- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03645408
The Effects of Exenatide, a GLP-1 Agonist, on Alcohol Self-Administration in Heavy Drinkers
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This proposal was intended to answer the call for accelerating drug development by exploring the potential of a glucagon-like peptide-1 (GLP-1) agonist, exenatide, as a candidate medication for the treatment of Alcohol Use Disorder. There is now substantial preclinical evidence that GLP-1 agonists can attenuate behaviors that model both the consumption and seeking of several commonly abused substances including alcohol, cocaine, and nicotine. This study was intended to accelerate medication development for Alcohol Use Disorder by testing a commercially-available and well-tolerated agent at a fraction of the cost of new drug discovery. None of the FDA-approved Alcohol Use Disorder medications or off-label Alcohol Use Disorder medications target this GLP-1 pathway, making exenatide a promising compound for Alcohol Use Disorder drug development.
The primary aim of this study was to test the effects of exenatide on alcohol self-administration and craving among heavy drinkers. In this within-subjects crossover design, 3 heavy drinkers were randomized to exposure order (exenatide or sham injection) prior to completing two alcohol self-administration trials. Subjects received a priming drink of alcohol and had access to 8 drinks over a 2-hour period. The investigators anticipated that subjects would consume less alcohol following the administration of exenatide compared to when they received a sham injection. Significant exenatide-induced reductions in drinking would be considered to be an indication that this drug may have value as an Alcohol Use Disorder medication. This study may provide a rationale for phase II randomized controlled trials testing exenatide with a treatment-seeking Alcohol Use Disorder population. These results may also help to spur further clinical investigation of the effects of exenatide and other available GLP-1 agonists on the factors implicated in the regulation of alcohol consumption.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02118
- Boston University Psychiatry Research Center, Clinical Studies Unit
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 21-55 years of age.
- Able to verify age with a state or federal picture identification.
- Exceeds safe weekly drinking limits [4 standard drink units (SDUs) for women or 21 SDUs for men per week]
- Reports at least one episode of binge drinking (>3 SDUs for women, >4 SDUs for men) an average of once per week in the four weeks prior to baseline screening.
- Meets Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition (DSM-5)criteria for mild alcohol use disorder or greater severity.
Exclusion Criteria:
- Seeking treatment for alcohol problems.
- Clinical Institute Withdrawal Assessment at ≥10
- DSM-5 diagnosis of current major depression, bipolar disorder, schizophrenia, bulimia/anorexia, dementia, or a substance use disorder other than alcohol, nicotine, marijuana or caffeine.
- If female, pregnant, nursing, have plans to become pregnant.
- If female, does not agree to use an accepted form of birth control.
- Has a medical contraindication to the use of exenatide.
- Has medical or mental condition for which further alcohol exposure at the planned dose range would be contraindicated.
- Current risk of suicidality (MINI suicidality score greater than 8 (low risk) or Yes to the ideation question #4 of the C-SSRS).
- BMI is less than 18 or greater than or equal to 30.
- History of diabetes.
- Baseline hemoglobin A1c ≥ 6.5%
- Baseline non fasting glucose >200
- Significantly elevated serum lipase levels.
- Impaired renal function (GFR <80 mL/min).
- Pancreatitis, gastroparesis or other severe gastrointestinal disease.
- Has had gastric bypass surgery
- Subject is currently taking warfarin.
- Has received alcohol counseling or other non-pharmacologic intervention to treat AUD in the past 90 days.
- Has taken medications that are used to treat alcohol use disorder (AUD) in the past 90 days.
- Subjects with a history of thyroid cancer or other thyroid disease.
- Has urine toxicology results positive for cocaine, opioids, amphetamines, buprenorphine, methadone, or methamphetamines.
- Prior history of anaphylaxis or angioedema with another GLP-1 receptor agonist.
- Prior use of exenatide
- Liver function values AST or ALT are twice the normal limit
- Unable to comfortably abstain from nicotine for a period of 8 hours.
- Has Chronic obstructive pulmonary disease (COPD), history of solid organ transplant, sickle cell disease, severe heart disease or other health condition for which exposure to COVID-19 represents an unreasonable risk as determined by the study staff physician using accepted COVID-19 guidance (e.g. Centers for Disease Control, etc.).
- Subject has prior history of Drug-induced thrombocytopenia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Exenatide then Placebo
This is a within subjects design study in which each subject receives both study drug and placebo.
Subjects in this arm received a 5 mcg dose of immediate release exenatide on the day of the first alcohol self-administration trial.
