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Validation of a Test System for Development of Medications for Alcoholism (TEMANX)

Primary Purpose

Alcoholism

Status
Completed
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Naltrexone
Placebo
Sponsored by
Technische Universität Dresden
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Alcoholism focused on measuring Alcoholism, alcohol self-administration

Eligibility Criteria

25 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • male and female volunteers aged 25 to 55 years
  • at least weekly alcohol consumption at a medium risk level according to WHO in the Timeline Follow-back Interview over the last 45 day with an average amount of alcohol of 41 g/day (men) or 31 g/day (women)
  • at least 6 days with an alcohol consumption of >100 g/day (men) or 75 g/day (women) and at least 4 non consecutive alcohol abstinent days in the last 45 days
  • at least 1 drinking day in each full week between screening and visit 1 and not more than 6 abstinent days in the week before visit 1
  • no demand of treatment of the risky alcohol consumption
  • written consent after Information

Exclusion Criteria:

  • a history of hypersensitivity against alcohol or one of the used medicinal products, of their ingredients or medicinal products with similar chemical structures
  • participation in another clinical trial within the last 4 weeks before inclusion
  • addiction or other disorders, which will not allow the subject to assess the character and importance or possible consequences of the clinical trial
  • pregnant or breastfeeding women
  • women capable of bearing children, except women who fulfil following criteria:- post-menopausal (12 months natural amenorrhoea or 6 month amenorrhoea and Serum FSH >40 ml U/ml) - post operative (6 weeks after ovariectomy on both sides with or without hysterectomy) - regular and correct use of a contraceptive method with an error Quote of < 1 % per year (for example implants, depot injections, oral contraceptive, IUP). It has to be recognized that a combined oral contraception - in contrast to pure progesterone compounds - have a failure rate of < 1 %. Hormone IUDs with a Pearl Index of 1 % are safer than copper IUDs. - sexual abstinence - vasectomy of the Partner
  • evidence that the participant is not expected to comply with the protocol (for example lacking compliance)
  • current or previous alcohol or substance dependence according to DSM-IV (exception: tobacco dependence)
  • current or previous treatment because of alcohol, for example in an addiction advisory cen-tre, self-help group, detoxification treatment
  • current or previous diseases, where an alcohol infusion can cause a clinically relevant hazard (e. g. pancreatitis, liver cirrhosis)
  • current or planned intake of opiate analgesics
  • current psychiatric treatment or intake of psychiatric drug or suffering from of a psychiatric disease requiring treatment
  • a history of suicide attempt
  • CIWA-Score >5 at Screening (alcohol withdrawal scale)
  • a history of symptoms of alcohol withdrawal, epileptic seizures or delirium
  • routine laboratory Parameters, indicating relevant liver-, pancreas- or kidney injury, an acute infection, anaemia or lack of vitamins (ASAT, ALAT > twofold of the standard at screening, gamma-GT, lipase >threefold of the standard, CRP < 15 mg/l, creatin indicating a moderate renal insufficiency ( eGFR <60 ml/min), leucocytes > 12000/µl, haemoglobin < 7,5 mmol/l (men) or 6,5 mmol/l (women), MCV > 100 fl)
  • Body weight > 130 kg
  • drug screening in urine: once positive at screening for opiate, cannabis, cocaine, amphetamines, benzodiazepines or positive once at visit 1 for opiates or positive twice at visit 1 for cannabis, cocaine, amphetamines, benzodiazepines
  • breath alcohol concentration at screening once > 0,00 g/kg or twice >0,00 g/kg at visit 1
  • unsuitable for fMRT (e. g. cardiac pacemaker, claustrophobia)
  • specific contraindications against naltrexone: o acute hepatitis o severe or acute liver disease o severe kidney disease o rare hereditary galactose intolerance, Lapp-lactase-deficiency or Glucose-galactose-malabsorption

Sites / Locations

  • Klinik und Poliklinik für Psychiatrie und Psychotherapie

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Naltrexone

Placebo

Arm Description

1 capsule naltrexone 25 mg per day, oral use, day 1 to day 3; 1 capsule naltrexone 50 mg per day, oral use, day 4 to day 28

1 capsule placebo, oral use, day 1 to day 28

Outcomes

Primary Outcome Measures

Difference CAT Trials alcohol
Difference of cumulative number of work sets for alcohol in the "constant attention task" between first measurement (without medication) and second measurement (with medication)

