopamine-blocking, dopamine-modulating, or other central dopamine-altering drug (e.g., antipsychotic drugs); a monoamine oxidase inhibitor (MAOI); or an opiate antagonist;
  5. Subject has an unstable medical, neurologic, or psychiatric illness that would interfere with the subject's safety, ability to participate in the study, or the interpretability of data. Subjects who meet the DSM-IV-TR criteria for psychosis, schizophrenia, bipolar disorder or clinically significant suicidal ideation;
  6. Subject had dependence on benzodiazepines, barbiturates, opiates or amphetamines according to DSM-IV-TR during the year prior to Screening. Opioid dependence includes methadone or buprenorphine maintenance treatment;
  7. Subject requiring medical detox for alcohol dependence;
  8. History of sensitivity to aluminium hydroxide gel;
  9. History of severe adverse reaction to cholera vaccine;
  10. Subject had previous vaccination with TA-CD;
  11. Subject received other vaccines, including flu vaccine, within 14 days prior to signing consent;
  12. Subject has participated in another clinical trial or received any other investigational compound within 14 days prior to signing consent;
  13. Subject has received blood or blood products within the 3 months prior to signing consent;
  14. Subject has liver function tests greater than 3 times the upper limit of normal at Screening;
  15. Subject has systolic blood pressure higher than 140 mmHg and/or diastolic blood pressure >90 mmHg;
  16. Female subjects with a positive pregnancy test, lactating mothers, women refusing to agree to adequate contraception and pregnancy tests during the study, or women who are planning to become pregnant during the period of the trial. Acceptable contraceptive methods are oral or parenteral hormonal contraceptives, intrauterine device (IUD), or barrier and spermicide, but not abstinence;
  17. Male subjects refusing to agree to adequate contraception during the study, or males who are part of a couple planning to become pregnant during the period of the trial;
  18. People who are involuntarily detained in a penal institution or people who become involuntarily detained during the study;
  19. Any other factor that in the opinion of the Investigator or designee would make the subject unsafe or unsuitable for the study.

Sites / Locations

  • Johns Hopkins University
  • NYU Langone Medical Center
  • Substance Abuse Treatment and Research Service (Downtown)
  • Cincinnati Addiction Research Center
  • University of Pennsylvania
  • Baylor College of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo injection

TA-CD Vaccination

Arm Description

TA-CD placebo will be administered intra muscular. A total of 5 injections will be given over 12 weeks (i.e., at Day 1 and at the beginning of Weeks 3, 5, 9 and 13).

TA-CD 400 μg will be administered intramuscular. A total of 5 injections will be given over 12 weeks (i.e., at Day 1 and at the beginning of Weeks 3, 5, 9 and 13).

Outcomes

Primary Outcome Measures

Cocaine Abstinence During Weeks 9 to 16 Inclusive
Number of patients having at least 2 weeks of cocaine-free urines between weeks 9-16 after vaccination with five doses of TA-CD 400 µg compared to placebo

Secondary Outcome Measures

•The Immunogenicity of TA-CD;
Peak antibody levels after five vaccinations with TA-CD, which occurred at week 16.

Full Information

First Posted
August 31, 2009
Last Updated
February 4, 2017
Sponsor
Baylor College of Medicine
Collaborators
National Institute on Drug Abuse (NIDA), US Department of Veterans Affairs Cooperative Studies Program, VA Maryland Health Care System, Columbia University, VA New York Harbor Healthcare System, University of Pennsylvania, Johns Hopkins University, University of Cincinnati, Celtic Pharma Development Services
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1. Study Identification

Unique Protocol Identification Number
NCT00969878
Brief Title
Multisite Controlled Trial of Cocaine Vaccine
Acronym
TA-CD
Official Title
A Double-Blind, Randomized, Placebo-Controlled, Multi-Center Study to Assess the Clinical Efficacy, Safety, and Immunogenicity of a Human Cocaine Vaccine (TA-CD) in the Treatment of Cocaine Dependence
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
August 2010 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Baylor College of Medicine
Collaborators
National Institute on Drug Abuse (NIDA), US Department of Veterans Affairs Cooperative Studies Program, VA Maryland Health Care System, Columbia University, VA New York Harbor Healthcare System, University of Pennsylvania, Johns Hopkins University, University of Cincinnati, Celtic Pharma Development Services

