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Safety and Preliminary Efficacy of ANS-6637 to Reduce Drug Craving and Harm in People With Opioid Use Disorder (SEARCH)

Primary Purpose

Opioid-use Disorder

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
ANS-6637
Placebo oral tablet
Sponsored by
University of Maryland, Baltimore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Opioid-use Disorder

Eligibility Criteria

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

Inclusion Criteria:

  • Must have the ability to understand and must personally sign a written informed consent form, which must be obtained prior to initiation of study procedures.
  • Must be between 18 and 65 years of age, inclusive.
  • Must have the diagnosis of opioid use disorder by DSM (Diagnostic and Statistical Manual of Mental Disorders) V criteria of at least mild severity
  • Must have a total score of 9 or greater (out of a total of 30) on the Opioid Craving Scale at screening
  • If on opioid agonist therapy, must be on Opioid Agonist Therapy (OAT) medication for a minimum of six months prior to screening.
  • If on medication for depression or anxiety, must be on a stable dose for a minimum of two months prior to screening.
  • Must be able to take oral medication and be willing to adhere to the medication regimen
  • Must agree to utilize the "AI Cure" platform, either on their personal phone or on a supplied device, for both daily video adherence monitoring as well as daily questionnaires for the entire study duration.
  • Male subjects must refrain from sperm donation throughout the study period, and continuing for at least 90 days following the last dose of study drug.
  • Subjects must refrain from blood donation throughout the study period, and continuing for at least 30 days following the last dose of study drug.
  • Must be willing to comply with contraception guidelines: The fetal risks associated with ANS-6637 are not known, but pre-clinical animal data demonstrate some risk. Subjects must agree not to become pregnant or impregnate a female. Females of childbearing potential must have a pregnancy test at screening and baseline (Day 0). If pregnancy occurs or is suspected to occur, study staff must be notified immediately. For the duration of the study, subjects or female partners of childbearing potential must use one of the following, unless she is surgically sterile, post-menopausal, or partner is surgically sterile: oral contraceptives (OCP), contraceptive sponge, patch double barrier (diaphragm + spermicide or condom + spermicide), intrauterine device (IUD), etonogestrel implant, injection, hormonal vaginal contraceptive ring or complete abstinence
  • Must be willing and able to comply with all study requirements and plan to attend all clinic visits.

Exclusion Criteria:

A subject will be ineligible for this study if 1 or more of the following criteria are met:

  • Clinically significant AND grade 2 or higher abnormal laboratory values at screening, as determined by principal investigator
  • Aspartate transaminase (AST) or Alanine transaminase (ALT) > 2.5 x upper limit of normal or total bilirubin > 1.6 x the upper limit of normal
  • Creatinine clearance < 60 mL/min/1.73m2 by Chronic kidney disease (CKD)-Epidemiology Collaboration (EPI) Score.
  • Personal or family history of Parkinson's Disease
  • Diagnosed major depression AND with current self-reported depression episode
  • Diagnosed generalized anxiety disorder AND with current self-reported uncontrolled anxiety
  • Current self-reported suicidal ideation
  • Diagnosed liver disease, including untreated chronic Hepatitis C (defined as detectable Hepatitis C RNA), Hepatitis B (defined as positive HBsAg), and/or cirrhosis (defined as Fibrosis (FIB)-4 > 3.25 AND confirmed by Fibroscan or Fibrosure)
  • Diagnosed Human Immunodeficiency Virus (HIV) AND detectable viral load > 40 copies/mL
  • Diagnosed moderate or serious dementia Taking any of the following medications in the last 6 months: dopamine agonist, dopamine antagonist, anti-psychotic, anti-convulsant (except for benzodiazepines and gabapentin) or barbiturate
  • Inability to obtain venous access for sample collection.
  • Had a prior history of any severe adverse reactions to ethanol [e.g., flushing (noticeable redness of the neck or throat) and/or increased heart rate (subject reports sensation of increased heart rate or palpitations) after drinking alcohol].
  • Known hypersensitivity to formulation excipients: microcrystalline cellulose, croscarmellose sodium, magnesium stearate, polyvinyl alcohol, titanium dioxide, polyethylene glycol, and talc.
  • Have previously participated in an investigational trial involving administration of any investigational compound within 30 days prior to screening
  • Have any unresolved legal issues that could jeopardize continuation or completion of the study, at the discretion of the principal investigator
  • Have any serious or active medical, surgical, or psychiatric conditions which, in the opinion of the Investigator, would interfere with subject treatment, assessment, or compliance with the protocol.
  • Are unable to comply with study requirements

