Safety, Tolerability and Activity of SRX246 in Adults With Intermittent Explosive Disorder (AVN009)
Primary Purpose
Intermittent Explosive Disorder
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SRX246
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Intermittent Explosive Disorder focused on measuring Intermittent Explosive Disorder, IED, Aggression, SRX246, Vasopressin 1a Receptor Antagonist, V1a
Eligibility Criteria
Inclusion Criteria:
- Male or Female (Women of child bearing potential must be non-pregnant, non-lactating and agree to be on an acceptable method of contraception.)
- Age 21 to 55 years, inclusive.
- In good general physical health as determined by medical history, a baseline physical examination, vital signs, clinical laboratory tests and electrocardiogram (EKG) measurement.
- Current IED by DSM-5
- LHA-Aggression ≥ 12.
- OAS-M Irritability score ≥ 6, and OAS-M Total Aggression score ≥ 15, respectively at Visit 1
- Mean Irritability and Total Aggression scores for Visit 2 and Visit 3, ≥ 6 and ≥ 15, respectively.
- Subject is willing and able to sign written informed consent prior to receipt of any study medication or beginning study procedures.
- Subject is willing and able to follow instructions, comply with the protocol requirements and make all required study visits.
Exclusion Criteria:
- Subject with a positive test for alcohol and/or drugs of abuse at screening or at any time during the study.
- Presence of any of the following serious and active medical conditions: Seizure Disorder (n.b.: history of < 2 febrile seizures prior to one year of age is acceptable); Demyelinating or Progressive Degenerative Disorders; central nervous system (CNS) Infection; Progressive Degenerative Neurological Disorder; Ischemic Heart Disease, Respiratory Disease, Renal Disease; Liver Disease; Type I Diabetes; Malignant Neoplasm; Hyper- or Hypo-Coagulopathy; Acquired Immuno-Deficiency Syndrome (AIDS).
- Routine or as needed consumption of medications or herbal supplements that the subject is unable or unwilling to discontinue during the study.
- Other ongoing psychotherapeutic treatment for the treatment of IED or anger begun less than three months before entry into this study.
- Not Current DSM-5 IED.
- LHA score < 12 at Visit 1 (screen).
- OAS-M Irritability score < 6 or OAS-M Total Aggression score < 15 at Visit 1 (screen).
- Current major depressive episode or life history of bipolar disorder, schizophrenia, organic mental syndrome, or mental retardation.
- Current DSM-5 Substance Use Disorder of moderate or greater severity (i.e., ≥ 4 SUD symptoms).
- Active suicidal ideation as determined by clinical assessment and Columbia-Suicide Severity Rating Scale (C-SSRS).
- Evidence of any out-of range laboratory value at screening that has not been reviewed, approved and documented as not clinically significant by the Study Investigator.
- A history of significant drug allergy or systemic allergic disease (e.g., urticaria, atopic dermatitis), or any known/suspected hypersensitivity to SRX246.
- A general medical or psychological condition or behavior, including current substance dependence or abuse that, in the opinion of the investigator, might not permit the subject to complete the study or sign the informed consent.
- Unwilling/unable to sign informed consent document.
- Any clinically significant abnormality on screening resting 12-lead EKG (e.g., heart block, conduction disorders, ventricular and/or atrial arrhythmias).
- Any other condition or clinically significant abnormal findings on the physical examination, medical history, or clinical laboratory results during screening that, in the opinion of the Study Investigator, would make the subject unsuitable for the study or put them at additional risk.
- Inability to understand or follow study instructions.
- Treatment with an investigational drug within 30 days preceding the first dose of study medication.
- Women who are currently breastfeeding and/or lactating.