Secondary Outcome Measures

Difference CAT Trials sodium chloride solution
Difference of cumulative number of work sets for sodium chloride solution in the "constant attention task" between first measurement (without medication) and second measurement (with medication)
break Point alcohol
Difference of the "break point" in the "progressive work" schedule for the work for alcohol between first measurement (without medication) and second measurement (with medication). The "break point" is the number of the last alcohol request before subjects stop to work for more alcohol.
max. BAC
Maximal achieved blood alcohol concentration (BAC) in alcohol self-administration between first measurement (without medication) and second measurement (with medication)
Drinking habits
Drinking habits measured with Timeline Follow-back Interview over 45 days before study start (measured at screening) and over the entire study duration (between screening and the last day of medicinal product intake, ascertained at visit 5): drinking days, amount of alcohol per drinking day and number of days with alcohol consumption over 60 g (men) or 48 g (women)
CDT - level
CDT - level: (carbohydrate-deficient transferrin), measured at visit 1 and visit 5
alcohol craving
Alcohol craving in daily routine (OCD - scale) measured at visit 1 and visit 4
subjective alcohol effects
Difference in subjective alcohol effects between first measurement (without medication) and second measurement (with medication), measured with visual analogue scales ("Quizzer") before, during and after the alcohol infusion
motor impulse control
Capacity for motor impulse control during infusion of physiologic saline solution or alcohol as NIMPs (single-blinded), measured with the counting stroop task (in Verum and placebo group) at visit 3 and 4
cerebral blood flow (CBF)
Regional cerebral perfusion in ml/100 g tissue per Minute during infusion of sodium chloride solution or alcohol as NIMPs (single-blinded), measured with arterial spin labeling (ASL) under verum or placebo condition at visit 3 and 4
Cerebral resting state activity
Cerebral resting state activity during infusion of sodium chloride solution or alcohol as NIMPs (single-blinded), measured with BOLD fMRI (in Verum and placebo group) at visit 3 and 4
adverse events
Medical survey concerning occurring adverse events at visit 1 to 5
ALAT
ALAT (alanine aminotransferase) in µmol/ s*l before inclusion (screening visit), at visit 4 and after finishing all study relating interventions (visit 5)
ASAT
ASAT (aspartate aminotransferase) in µmol/ s*l before inclusion (screening visit), at visit 4 and after finishing all study relating interventions (visit 5)
Gamma-GT
Gamma-GT in µmol/ s*l before inclusion (screening visit) and after finishing all study relating interventions (visit 5)
standard blood cell count
standard blood cell count before inclusion (screening visit), at visit 4 and after finishing all study relating interventions (visit 5)
creatinine
creatinine in µmol/l before inclusion (screening visit)
lipase
lipase in µmol/ s*l before inclusion (screening visit) and after finishing all study relating interventions (visit 5)
CRP
CRP (C-reactive protein) in mg / l before inclusion (screening visit) and after finishing all study relating interventions (visit 5)

Full Information

First Posted
January 6, 2016
Last Updated
September 26, 2017
Sponsor
Technische Universität Dresden
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1. Study Identification

Unique Protocol Identification Number
NCT02652585
Brief Title
Validation of a Test System for Development of Medications for Alcoholism
Acronym
TEMANX
Official Title
Validation of a Test System for Development of Medications for Alcoholism
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
February 2016 (Actual)
Primary Completion Date
August 25, 2017 (Actual)
Study Completion Date
September 4, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Technische Universität Dresden

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Using theTEMA (test system for development of medications for alcoholism) it can be shown, that naltrexone administration reduces the willingness to perform work for alcohol infusion in a laboratory experiment.
Detailed Description
Objective of this study is to show that a laboratory alcohol self-administration method can predict the therapeutic potential of new compounds to reduce relapse in alcohol-dependent patients. The 'TEMA" translates several animal behavioral paradigms of alcohol self-administration into corresponding human experiments. We will investigate the opiate antagonist Naltrexone, whose anti-relapse effect is well documented, as a reference drug for validation. Main objective: With TEMA (test system for development of medications for alcoholism ) it can be shown, that naltrexone administration reduces the willingness to perform work for alcohol infusion in a laboratory experiment. Secondary objectives: administration of naltrexone in comparison to placebo leads to a reduction of alcohol craving and real-life drinking administration of naltrexone in comparison to placebo leads to reduction of the CDT-Level administration of naltrexone in comparison to placebo leads to a change in perception of subjective alcohol effects the effectiveness of naltrexone can be predicted by the A118G polymorphism of the OPRM1 administration of naltrexone changes the baseline and alcohol-induced ability of motor inhibition administration of naltrexone changes the baseline and alcohol-induced regional cerebral perfusion administration of naltrexone changes the baseline and alcohol-induced cerebral resting state activity changes of alcohol effects to the brain activity induced by naltrexone in comparison to placebo correlate with effects of naltrexone on the willingness to work for alcohol self-administration