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    ANS-6637

    Placebo arm

    Arm Description

    ANS-6637 600mg once daily for 12 weeks

    Placebo 600 mg once daily for 12 weeks

    Outcomes

    Primary Outcome Measures

    Number of Grade 3-4 events, Grade 2 Significant event
    The number of Grade 3-4 adverse events, as defined by the Division of AIDS (DAIDS) Toxicity Table Version 2.1, July, 2017 as well as the number of Grade 2 events requiring medication interruption or deemed clinically significant by a study investigator

    Secondary Outcome Measures

    Urine Drug Screen
    Percentage opioid free period by urine drug screen
    Opioid Craving
    Opioid craving will be assessed using the Opioid Craving scale questionnaire. The questionnaire consists of three questions and each of these questions has a minimum value of 0 and a maximum value 10. A score of 0 on each question is the best outcome; a score of 10 on each question is the worst outcome.
    Opioid Agonist Therapy (OAT) concentration
    Serum concentration of buprenorphine or methadone
    Self reported description of drug use (Self-reported frequency/quantity/mode of opioid use, self-reported use of other drugs, overdose and overdose death)
    Self-reported frequency/quantity/mode of opioid use as well as self-reported use of other drugs will be gathered using the Drug Use Survey. Subjects will indicate frequency of opioid use by documenting the number of times they used an opioid during a given day. The quantity of opioids used will be determined by the dollar amount of opioids the subject reports they have consumed during that day. Subjects will also report mode of opioid use by indicating whether they are using opioids via injection, skin popping, snorting or oral. The Drug Use Survey will also ask subjects to report incidence of use of non-opioid substances. Incidence of overdose will be captured with the Naloxone questionnaire which asks, "since you last visit, have you experienced an overdose?". Incidence of overdose death will measured by the number of medical examiner confirmed deaths of study participants with cause of death listed as "overdose related to an opioid".

    Full Information

    First Posted
    November 5, 2019
    Last Updated
    January 25, 2021
    Sponsor
    University of Maryland, Baltimore
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04169360
    Brief Title
    Safety and Preliminary Efficacy of ANS-6637 to Reduce Drug Craving and Harm in People With Opioid Use Disorder
    Acronym
    SEARCH
    Official Title
    Safety and Preliminary Efficacy of ANS-6637 to Reduce Drug Craving and Harm in People With Opioid Use Disorder
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    The FDA determined that there is not adequate safety information to continue clinical investigations using ANS-6637 and Amygdala Neurosciences, the product company of ANS-6637, is no longer pursuing research with this compound.
    Study Start Date
    January 2021 (Anticipated)
    Primary Completion Date
    January 12, 2021 (Actual)
    Study Completion Date
    January 12, 2021 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of Maryland, Baltimore

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a double blind, placebo controlled, randomized trial to evaluate the safety and preliminary efficacy of ANS-6637 in adults with opioid use disorder with and without opioid agonist therapy. Patients will be randomized to two arms: (1) ANS-6637 for three months vs (2) Placebo for three months. Subjects will subsequently be followed for an additional one month post treatment.
    Detailed Description
    This is a double blind, placebo controlled, randomized trial to evaluate the safety and preliminary efficacy of ANS-6637 in adults with opioid use disorder with and without opioid agonist therapy. At screening, after providing consent, participants will be evaluated to ensure criteria for opioid use disorder by DSM V criteria is met, and whether the subject is receiving opioid agonist therapy will be determined. Participants will undergo a medical evaluation (including medical history, laboratory tests and EKG evaluation) to establish baseline medical and psychiatric diagnosis in order to ensure safety of participation. Once enrollment criteria are met, patients will be randomized in a blinded fashion to ANS-6637 or placebo, stratified by site and form of opioid agonist therapy. On Day 0, patients will be initiated on ANS-6637 vs. placebo according to randomization group. Subjects will be seen twice per week for two weeks, followed by weekly for two weeks, and then monthly for two months.

