Study to Assess the Efficacy, Safety, and Tolerability of AVP-786 for the Treatment of Neurobehavioral Disinhibition Including Aggression, Agitation, and Irritability in Participants With Traumatic Brain Injury
Neurobehavioral Disinhibition
About this trial
This is an interventional treatment trial for Neurobehavioral Disinhibition focused on measuring aggression, agitation, irritability, non-penetrating brain injury, traumatic brain injury, TBI, AVP-786
Eligibility Criteria
Inclusion Criteria:
- Participants with traumatic brain injury (TBI)
- Participants with neurobehavioral disinhibition symptoms that are present after trauma or after recovery of consciousness
- Score of โฅ4 on the modified Clinical Global Impression of Severity (mCGI-S) scale and the Agitation/Aggression or Irritability/Lability subscales of the Neuropsychiatric Inventory (NPI) scale at screening and baseline
- Participants with a reliable caregiver
Exclusion Criteria:
- Participants with significant symptoms of a major depressive disorder
- Participants with a history of or current clinical symptoms of schizophrenia, schizoaffective disorder, bipolar disorder, antisocial personality disorder, or borderline personality disorder
Sites / Locations
- Tuscaloosa Veterans Affairs Medical Center
- Absolute Clinical Research Site#207
- Perseverance Research Center Site#152
- ATP Clinical Research Site#150
- Kaizen Brain Center #224
- Sunwise Clinical Research, LLC Site#216
- Torrance Clinical Research Institute Site#157
- Tibor Rubin VA Medical Center, SCIRE Biomedical Research Institute
- Asclepes Research Centers - Panorama City Site #208
- The Neurology Group
- Mountain Mind
- Mountain View Clinical Research, Inc. Site# 202
- Medical Center of the Rockies
- Connecticut Clinical Research
- Bradenton Research Center, Inc
- Healthcare Innovative Institute, LLC Site# 173
- Science Connections, LLC Site#161
- Design Neuroscience Center, PL
- Alphab Global Research Site#163
- Meridien Research
- Premier Clinical Research Institute, Inc.
- Project 4 Research
- Allied Biomedical Research Institute, Inc. Site#151
- Health Synergy Clinical Research
- Roskamp Institute Clinic, Inc.
- USF Dept of Psychiatry and Behavioral Neurosciences Site# 214
- Meridien Research Site# 108
- Hawaii Pacific Neuroscience Site#184
- The University of Kentucky research foundation
- Baptist Health
- Sisu BHR Site#200
- Neurobehavioral Medicine Group #222
- Millennium Psychiatric Associates, LLC
- Sharlin Health and Neurology
- Clinical Research Professionals
- JFK Johnson Rehabilitation Institute
- The NeuroCognitive Insititute
- New York University School of Medicine Site #122
- Atrium Health - Carolinas Rehabilitation - Charlotte Site #166
- New Hope Clinical Research Site#194
- Carolina Headache Institute
- Salisbury VAMC
- Valley Medical Research
- Cincinnati VA Medical Center
- North Star Medical Research, LLC Site#154
- IPS Research Site#196
- University of Pittsburgh
- WJB Dorn VA-Wm. Jennings Bryan Dorn VA Medical Center
- University of Texas Southwestern Medical Site#140
- Polytrauma Rehabilitation Center S. Texas VA Health Care System Site# 146
- Cedar Clinical Research #221
- Virginia Commonwealth University #172
- Virginia Commonwealth University Site#172
- Salem Research Institute Site# 138
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Placebo Comparator
Experimental
Placebo Comparator
Experimental
Placebo Comparator
Experimental
Stage 1: Placebo
AVP-786
Stage 1: Placebo Non-responders to Stage 2: Placebo
Stage 1: Placebo Non-responders to Stage 2: AVP-786
Stage 1: Placebo Responders to Stage 2: Placebo
Stage 1: Placebo Responders to Stage 2: AVP-786
Participants will receive AVP-786 matching placebo capsules, orally, twice daily (BID) during Weeks 1 to 6 of the Stage 1 treatment period.
Participants will receive AVP-786-28/4.9 (deudextromethorpan hydrobromide [d6-DM] 28 milligrams (mg)/quinidine sulfate [Q] 4.9 mg) capsule, along with AVP-786 matching placebo capsule, orally, once daily (QD) during Week 1 followed by AVP-786-28/4.9 capsule, orally, BID during Week 2, and AVP-786-42.63/4.9 (d6-DM 42.63 mg/Q 4.9 mg) capsules (target dose), orally, BID during Weeks 3 to 12 of the treatment period.
Participants who will be randomized to receive placebo in Stage 1 and will be classified as non-responders (responders" if modified Clinical Global Impression of Severity [mCGI-S] score is โค 3 at Day 43 and Neuropsychiatric Inventory Clinician (NPI-C)-3 score has decreased by โฅ 25% from baseline. Participants who will not meet these criteria will be considered "non-responders) after Week 6 will be re-randomized to continue receiving AVP-786 matching placebo capsules, orally, BID during Weeks 7 to 12 of the Stage 2 treatment period.
Participants who will be randomized randomized to receive placebo in Stage 1 and will be classified as non-responders (responders" if mCGI-S score is โค 3 at Day 43 and NPI-C-3 score has decreased by โฅ 25% from baseline. Participants who will not meet these criteria will be considered "non-responders) after Week 6 will be re-randomized to receive AVP-786 in Stage 2 using the same dose escalation schedule used in Stage 1 i.e., AVP-786-28/4.9 capsule, along with AVP-786 matching placebo capsule, orally, QD during Week 7 followed by AVP-786-28/4.9 capsule, orally, BID during Week 8, and AVP-786-42.63/4.9 capsules, orally, BID, during Weeks 9 to 12 of the Stage 2 treatment period.
Participants who will be randomized to receive placebo in Stage 1 and will be classified as responders (responders" if mCGI-S score is โค 3 at Day 43 and NPI-C-3 score has decreased by โฅ 25% from baseline) after Week 6 will be re-randomized to continue receiving AVP-786 matching placebo capsules, orally, BID during Weeks 7 to 12 of the Stage 2 treatment period.
Participants who will be randomized to receive placebo in Stage 1 and will be classified as responders (responders" if mCGI-S score is โค 3 at Day 43 and NPI-C-3 score has decreased by โฅ 25% from baseline) after Week 6 will be re-randomized to receive AVP-786 in Stage 2 using the same dose escalation schedule used in Stage 1 i.e., AVP-786-28/4.9 capsule, along with AVP-786 matching placebo capsule, orally, QD during Week 7 followed by AVP-786-28/4.9 capsule, orally, BID during Week 8, and AVP-786-42.63/4.9 capsules, orally, BID, during Weeks 9 to 12 of the Stage 2 treatment period.