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcoholism
Keywords
Alcoholism, alcohol self-administration

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Naltrexone
Arm Type
Active Comparator
Arm Description
1 capsule naltrexone 25 mg per day, oral use, day 1 to day 3; 1 capsule naltrexone 50 mg per day, oral use, day 4 to day 28
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
1 capsule placebo, oral use, day 1 to day 28
Intervention Type
Drug
Intervention Name(s)
Naltrexone
Other Intervention Name(s)
Adepend
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
capsule filled with micro crystalline cellulose, manufactured to mimic naltrexone capsule
Primary Outcome Measure Information:
Title
Difference CAT Trials alcohol
Description
Difference of cumulative number of work sets for alcohol in the "constant attention task" between first measurement (without medication) and second measurement (with medication)
Time Frame
one year
Secondary Outcome Measure Information:
Title
Difference CAT Trials sodium chloride solution
Description
Difference of cumulative number of work sets for sodium chloride solution in the "constant attention task" between first measurement (without medication) and second measurement (with medication)
Time Frame
one year
Title
break Point alcohol
Description
Difference of the "break point" in the "progressive work" schedule for the work for alcohol between first measurement (without medication) and second measurement (with medication). The "break point" is the number of the last alcohol request before subjects stop to work for more alcohol.
Time Frame
one year
Title
max. BAC
Description
Maximal achieved blood alcohol concentration (BAC) in alcohol self-administration between first measurement (without medication) and second measurement (with medication)
Time Frame
one year
Title
Drinking habits
Description
Drinking habits measured with Timeline Follow-back Interview over 45 days before study start (measured at screening) and over the entire study duration (between screening and the last day of medicinal product intake, ascertained at visit 5): drinking days, amount of alcohol per drinking day and number of days with alcohol consumption over 60 g (men) or 48 g (women)
Time Frame
one year
Title
CDT - level
Description
CDT - level: (carbohydrate-deficient transferrin), measured at visit 1 and visit 5
Time Frame
one year
Title
alcohol craving
Description
Alcohol craving in daily routine (OCD - scale) measured at visit 1 and visit 4
Time Frame
one year
Title
subjective alcohol effects
Description
Difference in subjective alcohol effects between first measurement (without medication) and second measurement (with medication), measured with visual analogue scales ("Quizzer") before, during and after the alcohol infusion
Time Frame
one year
Title
motor impulse control
Description
Capacity for motor impulse control during infusion of physiologic saline solution or alcohol as NIMPs (single-blinded), measured with the counting stroop task (in Verum and placebo group) at visit 3 and 4
Time Frame
one year
Title
cerebral blood flow (CBF)
Description
Regional cerebral perfusion in ml/100 g tissue per Minute during infusion of sodium chloride solution or alcohol as NIMPs (single-blinded), measured with arterial spin labeling (ASL) under verum or placebo condition at visit 3 and 4
Time Frame
one year
Title
Cerebral resting state activity
Description
Cerebral resting state activity during infusion of sodium chloride solution or alcohol as NIMPs (single-blinded), measured with BOLD fMRI (in Verum and placebo group) at visit 3 and 4
Time Frame
one year
Title
adverse events
Description
Medical survey concerning occurring adverse events at visit 1 to 5
Time Frame
one year
Title
ALAT
Description
ALAT (alanine aminotransferase) in µmol/ s*l before inclusion (screening visit), at visit 4 and after finishing all study relating interventions (visit 5)
Time Frame
one year
Title
ASAT
Description
ASAT (aspartate aminotransferase) in µmol/ s*l before inclusion (screening visit), at visit 4 and after finishing all study relating interventions (visit 5)
Time Frame
one year
Title
Gamma-GT
Description
Gamma-GT in µmol/ s*l before inclusion (screening visit) and after finishing all study relating interventions (visit 5)
Time Frame
one year
Title
standard blood cell count
Description
standard blood cell count before inclusion (screening visit), at visit 4 and after finishing all study relating interventions (visit 5)
Time Frame
one year
Title
creatinine
Description
creatinine in µmol/l before inclusion (screening visit)
