Effects of Intranasal Administration of a Single Dose of Oxytocin Using a Novel Device in Adults With Autism Spectrum Disorder

A Randomized, Placebo Controlled, Double-blind, 3-period Cross-over Study in Adult Patients With Autism Spectrum Disorders Evaluating Cognitive Response After Single- Dose Oxytocin 8 or 24 IU Intranasal Administration Using the OptiNose Bi-directional Nose-to-brain Device

Oxytocin (OT) is a small, naturally occurring peptide currently in clinical use to stimulate lactation in breastfeeding women. The intranasal administration of OT has recently attracted attention as a potential novel treatment in several psychiatric disorders in autism. However, given the anatomy of the nasal cavity, the current design of nasal sprays would be expected to provide an inadequate delivery of medication to the areas of the nasal cavity where direct transport into the brain via the olfactory nerve could potentially occur. OptiNose has developed an intranasal delivery device that provides improved reproducibility of nasal delivery, improved deposition to the upper posterior regions of the nasal cavity where the olfactory nerve innervates the nasal cavity.

The primary objective of this study is to identify any differences between a single dose of 8 international units (IU) oxytocin, 24 IU oxytocin, and placebo delivered intranasally with the optimised OptiNose device in volunteers with Autism Spectrum Disorder. This will be measured in terms of performance on cognitive tests and physiological markers.

Study Overview

• Status: Completed
• Conditions: Autism Spectrum Disorder
• Intervention / Treatment: Drug: Placebo; Drug: 8IU intranasal oxytocin; Device: OptiNose Breath Powered Bi; Drug: 24IU intranasal oxytocin

• Study Type: Interventional
• Enrollment (Actual): 17
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway, 0424
    • NORMENT, KG Jebsen Centre for Psychosis Research - TOP Study

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 35 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Male subjects between the ages of 18 and 35, both inclusive, with a confirmed diagnosis of autism spectrum disorder (ASD) diagnosis.
• Subjects must be in good general health, as determined by the investigator.
• Subject's pre-study physical examination, vital signs and electrocardiogram (ECG) must not show any clinically significant abnormalities as determined by the investigator.
• Subjects must be able to communicate well with the Investigator, to understand and comply with the requirements of the study, and to understand the oral and written patient information
• Provision of a signed, written informed consent.

Exclusion Criteria:

• Subjects showing major septal deviation or a significantly altered nasal epithelium.
• Subjects with evidence of previous nasal disease, surgery, and dependence on inhaled drugs.
• Subjects with current significant nasal congestion due to common colds.
• Subjects with a clinically relevant history of significant hepatic, renal, endocrine, cardiac, nervous, pulmonary, haematological or metabolic disorder.
• Psychiatric co-morbidity that requires intervention (e.g., psychosis spectrum disorders, suicide intent)
• Systemic illness requiring treatment within 2 weeks prior to Study Day 1.
• History of significant drug or alcohol abuse (as per WHO Alcohol use disorder identification test and drug use disorder identification test criteria) Subjects with a positive screen for alcohol or drugs of abuse at screening/admission will be excluded from participation in the study.
• Abnormal laboratory values which is deemed clinically significant by investigator.
• Full scale IQ < 75 (due to the prerequisite ability to complete self report measures).
• Known allergic reactions or hypersensitivity to any component of the study medication in the nasal spray, such as propyl parahydroxybenzoate (E216), methyl parahydroxybenzoate (E218) and chlorobutanol hemihydrate.
• Participation in any (other) clinical trial with an investigational medicinal product or medical device within 3 months prior to randomisation.
• Other unspecified reasons that, in the opinion of the investigator or the sponsor make the subject unsuitable for enrollment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: 8IU intranasal oxytocin; 8IU intranasal oxytocin delivered with the OptiNose Breath Powered Bi directional liquid device	Drug: 8IU intranasal oxytocin; Device: OptiNose Breath Powered Bi
Active Comparator: 24IU intranasal oxytocin; 24IU intranasal oxytocin delivered with the OptiNose Breath Powered Bi directional liquid device	Device: OptiNose Breath Powered Bi; Drug: 24IU intranasal oxytocin
Placebo Comparator: Placebo; Placebo delivered with the OptiNose Breath Powered Bi directional liquid device	Drug: Placebo; Device: OptiNose Breath Powered Bi

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performance on an emotion sensitivity test	Participants will complete a task evaluating emotional expressions. These stimuli are identical to those published previously by Leknes et al., (2012).	45 mins after oxytocin/placebo administration
Performance on a facial emotion morphing task	Participants will complete a task evaluating faces that morph into different emotional expressions.	45 mins after oxytocin/placebo administration

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Performance on the reading the mind in the eyes test	Participants will complete the reading the mind in the eyes test	45 mins after oxytocin/placebo administration
Performance on an emotional dot probe task	Participants will complete an emotional dot probe task	45 mins after oxytocin/placebo administration
Heart rate variability	Electrocardiogram data will be collected to assess heart rate variability, a measure of cardiac autonomic function.	40 minutes after oxytocin/placebo administration
Eyetracking	An eyetracking device will measure eyegaze and pupillometry.	45 mins after oxytocin/placebo administration

Collaborators and Investigators

• Sponsor: OptiNose AS
• Collaborators: University of Oslo; Oslo University Hospital
• Investigators: Principal Investigator: Ole A Andreassen, MD, PhD, University of Oslo

Publications and helpful links

General Publications

• Leknes S, Wessberg J, Ellingsen DM, Chelnokova O, Olausson H, Laeng B. Oxytocin enhances pupil dilation and sensitivity to 'hidden' emotional expressions. Soc Cogn Affect Neurosci. 2013 Oct;8(7):741-9. doi: 10.1093/scan/nss062. Epub 2012 May 29.

Helpful Links

• Norwegian Centre for Mental Disorders Research

Study record dates

Study Major Dates

• Study Start: April 1, 2015
• Primary Completion (Actual): February 1, 2016
• Study Completion (Actual): February 1, 2016

Study Registration Dates

• First Submitted: March 31, 2015
• First Submitted That Met QC Criteria: April 9, 2015
• First Posted (Estimate): April 10, 2015

Study Record Updates

• Last Update Posted (Estimate): September 27, 2016
• Last Update Submitted That Met QC Criteria: September 26, 2016
• Last Verified: September 1, 2016

More Information

Terms related to this study

• Keywords: oxytocin; social cognition
• Additional Relevant MeSH Terms: Mental Disorders; Neurodevelopmental Disorders; Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive; Physiological Effects of Drugs; Reproductive Control Agents; Oxytocics; Oxytocin
• Other Study ID Numbers: SMR-2728; 2014-005452-26 (EudraCT Number)