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PH94B in the Treatment of Adjustment Disorder With Anxiety

Primary Purpose

Adjustment Disorder With Anxious Mood

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PH94B
Placebo
Sponsored by
VistaGen Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adjustment Disorder With Anxious Mood

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Written informed consent provided prior to conducting any study-specific assessment.
  2. Male and female adults, 18 through 65 years of age, inclusive.
  3. Current diagnosis of AjDA as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.
  4. Clinician-rated Hamilton Anxiety Scale (HAM-A) score ≥20 at Screening (Visit 1) and no greater than 15% decrease at Baseline (Visit 2).
  5. Clinician-rated Hamilton Depression Scale (HAM-D) total score <18 at Screening (Visit 1) and Baseline (Visit 2).
  6. Clinical Global Impression - Severity Scale (CGI-S) score ≥4 at both Screening (Visit 1) and Baseline (Visit 2)
  7. Women of child bearing-potential must be able to commit to the consistent and correct use of an effective method of birth control throughout the Study, and must also have a negative urine pregnancy test result at both Screening (Visit 1) and Baseline (Visit 2), prior to investigational product (IP) administration. Effective methods of contraception include: condoms with spermicide, diaphragm with spermicide, hormonal contraceptive agents (oral, transdermal, or injectable), or implantable contraceptive devices.
  8. Males whose sexual partners are women of childbearing potential must commit to the consistent and correct use of an effective method of birth control throughout the study.
  9. Negative COVID-19 test either in the presence of COVID-19 symptoms or after exposure to someone with a positive COVID-19 test.

Exclusion Criteria:

  1. Any history of schizophrenia or schizoaffective disorder.
  2. Any other current Axis I disorder, including, but not limited to, major depressive disorder, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder, premenstrual dysphoric disorder, and generalized anxiety disorder, which is in poor control and the primary focus of treatment.
  3. A diagnosis of social anxiety disorder with a score >60 on the Liebowitz Social Anxiety Scale.
  4. Subjects who meet criteria for moderate or severe alcohol or substance use disorder within the 1 year prior to Study entry.
  5. In the opinion of the investigator, the subject has a significant risk for suicidal behavior during the course of their participation in the study, or considered to be an imminent danger to themselves or others.
  6. Clinically significant nasal pathology or history of significant nasal trauma, nasal surgery, anosmia, or nasal septum perforation that may have damaged the nasal chemosensory epithelium.
  7. An acute or chronic condition, including an infectious illness, uncontrolled seasonal allergies at the time of the study, or significant nasal congestion that potentially could affect drug delivery to the nasal chemosensory epithelium. The Investigator may allow concomitant use of over-the-counter nasal decongenstants as needed, since there is no apparent drug interaction between these and PH94B.
  8. Concomitant use of any anxiolytics, such as benzodiazepines or buspirone, during the Study and within 30 days of Baseline (Visit 2).
  9. Concomitant use of any over-the-counter, prescription product, or herbal preparation for treatment of the symptoms of anxiety during the Study and within 30 days before Study entry. Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or other approved antidepressants are permitted as long as the dose has been stable for 30 days prior to Baseline (Visit 2).
  10. Women who have a positive urine or serum pregnancy test at either Screening or Baseline visit or are currently breast feeding.
  11. Subjects with clinically significant abnormalities in hematology, blood chemistry, urinalysis, electrocardiogram, or physical examination identified at the Screening visit that in the clinical judgment of the Investigator, could place the subject at undue risk, interfere with study participation, or confound the results of the study.
  12. Subjects with a positive urine drug screen at either the Screening visit or Baseline visit (not including tetrahydrocannabinol).
  13. Any current clinically significant and/or uncontrolled medical condition, based on medical history or as evidenced in screening assessments, such as SARS-Cov-2, HIV, cancer, stroke, congestive heart failure, uncontrolled diabetes mellitus, or any other medical condition or disease that, in the clinical judgment of the Investigator, could place the subject at undue risk, interfere with Study participation, or confound the results of the Study.
  14. Use of a concomitant medication that, in the clinical judgement of the Investigator, could place the subject at undue risk, interfere with study participation, or confound the results of the study.
  15. History of cancer or malignant tumor not in remission for at least 2 years. Basal cell skin cancers are not exclusionary.