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

    8. Arms, Groups, and Interventions

    Arm Title
    ANS-6637
    Arm Type
    Experimental
    Arm Description
    ANS-6637 600mg once daily for 12 weeks
    Arm Title
    Placebo arm
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo 600 mg once daily for 12 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    ANS-6637
    Intervention Description
    White, oblong 300 mg tablet
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo oral tablet
    Intervention Description
    White, oblong 300 mg tablet
    Primary Outcome Measure Information:
    Title
    Number of Grade 3-4 events, Grade 2 Significant event
    Description
    The number of Grade 3-4 adverse events, as defined by the Division of AIDS (DAIDS) Toxicity Table Version 2.1, July, 2017 as well as the number of Grade 2 events requiring medication interruption or deemed clinically significant by a study investigator
    Time Frame
    16 weeks
    Secondary Outcome Measure Information:
    Title
    Urine Drug Screen
    Description
    Percentage opioid free period by urine drug screen
    Time Frame
    16 weeks
    Title
    Opioid Craving
    Description
    Opioid craving will be assessed using the Opioid Craving scale questionnaire. The questionnaire consists of three questions and each of these questions has a minimum value of 0 and a maximum value 10. A score of 0 on each question is the best outcome; a score of 10 on each question is the worst outcome.
    Time Frame
    16 weeks
    Title
    Opioid Agonist Therapy (OAT) concentration
    Description
    Serum concentration of buprenorphine or methadone
    Time Frame
    16 weeks
    Title
    Self reported description of drug use (Self-reported frequency/quantity/mode of opioid use, self-reported use of other drugs, overdose and overdose death)
    Description
    Self-reported frequency/quantity/mode of opioid use as well as self-reported use of other drugs will be gathered using the Drug Use Survey. Subjects will indicate frequency of opioid use by documenting the number of times they used an opioid during a given day. The quantity of opioids used will be determined by the dollar amount of opioids the subject reports they have consumed during that day. Subjects will also report mode of opioid use by indicating whether they are using opioids via injection, skin popping, snorting or oral. The Drug Use Survey will also ask subjects to report incidence of use of non-opioid substances. Incidence of overdose will be captured with the Naloxone questionnaire which asks, "since you last visit, have you experienced an overdose?". Incidence of overdose death will measured by the number of medical examiner confirmed deaths of study participants with cause of death listed as "overdose related to an opioid".
    Time Frame
    16 weeks
    Other Pre-specified Outcome Measures:
    Title
    Change in Darke HIV Risk Taking Behavior Survey Score
    Description
    The Darke HIV Risk Taking Behavior Questionnaire will be administered to assess subject's self-reported risk taking behaviors. Total scores on the test range from 0 to 55, with higher scores indicating a greater degree of risk-taking behavior.
    Time Frame
    16 weeks
    Title
    Change in HIV Test Result
    Description
    An HIV test (fourth generation antigen/antibody test) will be administered and the results are reported as either positive or negative.
    Time Frame
    16 weeks
    Title
    Change in Hepatitis C (HCV) RNA result
    Description
    A Hepatitis C (HCV) RNA test will be administered. This test measures the quantity of detectable RNA which is measured in IU/ml.
    Time Frame
    16 weeks
    Title
    Change in appetite
    Description
    Self reported changes in appetite will be captured by the Adverse Event Survey. The survey will ask, "since your last visit, have you had an increase in your appetite or a decrease in your appetite?".
    Time Frame
    16 weeks