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to test the efficacy of a newly developed active vaccine against cocaine (TA-CD).
Detailed Description
This 18-week, placebo-controlled randomized clinical trial among 300 cocaine dependent patients is designed to test the efficacy of a newly developed active vaccine against cocaine (TA-CD). TA-CD vaccine consists of succinylnorcocaine (SNC) coupled to a recombinant cholera toxin B subunit (rCTB) and is designed to raise anti-cocaine antibodies in the circulation to bind to cocaine entering the bloodstream, following administration by intravenous or intranasal routes or by smoking. The antigen-antibody complexes will be too large to cross the blood-brain barrier, preventing high concentrations of cocaine reaching the brain's nucleus accumbens thereby blocking the pleasurable response to cocaine and reducing rates of drug use. The effectiveness of the vaccine is dependent on inducing sufficient levels of anti-cocaine antibodies to match the challenge from a subsequent dose of cocaine. Because TA-CD takes several weeks to generate an antibody response, we plan to use contingency management in this interval to sustain treatment engagement. Furthermore, since TA-CD may prove most effective in patients where the antibodies can prevent a cocaine slip from turning into a binge (or return to regular use) by attenuating the priming effect, we are complementing the vaccine by using cognitive behavioral therapy (CBT) to teach patients how to cope with this priming effect and prevent a full relapse.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cocaine Dependence
Keywords
Cocaine Vaccine, TA-CD 09