Time Frame
one year
Title
lipase
Description
lipase in µmol/ s*l before inclusion (screening visit) and after finishing all study relating interventions (visit 5)
Time Frame
one year
Title
CRP
Description
CRP (C-reactive protein) in mg / l before inclusion (screening visit) and after finishing all study relating interventions (visit 5)
Time Frame
one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: male and female volunteers aged 25 to 55 years at least weekly alcohol consumption at a medium risk level according to WHO in the Timeline Follow-back Interview over the last 45 day with an average amount of alcohol of 41 g/day (men) or 31 g/day (women) at least 6 days with an alcohol consumption of >100 g/day (men) or 75 g/day (women) and at least 4 non consecutive alcohol abstinent days in the last 45 days at least 1 drinking day in each full week between screening and visit 1 and not more than 6 abstinent days in the week before visit 1 no demand of treatment of the risky alcohol consumption written consent after Information Exclusion Criteria: a history of hypersensitivity against alcohol or one of the used medicinal products, of their ingredients or medicinal products with similar chemical structures participation in another clinical trial within the last 4 weeks before inclusion addiction or other disorders, which will not allow the subject to assess the character and importance or possible consequences of the clinical trial pregnant or breastfeeding women women capable of bearing children, except women who fulfil following criteria:- post-menopausal (12 months natural amenorrhoea or 6 month amenorrhoea and Serum FSH >40 ml U/ml) - post operative (6 weeks after ovariectomy on both sides with or without hysterectomy) - regular and correct use of a contraceptive method with an error Quote of < 1 % per year (for example implants, depot injections, oral contraceptive, IUP). It has to be recognized that a combined oral contraception - in contrast to pure progesterone compounds - have a failure rate of < 1 %. Hormone IUDs with a Pearl Index of 1 % are safer than copper IUDs. - sexual abstinence - vasectomy of the Partner evidence that the participant is not expected to comply with the protocol (for example lacking compliance) current or previous alcohol or substance dependence according to DSM-IV (exception: tobacco dependence) current or previous treatment because of alcohol, for example in an addiction advisory cen-tre, self-help group, detoxification treatment current or previous diseases, where an alcohol infusion can cause a clinically relevant hazard (e. g. pancreatitis, liver cirrhosis) current or planned intake of opiate analgesics current psychiatric treatment or intake of psychiatric drug or suffering from of a psychiatric disease requiring treatment a history of suicide attempt CIWA-Score >5 at Screening (alcohol withdrawal scale) a history of symptoms of alcohol withdrawal, epileptic seizures or delirium routine laboratory Parameters, indicating relevant liver-, pancreas- or kidney injury, an acute infection, anaemia or lack of vitamins (ASAT, ALAT > twofold of the standard at screening, gamma-GT, lipase >threefold of the standard, CRP < 15 mg/l, creatin indicating a moderate renal insufficiency ( eGFR <60 ml/min), leucocytes > 12000/µl, haemoglobin < 7,5 mmol/l (men) or 6,5 mmol/l (women), MCV > 100 fl) Body weight > 130 kg drug screening in urine: once positive at screening for opiate, cannabis, cocaine, amphetamines, benzodiazepines or positive once at visit 1 for opiates or positive twice at visit 1 for cannabis, cocaine, amphetamines, benzodiazepines breath alcohol concentration at screening once > 0,00 g/kg or twice >0,00 g/kg at visit 1 unsuitable for fMRT (e. g. cardiac pacemaker, claustrophobia) specific contraindications against naltrexone: o acute hepatitis o severe or acute liver disease o severe kidney disease o rare hereditary galactose intolerance, Lapp-lactase-deficiency or Glucose-galactose-malabsorption
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ulrich S Zimmermann, MD
Organizational Affiliation
Klinik und Poliklinik für Psychiatrie und Psychotherapie Unversitätsklinikum Carl Gustav Carus Dresden
Official's Role
Study Director
Facility Information:
Facility Name
Klinik und Poliklinik für Psychiatrie und Psychotherapie
City
Dresden
ZIP/Postal Code
01307
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Validation of a Test System for Development of Medications for Alcoholism

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