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Treatment of Patients Suffering of Alcohol Dependence and Impaired Liver Function With Selincro® As-needed Use

Primary Purpose

Alcohol Dependence

Status
Completed
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
nalmefene
Sponsored by
H. Lundbeck A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcohol Dependence focused on measuring nalmefene, alcohol consumption, liver effects

Eligibility Criteria

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

Inclusion Criteria:

  • The patient has alcohol dependence, diagnosed at screening according to DSM-IV-TR™
  • The patient has had an average alcohol consumption at, at least, a high drinking risk level (that is >60 g of alcohol/day for men and >40 g of alcohol/day for women) in the 4 weeks preceding the Screening Visit and in the period between the Screening and Inclusion Visits (that is, in the Screening Period)
  • The patient has liver impairment defined by elevated liver stiffness and elevated liver enzymes at the Screening Visit (both criteria have to be fulfilled): liver stiffness (LS) as measured by Fibroscan >6 kPa, elevated transaminases (AST or ALT). Transaminase levels up to 5 times the upper limit of the reference range and γGT levels up to 10 times the upper limit of the reference range are allowed. At the discretion of the investigator, transaminase levels >5 times the upper limit of the reference range and γGT >10 times the upper limit of the reference range can be allowed if considered habitual for the patient, either confirmed by patient records or a repeat measurement during the Screening Period
  • The patient has a breath alcohol concentration (BrAC) <0.02% at the Screening Visit.
  • The patient provides a stable address and telephone number
  • The patient is a man or woman, aged ≥ 18 years
  • The patient has BMI≤30 kg/m2

Exclusion Criteria:

  • The patient has any psychiatric disorder or Axis I disorder (DSM-IV-TR™ criteria), established as the primary diagnosis, other than alcohol dependence assessed using the Mini International Neuropsychiatric Interview (MINI) or another diagnostic interview , that in any way will interfere with the ability of the patient to take part in the study
  • The patient has reported current use of, or has been tested positive for, drugs of abuse (opiates, methadone, cocaine, amphetamines [including ecstasy], barbiturates)
  • The patient has severe liver impairment classified with a Child-Pugh Score C
  • The patient has one or more clinical laboratory test values outside the reference range, based on the blood and urine samples taken at the Screening Visit, that are of potential risk to the patient's safety, or the patient has: Severe renal impairment (eGFR <30 mL/min per 1.73 m2), and/or Hypercholesterolemia with serum cholesterol levels > 300 mg/dL, (>7,758 mmol/L), and/or bilirubin > 3 mg/dL (50 μmol/L)
  • The patient has had <6 heavy drinking days (HDDs, defined by the European Medicines Agency as a day with an alcohol consumption >60 g for men or >40 g for women) in the 4 weeks preceding the Screening Visit
  • The patient has >5 consecutive abstinence days in the 4 weeks preceding the Screening Visit
  • The patient has a recent history of acute alcohol withdrawal syndrome (including hallucinations, seizures, or delirium tremens)

Other protocol-defined inclusion and exclusion criteria may apply.

Sites / Locations

  • DE001
  • DE002
  • Optuminisight

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Selincro® (nalmefene) 18 mg, tablets

Arm Description

One tablet orally for 12 weeks on days when the patient perceives a risk of drinking alcohol, preferably 1-2 hours prior to the anticipated risk of drinking.

Outcomes

Primary Outcome Measures

Change from baseline in the number of heavy drinking days per month (HDDs) (days/month)
Change from baseline in the number of HDDs per week (days/week)
Change from baseline in total alcohol consumption (TAC) (g alcohol/day)
Change from baseline in TAC (g alcohol/day)
Response Shift Drinking Risk Level (RSDRL)
Defined as a downward shift from baseline in drinking risk level (DRL); for patients with a very high DRL at baseline, a shift to medium DRL or lower; for patients with a high DRL at baseline, a shift to low DRL or below
Response Low Drinking Risk Level (RLDRL)
Defined as a downward shift from baseline in DRL to low DRL or below
Response defined as ≥70% reduction in TAC
Response defined as 0 to 4 HDDs (days/month)
Clinical Global Impression, global improvement (CGI-I).
Change from baseline in Clinical Global Impression, Severity of illness (CGI-S)
Change in the Short-Form 36-Item Health Survey (SF-36)
Change in liver stiffness
Category shift in fibrosis stage
Change in transaminases and γ-glutamyl transferase (γGT)
Change in bilirubin, albumin, and International Normalized Ratio (INR)
Number of adverse events

Secondary Outcome Measures

Full Information

First Posted
July 21, 2014
Last Updated
December 13, 2016
Sponsor
H. Lundbeck A/S
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1. Study Identification

Unique Protocol Identification Number
NCT02197598
Brief Title
Treatment of Patients Suffering of Alcohol Dependence and Impaired Liver Function With Selincro® As-needed Use
Official Title
Exploratory, Interventional, Open-label, Fixed-dose Study With Selincro® As-needed Use, in Alcohol Dependent Patients With Liver Impairment
Study Type
Interventional

2. Study Status

Record Verification Date
December 2016
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lundbeck A/S

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to explore the treatment effects of Selincro in alcohol dependent patients with liver impairment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcohol Dependence
Keywords
nalmefene, alcohol consumption, liver effects