Sites / Locations

  • VistaGen Clinical Site
  • VistaGen Clinical Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

PH94B

Placebo

Arm Description

Intranasal spray 3.2 micrograms four times a day for 28 days

Intranasal spray four times a day for 28 days

Outcomes

Primary Outcome Measures

Hamilton Anxiety Scale
Questionnaire on anxiety symptoms - change from baseline compared to placebo

Secondary Outcome Measures

Sheehan Disability Scale
Questionnaire on functioning - change from baseline compared to placebo
International adjustment disorder questionnaire (IADQ)
Questionnaire on worrying etc. - change from baseline compared to placebo
Clinical Global Impression - Improvement rating (CGI-I)
Clinical impression of improvement - change from baseline compared to placebo

Full Information

First Posted
May 21, 2020
Last Updated
July 11, 2023
Sponsor
VistaGen Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04404192
Brief Title
PH94B in the Treatment of Adjustment Disorder With Anxiety
Official Title
A Phase 2a Double-blind, Placebo-controlled, Parallel Study of PH94B Nasal Spray in the Treatment of Adjustment Disorder With Anxiety
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
October 12, 2021 (Actual)
Primary Completion Date
December 14, 2022 (Actual)
Study Completion Date
December 14, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
VistaGen Therapeutics, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This placebo-controlled clinical study is designed to evaluate the efficacy, safety and tolerability of administration of PH94B nasal spray four times per day as a treatment of Adjustment Disorder with Anxiety symptoms in adults. Subject participation in the Study will last a total of 6 to 10 weeks, depending on the duration of the screening period and whether they need a washout of concomitant anxiolytics. Upon signing an investigation review board approved informed consent, all subjects will complete Visit 1 (Screening) and enter a screening period lasting 7 to 35 days that could include taper of concomitant anxiolytics, if necessary. Screening visit will consist of safety assessments (medical history, physical examination, laboratory samples, electrocardiogram, urine drug screen, and urine pregnancy test [if appropriate]) and psychiatric assessments to determine eligibility. Subjects will then return to complete Visit 2 (Baseline). If the subject continues to meet inclusion and exclusion criteria, the subject will be randomized 1:1 to PH94B or placebo. Subjects will then commence 4 weeks of double-blind treatment with randomized investigational product (PH94B or placebo) four times per day. Subjects will return for weekly site visits (Visits 3, 4, 5, and 6), in which the subject will return the vial dispensed at the previous visit and receive a new vial, except at Visit 6 in which no new vial will be dispensed. Changes in AEs and concomitant medications will be collected. During these visits, psychiatric scales will be completed. When the subject returns for Visit 6, besides the assessments completed at Visits 3 through 5, the subjects will complete a brief physical examination, electrocardiogram, laboratory tests (chemistry and blood), and urinalysis. Any remaining IP vials will be collected. The subject will then come back after a one week washout period for Follow-up visit (Visit 7).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adjustment Disorder With Anxious Mood