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Placebo injection
Arm Type
Placebo Comparator
Arm Description
TA-CD placebo will be administered intra muscular. A total of 5 injections will be given over 12 weeks (i.e., at Day 1 and at the beginning of Weeks 3, 5, 9 and 13).
Arm Title
TA-CD Vaccination
Arm Type
Experimental
Arm Description
TA-CD 400 μg will be administered intramuscular. A total of 5 injections will be given over 12 weeks (i.e., at Day 1 and at the beginning of Weeks 3, 5, 9 and 13).
Intervention Type
Drug
Intervention Name(s)
TA-CD Vaccination
Other Intervention Name(s)
An aluminium hydroxide gel adjuvant in a saline solution.
Intervention Description
On Day 1, subjects will be randomized to receive vaccination. Day 1 to Week 16 (3 visits per week) Subsequent vaccinations will be administered at the beginning of Weeks 3, 5, 9 and 13. There should be at least 10 days between vaccinations. Three times per week visits will be scheduled during this period through Week 16. The assessments for the active phase will be scheduled. Therapy sessions will be provided by a qualified professional such as a master's level counselor.
Intervention Type
Other
Intervention Name(s)
Placebo Injection
Other Intervention Name(s)
An aluminium hydroxide gel adjuvant in a saline solution.
Intervention Description
On Day 1, subjects will be randomized to receive placebo injection. Day 1 to Week 16 (3 visits per week) Subsequent placebo injections will be administered at the beginning of Weeks 3, 5, 9 and 13. There should be at least 10 days between injections. Three times per week visits will be scheduled during this period through Week 16. The assessments for the efficacy and safety monitor will be scheduled.Therapy sessions will be provided by a qualified professional such as a master's level counselor.
Primary Outcome Measure Information:
Title
Cocaine Abstinence During Weeks 9 to 16 Inclusive
Description
Number of patients having at least 2 weeks of cocaine-free urines between weeks 9-16 after vaccination with five doses of TA-CD 400 µg compared to placebo
Time Frame
Over 8 weeks ( Study Weeks 9 to 16 inclusive)
Secondary Outcome Measure Information:
Title
•The Immunogenicity of TA-CD;
Description
Peak antibody levels after five vaccinations with TA-CD, which occurred at week 16.
Time Frame
During the 18 weeks study period.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Male or female. Females either must be of non-child bearing potential (i.e., surgically sterilized or postmenopausal) or must be using adequate contraception, have a negative pregnancy test, and must agree to continue to use such precautions for 3 months after the last vaccination; Meets DSM-IV-TR criteria for a principal diagnosis of cocaine dependence as confirmed by the MINI; Motivated to discontinue or reduce cocaine use during the period of the study as evidenced both by the judgment of the Investigator or designee and by the subject providing at least 2 urine samples in each of the 2 baseline weeks; In good general health as determined by medical history, general clinical examination, laboratory tests; Has provided written informed consent. Subjects should be cooperative, willing and able to participate and adhere to the Protocol requirements. EXCLUSION CRITERIA: Subject is cocaine-free (i.e., negative urine results [BE level]) during the 2-week screening period; Subject has known immunodeficiency or has a history of autoimmune disease or hypersensitivity to other vaccines. A human immunodeficiency virus (HIV) test must be performed at Screening and reported as negative for HIV-1 and HIV-2; Currently taking medication known to have significant immunosuppressive effects such as systemic glucocorticoids (topical and inhaled formulations are permitted) or oral systemic corticosteroids, within 30 days prior to randomization; Currently taking a dopaminergic, dopamine-blocking, dopamine-modulating, or other central dopamine-altering drug (e.g., antipsychotic drugs); a monoamine oxidase inhibitor (MAOI); or an opiate antagonist; Subject has an unstable medical, neurologic, or psychiatric illness that would interfere with the subject's safety, ability to participate in the study, or the interpretability of data. Subjects who meet the DSM-IV-TR criteria for psychosis, schizophrenia, bipolar disorder or clinically significant suicidal ideation; Subject had dependence on benzodiazepines, barbiturates, opiates or amphetamines according to DSM-IV-TR during the year prior to Screening. Opioid dependence includes methadone or buprenorphine maintenance treatment; Subject requiring medical detox for alcohol dependence; History of sensitivity to aluminium hydroxide gel; History of severe adverse reaction to cholera vaccine; Subject had previous vaccination with TA-CD; Subject received other vaccines, including flu vaccine, within 14 days prior to signing consent; Subject has participated in another clinical trial or received any other investigational compound within 14 days prior to signing consent; Subject has received blood or blood products within the 3 months prior to signing consent; Subject has liver function tests greater than 3 times the upper limit of normal at Screening; Subject has systolic blood pressure higher than 140 mmHg and/or diastolic blood pressure >90 mmHg; Female subjects with a positive pregnancy test, lactating mothers, women refusing to agree to adequate contraception and pregnancy tests during the study, or women who are planning to become pregnant during the period of the trial. Acceptable contraceptive methods are oral or parenteral hormonal contraceptives, intrauterine device (IUD), or barrier and spermicide, but not abstinence; Male subjects refusing to agree to adequate contraception during the study, or males who are part of a couple planning to become pregnant during the period of the trial; People who are involuntarily detained in a penal institution or people who become involuntarily detained during the study; Any other factor that in the opinion of the Investigator or designee would make the subject unsafe or unsuitable for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas R Kosten, M.D.
Organizational Affiliation
Baylor College of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Facility Name
NYU Langone Medical Center
City
New york
State/Province
New York
ZIP/Postal Code
10010
Country
United States
Facility Name
Substance Abuse Treatment and Research Service (Downtown)
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Cincinnati Addiction Research Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45220
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
24793366
Citation
Kosten TR, Domingo CB, Shorter D, Orson F, Green C, Somoza E, Sekerka R, Levin FR, Mariani JJ, Stitzer M, Tompkins DA, Rotrosen J, Thakkar V, Smoak B, Kampman K. Vaccine for cocaine dependence: a randomized double-blind placebo-controlled efficacy trial. Drug Alcohol Depend. 2014 Jul 1;140:42-7. doi: 10.1016/j.drugalcdep.2014.04.003. Epub 2014 Apr 16.
Results Reference
derived
PubMed Identifier
19805702
Citation
Martell BA, Orson FM, Poling J, Mitchell E, Rossen RD, Gardner T, Kosten TR. Cocaine vaccine for the treatment of cocaine dependence in methadone-maintained patients: a randomized, double-blind, placebo-controlled efficacy trial. Arch Gen Psychiatry. 2009 Oct;66(10):1116-23. doi: 10.1001/archgenpsychiatry.2009.128.
Results Reference
derived

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Multisite Controlled Trial of Cocaine Vaccine

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