The 5mcg dose of exenatide was approved as the first dose administered to patients at the start of their treatment with this drug for FDA-approved indications.
Subjects in this arm then received a sham injection on the day of the second alcohol self-administration trial.
The sham injection was a needle stick using a syringe with no drug injected.
Note that the volume of fluid injected for a 5mcg dose is so small that subjects would not sense this volume of fluid (or lack thereof) during the injection.
Subjects were shielded from seeing the injection to maintain the blind.
|
Subject received an injection of 5 mcg of immediate release exenatide.
Other Names:
Subjects received a sham injection with no study drug.
Other Names:
|
Experimental: Placebo then Exenatide
This is a within subjects design study in which each subject receives both study drug and placebo.
Subjects in this arm received a sham injection on the day of the first alcohol self-administration trial.
The sham injection was a needle stick using a syringe with no drug injected.
Subjects in this arm then received a 5 mcg dose of immediate release exenatide on the day of the second alcohol self-administration trial.
The 5mcg dose of exenatide was approved as the first dose administered to patients at the start of their treatment with this drug for FDA-approved indications.
Note that the volume of fluid injected for a 5mcg dose is so small that subjects would not sense this volume of fluid (or lack thereof) during the injection.
Subjects were shielded from seeing the injection to maintain the blind.
|
Subject received an injection of 5 mcg of immediate release exenatide.
Other Names:
Subjects received a sham injection with no study drug.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Alcohol Consumption
Time Frame: 2 hours
|
Alcohol consumption was measured by using a graduated cylinder to determine the amount of alcohol given to the subject that was not consumed.
The amount not consumed was then subtracted from the total amount of alcohol served to the subject in order to calculate the amount consumed.
This outcome was measured in standard drink units (SDUs).
A standard drink contains approximately 0.6 fluid ounces of pure alcohol.
|
2 hours
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Eric Devine, PhD, Boston Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-38015
- R21AA027332-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Alcohol Use Disorder
-
Washington State UniversityRecruitingNicotine Use Disorder | Alcohol Use Disorder (AUD)United States
-
University of North Carolina, Chapel HillCompletedAlcohol Use Disorder, Mild | Alcohol Use Disorder, ModerateUnited States
-
Université du Québec à Trois-RivièresCompletedAlcohol Use, Unspecified | Alcohol Use Disorder, MildCanada
-
Woebot HealthStanford UniversityCompletedSubstance Use Disorders | Alcohol Use Disorder (AUD)United States
-
Medical University of South CarolinaNational Institute on Alcohol Abuse and Alcoholism (NIAAA); National Institutes...RecruitingAlcohol Drinking | Substance Use | Alcohol Use Disorder | Drinking, Alcohol | Alcohol Use Disorder (AUD)United States
-
Kaiser PermanenteNORC at the University of Chicago; Agency for Healthcare Research and Quality... and other collaboratorsCompleted
-
ITAB - Institute for Advanced Biomedical TechnologiesNot yet recruitingNeurobiological Effects of Transcranial Direct Current Stimulation Treatment in Alcohol Use DisorderAlcohol Dependence | Alcohol-Related Disorders | Substance Use Disorders | Drug Abuse | Mental Disorder | Alcohol Abuse | Alcohol Use Disorder (AUD)
-
Centre Hospitalier Universitaire de NīmesRecruiting
-
Central Institute of Mental Health, MannheimNot yet recruitingAlcohol Use Disorder (AUD)Germany
-
Massachusetts General HospitalMbarara University of Science and TechnologyCompletedAlcohol Use Disorder (AUD)Uganda
Clinical Trials on Exenatide
-
AstraZenecaEli Lilly and CompanyCompletedType 2 Diabetes MellitusUnited States
-
AstraZenecaCompletedType 2 Diabetes MellitusCanada, United States
-
AstraZenecaEli Lilly and CompanyCompletedType 2 Diabetes MellitusKorea, Republic of, China, Japan, Taiwan, India
-
AstraZenecaCompletedDiabetes Mellitus, Type 2United States
-
AstraZenecaEli Lilly and CompanyCompletedType 2 Diabetes MellitusKorea, Republic of, Mexico, Germany, Greece, Argentina, India, Australia
-
AstraZenecaEli Lilly and CompanyCompletedType 2 Diabetes MellitusUnited States
-
AstraZenecaCelerionCompleted
-
Beijing Chao Yang HospitalCompleted
-
AstraZenecaEli Lilly and CompanyCompletedType 2 DiabetesUnited States
-
University at BuffaloAmylin Pharmaceuticals, LLC.Completed