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
41 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PH94B
Arm Type
Experimental
Arm Description
Intranasal spray 3.2 micrograms four times a day for 28 days
Arm Title
Placebo
Arm Type
Experimental
Arm Description
Intranasal spray four times a day for 28 days
Intervention Type
Drug
Intervention Name(s)
PH94B
Other Intervention Name(s)
Aloradine
Intervention Description
Intranasal administration of 100 microliters to each nostril 4 times a day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Intranasal administration of 100 microliters to each nostril 4 times a day.
Primary Outcome Measure Information:
Title
Hamilton Anxiety Scale
Description
Questionnaire on anxiety symptoms - change from baseline compared to placebo
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Sheehan Disability Scale
Description
Questionnaire on functioning - change from baseline compared to placebo
Time Frame
28 days
Title
International adjustment disorder questionnaire (IADQ)
Description
Questionnaire on worrying etc. - change from baseline compared to placebo
Time Frame
28 days
Title
Clinical Global Impression - Improvement rating (CGI-I)
Description
Clinical impression of improvement - change from baseline compared to placebo
Time Frame
28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent provided prior to conducting any study-specific assessment. Male and female adults, 18 through 65 years of age, inclusive. Current diagnosis of AjDA as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Clinician-rated Hamilton Anxiety Scale (HAM-A) score ≥20 at Screening (Visit 1) and no greater than 15% decrease at Baseline (Visit 2). Clinician-rated Hamilton Depression Scale (HAM-D) total score <18 at Screening (Visit 1) and Baseline (Visit 2). Clinical Global Impression - Severity Scale (CGI-S) score ≥4 at both Screening (Visit 1) and Baseline (Visit 2) Women of child bearing-potential must be able to commit to the consistent and correct use of an effective method of birth control throughout the Study, and must also have a negative urine pregnancy test result at both Screening (Visit 1) and Baseline (Visit 2), prior to investigational product (IP) administration. Effective methods of contraception include: condoms with spermicide, diaphragm with spermicide, hormonal contraceptive agents (oral, transdermal, or injectable), or implantable contraceptive devices. Males whose sexual partners are women of childbearing potential must commit to the consistent and correct use of an effective method of birth control throughout the study. Negative COVID-19 test either in the presence of COVID-19 symptoms or after exposure to someone with a positive COVID-19 test. Exclusion Criteria: Any history of schizophrenia or schizoaffective disorder. Any other current Axis I disorder, including, but not limited to, major depressive disorder, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder, premenstrual dysphoric disorder, and generalized anxiety disorder, which is in poor control and the primary focus of treatment. A diagnosis of social anxiety disorder with a score >60 on the Liebowitz Social Anxiety Scale. Subjects who meet criteria for moderate or severe alcohol or substance use disorder within the 1 year prior to Study entry. In the opinion of the investigator, the subject has a significant risk for suicidal behavior during the course of their participation in the study, or considered to be an imminent danger to themselves or others. Clinically significant nasal pathology or history of significant nasal trauma, nasal surgery, anosmia, or nasal septum perforation that may have damaged the nasal chemosensory epithelium. An acute or chronic condition, including an infectious illness, uncontrolled seasonal allergies at the time of the study, or significant nasal congestion that potentially could affect drug delivery to the nasal chemosensory epithelium. The Investigator may allow concomitant use of over-the-counter nasal decongenstants as needed, since there is no apparent drug interaction between these and PH94B. Concomitant use of any anxiolytics, such as benzodiazepines or buspirone, during the Study and within 30 days of Baseline (Visit 2). Concomitant use of any over-the-counter, prescription product, or herbal preparation for treatment of the symptoms of anxiety during the Study and within 30 days before Study entry. Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or other approved antidepressants are permitted as long as the dose has been stable for 30 days prior to Baseline (Visit 2). Women who have a positive urine or serum pregnancy test at either Screening or Baseline visit or are currently breast feeding. Subjects with clinically significant abnormalities in hematology, blood chemistry, urinalysis, electrocardiogram, or physical examination identified at the Screening visit that in the clinical judgment of the Investigator, could place the subject at undue risk, interfere with study participation, or confound the results of the study. Subjects with a positive urine drug screen at either the Screening visit or Baseline visit (not including tetrahydrocannabinol). Any current clinically significant and/or uncontrolled medical condition, based on medical history or as evidenced in screening assessments, such as SARS-Cov-2, HIV, cancer, stroke, congestive heart failure, uncontrolled diabetes mellitus, or any other medical condition or disease that, in the clinical judgment of the Investigator, could place the subject at undue risk, interfere with Study participation, or confound the results of the Study. Use of a concomitant medication that, in the clinical judgement of the Investigator, could place the subject at undue risk, interfere with study participation, or confound the results of the study. History of cancer or malignant tumor not in remission for at least 2 years. Basal cell skin cancers are not exclusionary.
Facility Information:
Facility Name
VistaGen Clinical Site
City
Watertown
State/Province
Massachusetts
ZIP/Postal Code
02472
Country
United States
Facility Name
VistaGen Clinical Site
City
New York
State/Province
New York
ZIP/Postal Code
10128
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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PH94B in the Treatment of Adjustment Disorder With Anxiety

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