Sites / Locations
- Atlanta Center for Medical Research
- University of Chicago, Department of Psychiatry
- Psychiatric Care and Research Center
- SPRI Clinical Trials, LLC
- Icahn School of Medicine at Mount Sinai
- Lindner Center of HOPE
- Rhode Island Hospital, Department of Psychiatry
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
SRX246
Placebo
Arm Description
SRX246 capsules, 120mg bid for 4 weeks followed by 160mg bid for 4 weeks
Placebo capsules to match the amount of SRX246 capsules for 8 weeks
Outcomes
Primary Outcome Measures
Safety and Tolerability
measured as the number of participants with adverse events
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02055638
Brief Title
Safety, Tolerability and Activity of SRX246 in Adults With Intermittent Explosive Disorder
Acronym
AVN009
Official Title
An Exploratory Phase II Study to Determine the Safety, Tolerability and Activity of a Novel Vasopressin 1a Receptor Antagonist (SRX246) in Adults With Diagnostic and Statistical Manual Version 5 (DSM-5) Intermittent Explosive Disorder (IED)
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
May 2014 (undefined)
Primary Completion Date
May 2016 (Actual)
Study Completion Date
May 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Azevan Pharmaceuticals
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study is designed to explore the safety and tolerability, and to compare the activity of SRX246 against placebo, in adults with Intermittent Explosive Disorder (IED).
Adult Male and Female subjects with a current diagnosis of IED will be enrolled. After a two-week baseline lead-in phase, study subjects who continue to meet enrollment criteria will be randomized to either SRX246 or Placebo treatment groups.
Study subjects will be examined and asked to answer questionnaires at weekly scheduled visits throughout the trial. The study results will be determined based on any changes observed over the study period.
Detailed Description
This exploratory Phase II study has been designed to examine the safety and tolerability profile, and to compare the activity of the novel V1a vasopressin antagonist (SRX246) against placebo, in adults with DSM-5 Intermittent Explosive Disorder (IED).
Adult Male and Female subjects with a current DSM-5 diagnosis of IED will be enrolled. All subjects will undergo systematic diagnostic assessment for DSM-5 Axis I and II disorders. Subjects with DSM-5 IED (without current, co-morbid, DSM-5 Major Depression) whose: (a) Life History of Aggression (LHA) score is > 12, (b) Overt Aggression Scale Modified (OAS-M) "Irritability" score is > 6 and, (c) screening OAS-M "Aggression" score is > 15, will be entered into a two-week baseline lead-in phase.
After the lead-in phase, study subjects who continue to meet OAS-M criteria will be randomized to one of the two (2) treatment conditions and stratified by gender so that equal numbers of males and females are assigned to SRX246 and Placebo Groups. Those who do not meet the criteria will exit the protocol at that time. Treatment Conditions: (a) 8-week course of SRX246 (4 weeks at 120 mg bid, and 4 weeks at 160 mg bid) or (b) 8-week course of Placebo, followed by a one-week "taper" to withdraw subjects from study medication.
IED subjects in all conditions will have structured diagnostic interview sessions and questionnaires administered throughout the trial. Blinding to treatment condition will be maintained by using different personnel for these activities. Analysis of a change from baseline in the diagnostic measures will be performed.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intermittent Explosive Disorder
Keywords
Intermittent Explosive Disorder, IED, Aggression, SRX246, Vasopressin 1a Receptor Antagonist, V1a
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
97 (Actual)
8. Arms, Groups, and Interventions
Arm Title
SRX246
Arm Type
Experimental
Arm Description
SRX246 capsules, 120mg bid for 4 weeks followed by 160mg bid for 4 weeks
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo capsules to match the amount of SRX246 capsules for 8 weeks
Intervention Type
Drug
Intervention Name(s)
SRX246
Intervention Description
capsules
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Safety and Tolerability
Description
measured as the number of participants with adverse events
Time Frame
from initial dose of intervention until completion of the study up to 8 weeks
Other Pre-specified Outcome Measures:
Title
Overt Aggression Scale Modified (OAS-M) Total Aggression Score
Description
Change from Baseline OAS-M Score. Higher values represent a worse outcome. The OAS-M contains 3 scales: Aggression (Questions [Q]1 to 4), Irritability (Q5 to 6), and Suicidality (Q7 to 7b). Aggression total score was calculated by summing the weighted scores in Q1 to 4. Scores for each question ranged from 0 (no events) to 5 (very severe events). Total scores ranged from 0 (no aggression) to any number with no upper limit depending on the frequency of aggressive behavior in a week.