    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: Must have the ability to understand and must personally sign a written informed consent form, which must be obtained prior to initiation of study procedures. Must be between 18 and 65 years of age, inclusive. Must have the diagnosis of opioid use disorder by DSM (Diagnostic and Statistical Manual of Mental Disorders) V criteria of at least mild severity Must have a total score of 9 or greater (out of a total of 30) on the Opioid Craving Scale at screening If on opioid agonist therapy, must be on Opioid Agonist Therapy (OAT) medication for a minimum of six months prior to screening. If on medication for depression or anxiety, must be on a stable dose for a minimum of two months prior to screening. Must be able to take oral medication and be willing to adhere to the medication regimen Must agree to utilize the "AI Cure" platform, either on their personal phone or on a supplied device, for both daily video adherence monitoring as well as daily questionnaires for the entire study duration. Male subjects must refrain from sperm donation throughout the study period, and continuing for at least 90 days following the last dose of study drug. Subjects must refrain from blood donation throughout the study period, and continuing for at least 30 days following the last dose of study drug. Must be willing to comply with contraception guidelines: The fetal risks associated with ANS-6637 are not known, but pre-clinical animal data demonstrate some risk. Subjects must agree not to become pregnant or impregnate a female. Females of childbearing potential must have a pregnancy test at screening and baseline (Day 0). If pregnancy occurs or is suspected to occur, study staff must be notified immediately. For the duration of the study, subjects or female partners of childbearing potential must use one of the following, unless she is surgically sterile, post-menopausal, or partner is surgically sterile: oral contraceptives (OCP), contraceptive sponge, patch double barrier (diaphragm + spermicide or condom + spermicide), intrauterine device (IUD), etonogestrel implant, injection, hormonal vaginal contraceptive ring or complete abstinence Must be willing and able to comply with all study requirements and plan to attend all clinic visits. Exclusion Criteria: A subject will be ineligible for this study if 1 or more of the following criteria are met: Clinically significant AND grade 2 or higher abnormal laboratory values at screening, as determined by principal investigator Aspartate transaminase (AST) or Alanine transaminase (ALT) > 2.5 x upper limit of normal or total bilirubin > 1.6 x the upper limit of normal Creatinine clearance < 60 mL/min/1.73m2 by Chronic kidney disease (CKD)-Epidemiology Collaboration (EPI) Score. Personal or family history of Parkinson's Disease Diagnosed major depression AND with current self-reported depression episode Diagnosed generalized anxiety disorder AND with current self-reported uncontrolled anxiety Current self-reported suicidal ideation Diagnosed liver disease, including untreated chronic Hepatitis C (defined as detectable Hepatitis C RNA), Hepatitis B (defined as positive HBsAg), and/or cirrhosis (defined as Fibrosis (FIB)-4 > 3.25 AND confirmed by Fibroscan or Fibrosure) Diagnosed Human Immunodeficiency Virus (HIV) AND detectable viral load > 40 copies/mL Diagnosed moderate or serious dementia Taking any of the following medications in the last 6 months: dopamine agonist, dopamine antagonist, anti-psychotic, anti-convulsant (except for benzodiazepines and gabapentin) or barbiturate Inability to obtain venous access for sample collection. Had a prior history of any severe adverse reactions to ethanol [e.g., flushing (noticeable redness of the neck or throat) and/or increased heart rate (subject reports sensation of increased heart rate or palpitations) after drinking alcohol]. Known hypersensitivity to formulation excipients: microcrystalline cellulose, croscarmellose sodium, magnesium stearate, polyvinyl alcohol, titanium dioxide, polyethylene glycol, and talc. Have previously participated in an investigational trial involving administration of any investigational compound within 30 days prior to screening Have any unresolved legal issues that could jeopardize continuation or completion of the study, at the discretion of the principal investigator Have any serious or active medical, surgical, or psychiatric conditions which, in the opinion of the Investigator, would interfere with subject treatment, assessment, or compliance with the protocol. Are unable to comply with study requirements
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Sarah Kattakuzhy, MD
    Organizational Affiliation
    Institute of Human Virology at the University of Maryland
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    The investigator will share de-identified data with approved outside collaborators under appropriate agreements, at the time of publication or shortly thereafter.
    IPD Sharing Time Frame
    Data will be available at the time of publication or shortly thereafter, and will be kept indefinitely.
    IPD Sharing Access Criteria
    Will be determined by Principal Investigator

    Learn more about this trial

    Safety and Preliminary Efficacy of ANS-6637 to Reduce Drug Craving and Harm in People With Opioid Use Disorder

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