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Selincro® (nalmefene) 18 mg, tablets
Arm Type
Experimental
Arm Description
One tablet orally for 12 weeks on days when the patient perceives a risk of drinking alcohol, preferably 1-2 hours prior to the anticipated risk of drinking.
Intervention Type
Drug
Intervention Name(s)
nalmefene
Other Intervention Name(s)
Selincro®
Primary Outcome Measure Information:
Title
Change from baseline in the number of heavy drinking days per month (HDDs) (days/month)
Time Frame
Baseline to months 1, 2 and 3
Title
Change from baseline in the number of HDDs per week (days/week)
Time Frame
Baseline to weeks 1 and 2
Title
Change from baseline in total alcohol consumption (TAC) (g alcohol/day)
Time Frame
Baseline to months 1, 2 and 3
Title
Change from baseline in TAC (g alcohol/day)
Time Frame
Baseline to weeks 1 and 2
Title
Response Shift Drinking Risk Level (RSDRL)
Description
Defined as a downward shift from baseline in drinking risk level (DRL); for patients with a very high DRL at baseline, a shift to medium DRL or lower; for patients with a high DRL at baseline, a shift to low DRL or below
Time Frame
Baseline to month 3
Title
Response Low Drinking Risk Level (RLDRL)
Description
Defined as a downward shift from baseline in DRL to low DRL or below
Time Frame
Baseline to month 3
Title
Response defined as ≥70% reduction in TAC
Time Frame
Baseline to month 3
Title
Response defined as 0 to 4 HDDs (days/month)
Time Frame
Month 3
Title
Clinical Global Impression, global improvement (CGI-I).
Time Frame
Weeks 4 and 12
Title
Change from baseline in Clinical Global Impression, Severity of illness (CGI-S)
Time Frame
Baseline to weeks 4 and 12
Title
Change in the Short-Form 36-Item Health Survey (SF-36)
Time Frame
Baseline to week 12
Title
Change in liver stiffness
Time Frame
Baseline to weeks 1,2 4 and 12
Title
Category shift in fibrosis stage
Time Frame
Baseline to weeks 1,2 4, and 12
Title
Change in transaminases and γ-glutamyl transferase (γGT)
Time Frame
Baseline to weeks 1,2,4,8, and 12
Title
Change in bilirubin, albumin, and International Normalized Ratio (INR)
Time Frame
Baseline to weeks 1,2,4,8, and 12
Title
Number of adverse events
Time Frame
Screening to week 14

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient has alcohol dependence, diagnosed at screening according to DSM-IV-TR™ The patient has had an average alcohol consumption at, at least, a high drinking risk level (that is >60 g of alcohol/day for men and >40 g of alcohol/day for women) in the 4 weeks preceding the Screening Visit and in the period between the Screening and Inclusion Visits (that is, in the Screening Period) The patient has liver impairment defined by elevated liver stiffness and elevated liver enzymes at the Screening Visit (both criteria have to be fulfilled): liver stiffness (LS) as measured by Fibroscan >6 kPa, elevated transaminases (AST or ALT). Transaminase levels up to 5 times the upper limit of the reference range and γGT levels up to 10 times the upper limit of the reference range are allowed. At the discretion of the investigator, transaminase levels >5 times the upper limit of the reference range and γGT >10 times the upper limit of the reference range can be allowed if considered habitual for the patient, either confirmed by patient records or a repeat measurement during the Screening Period The patient has a breath alcohol concentration (BrAC) <0.02% at the Screening Visit. The patient provides a stable address and telephone number The patient is a man or woman, aged ≥ 18 years The patient has BMI≤30 kg/m2 Exclusion Criteria: The patient has any psychiatric disorder or Axis I disorder (DSM-IV-TR™ criteria), established as the primary diagnosis, other than alcohol dependence assessed using the Mini International Neuropsychiatric Interview (MINI) or another diagnostic interview , that in any way will interfere with the ability of the patient to take part in the study The patient has reported current use of, or has been tested positive for, drugs of abuse (opiates, methadone, cocaine, amphetamines [including ecstasy], barbiturates) The patient has severe liver impairment classified with a Child-Pugh Score C The patient has one or more clinical laboratory test values outside the reference range, based on the blood and urine samples taken at the Screening Visit, that are of potential risk to the patient's safety, or the patient has: Severe renal impairment (eGFR <30 mL/min per 1.73 m2), and/or Hypercholesterolemia with serum cholesterol levels > 300 mg/dL, (>7,758 mmol/L), and/or bilirubin > 3 mg/dL (50 μmol/L) The patient has had <6 heavy drinking days (HDDs, defined by the European Medicines Agency as a day with an alcohol consumption >60 g for men or >40 g for women) in the 4 weeks preceding the Screening Visit The patient has >5 consecutive abstinence days in the 4 weeks preceding the Screening Visit The patient has a recent history of acute alcohol withdrawal syndrome (including hallucinations, seizures, or delirium tremens) Other protocol-defined inclusion and exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Email contact via H.Lundbeck A/S
Organizational Affiliation
LundbeckClinicalTrials@lundbeck.com
Official's Role
Study Director
Facility Information:
Facility Name
DE001
City
Heidelberg
Country
Germany
Facility Name
DE002
City
Mannheim
Country
Germany
Facility Name
Optuminisight
City
München
Country
Germany

12. IPD Sharing Statement

Available IPD and Supporting Information:
Available IPD/Information Type
EMA EudraCT Results
Available IPD/Information URL
https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-000413-31/results
Available IPD/Information Identifier
2014-000413-31

Learn more about this trial

Treatment of Patients Suffering of Alcohol Dependence and Impaired Liver Function With Selincro® As-needed Use

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