Time Frame
Comparison of baseline score to score at end of treatment period of 8 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or Female (Women of child bearing potential must be non-pregnant, non-lactating and agree to be on an acceptable method of contraception.)
Age 21 to 55 years, inclusive.
In good general physical health as determined by medical history, a baseline physical examination, vital signs, clinical laboratory tests and electrocardiogram (EKG) measurement.
Current IED by DSM-5
LHA-Aggression ≥ 12.
OAS-M Irritability score ≥ 6, and OAS-M Total Aggression score ≥ 15, respectively at Visit 1
Mean Irritability and Total Aggression scores for Visit 2 and Visit 3, ≥ 6 and ≥ 15, respectively.
Subject is willing and able to sign written informed consent prior to receipt of any study medication or beginning study procedures.
Subject is willing and able to follow instructions, comply with the protocol requirements and make all required study visits.
Exclusion Criteria:
Subject with a positive test for alcohol and/or drugs of abuse at screening or at any time during the study.
Presence of any of the following serious and active medical conditions: Seizure Disorder (n.b.: history of < 2 febrile seizures prior to one year of age is acceptable); Demyelinating or Progressive Degenerative Disorders; central nervous system (CNS) Infection; Progressive Degenerative Neurological Disorder; Ischemic Heart Disease, Respiratory Disease, Renal Disease; Liver Disease; Type I Diabetes; Malignant Neoplasm; Hyper- or Hypo-Coagulopathy; Acquired Immuno-Deficiency Syndrome (AIDS).
Routine or as needed consumption of medications or herbal supplements that the subject is unable or unwilling to discontinue during the study.
Other ongoing psychotherapeutic treatment for the treatment of IED or anger begun less than three months before entry into this study.
Not Current DSM-5 IED.
LHA score < 12 at Visit 1 (screen).
OAS-M Irritability score < 6 or OAS-M Total Aggression score < 15 at Visit 1 (screen).
Current major depressive episode or life history of bipolar disorder, schizophrenia, organic mental syndrome, or mental retardation.
Current DSM-5 Substance Use Disorder of moderate or greater severity (i.e., ≥ 4 Substance Use Disorder (SUD) symptoms).
Active suicidal ideation as determined by clinical assessment and Columbia-Suicide Severity Rating Scale (C-SSRS).
Evidence of any out-of range laboratory value at screening that has not been reviewed, approved and documented as not clinically significant by the Study Investigator.
A history of significant drug allergy or systemic allergic disease (e.g., urticaria, atopic dermatitis), or any known/suspected hypersensitivity to SRX246.
A general medical or psychological condition or behavior, including current substance dependence or abuse that, in the opinion of the investigator, might not permit the subject to complete the study or sign the informed consent.
Unwilling/unable to sign informed consent document.
Any clinically significant abnormality on screening resting 12-lead EKG (e.g., heart block, conduction disorders, ventricular and/or atrial arrhythmias).
Any other condition or clinically significant abnormal findings on the physical examination, medical history, or clinical laboratory results during screening that, in the opinion of the Study Investigator, would make the subject unsuitable for the study or put them at additional risk.
Inability to understand or follow study instructions.
Treatment with an investigational drug within 30 days preceding the first dose of study medication.
Women who are currently breastfeeding and/or lactating.
Facility Information:
Facility Name
Atlanta Center for Medical Research
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30331
Country
United States
Facility Name
University of Chicago, Department of Psychiatry
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Psychiatric Care and Research Center
City
O'Fallon
State/Province
Missouri
ZIP/Postal Code
63368
Country
United States
Facility Name
SPRI Clinical Trials, LLC
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11235
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Lindner Center of HOPE
City
Mason
State/Province
Ohio
ZIP/Postal Code
45040
Country
United States
Facility Name
Rhode Island Hospital, Department of Psychiatry
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Safety, Tolerability and Activity of SRX246 in Adults With Intermittent Explosive Disorder
We'll reach out to this number within 24 hrs