Trial of Cytisine in Adult Smokers

A Multicenter, Double-blind, Randomized, Placebo-controlled Phase 2b Trial of Cytisine in Adult Smokers

This placebo-controlled Phase 2b trial is being conducted at sites within the United States (US) to evaluate the effectiveness cytisine dosage (1.5 mg, 3.0 mg) and administration schedule (commercial titration versus simplified 3 times daily [TID] schedule) within a 25-day treatment period.

Study Overview

• Status: Completed
• Conditions: Smoking Cessation
• Intervention / Treatment: Drug: Cytisine; Behavioral: Behavioral support; Drug: Placebo Comparator

• Study Type: Interventional
• Enrollment (Actual): 254
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Tempe, Arizona, United States, 85283
      • Clinical Research Consortium
  • California
    • Burbank, California, United States, 91505
      • Los Angeles Clinical Trials
  • Kentucky
    • Lexington, Kentucky, United States, 40509
      • Central Kentucky Research Associates, LLC
  • Missouri
    • Kansas City, Missouri, United States, 64114
      • Center for Pharmaceutical Research, LLC
  • New York
    • Rochester, New York, United States, 14609
      • Rochester Clinical Research, Inc
  • South Carolina
    • Mount Pleasant, South Carolina, United States, 29464
      • Coastal Carolina Research Center, Inc
  • Tennessee
    • Knoxville, Tennessee, United States, 37920
      • Volunteer Research Group
  • Texas
    • Dallas, Texas, United States, 57231
      • FutureSearch Trails of Dallas, LP

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Male or female subjects, age ≥ 18 years.
2. Current daily cigarette smokers (averaging ≥ 10 cigarettes per day upon completing a 7-day screening diary) and who intend to quit smoking.
3. Expired air carbon monoxide (CO) ≥ 10 parts per million (ppm).
4. Failed at least one previous attempt to stop smoking with or without therapeutic support.
5. Willing to initiate study treatment on the day after randomization and set a quit date that is 5-7 days after starting treatment.
6. Willing to actively participate in the study's smoking cessation behavioral support provided throughout the study.
7. Able to fully understand all study requirements, willing to participate, comply with dosing schedule, and sign the Informed Consent Form.

Exclusion Criteria:

1. Known hypersensitivity to cytisine or any of the excipients.
2. Positive urinary drugs of abuse screen, determined within 28 days before the first dose of cytisine.
3. Clinically significant abnormal serum chemistry or hematology values within 28 days of randomization (i.e. requiring treatment).
4. Clinically significant abnormalities in 12-lead electrocardiogram (ECG) determined after minimum of 5 minutes in supine position within 28 days of randomization (i.e. requiring treatment or further assessment).
5. Body mass index (BMI) classification for being underweight (< 18.5 kg/m^2) or having ≥ Class 2 obesity (≥ 35 kg/m^2).
6. Recent history (within 3 months) of acute myocardial infarction, unstable angina, stroke, cerebrovascular incident or hospitalization for congestive heart failure.
7. Current uncontrolled hypertension (blood pressure ≥ 160/100 mmHg).
8. Documented diagnosis of schizophrenia or bipolar psychiatric illness; currently psychotic; having suicidal ideation (Suicide Behaviors Questionnaire-Revised [SBQ-R] score ≥ 7); or current symptoms of moderate to severe depression (Hospital Anxiety and Depression Scale [HADS] score ≥ 11).
9. Renal impairment defined as a creatinine clearance (CrCl) < 60 mL/min (estimated with the Cockroft-Gault equation) or hepatic impairment defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.0 times the upper limit of normal (ULN).
10. Women who are pregnant or breast-feeding.
11. Male or Female subjects of child bearing potential who do not agree to use acceptable methods of birth control during the study treatment period.
12. Participation in a clinical study with an investigational drug within 4 weeks of randomization.
13. Treatment with other smoking cessation medications (bupropion, varenicline, nortriptyline, or any nicotine replacement therapy [NRT]) within 4 weeks of randomization or planned use of these other smoking cessation medications during the study.
14. Use within 2 weeks of randomization or planned use during the study of non-cigarette nicotine products (e-cigarettes, pipe tobacco, cigars, snuff, chewing tobacco, hookah) or marijuana vaping or smoking.
15. Any other reason that the investigator views the subject should not participate or would be unable to fulfill the requirements for the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1.5 mg Cytisine, Commercial Schedule; 1.5 mg cytisine dose using the commercial 25-day titration schedule + behavioral support	Drug: Cytisine; film coated tablet containing 1.5 mg cytisine in a single tablet; Behavioral: Behavioral support; 12 behavioral support sessions by a qualified staff member plus supportive literature and online resources
Experimental: 3.0 mg Cytisine, Commercial Schedule; 3.0 mg cytisine dose using the commercial 25-day titration schedule + behavioral support	Drug: Cytisine; film coated tablet containing 1.5 mg cytisine in a single tablet; Behavioral: Behavioral support; 12 behavioral support sessions by a qualified staff member plus supportive literature and online resources
Placebo Comparator: Placebo, Commercial Schedule; Placebo tablets using the commercial 25-day titration schedule + behavioral support	Behavioral: Behavioral support; 12 behavioral support sessions by a qualified staff member plus supportive literature and online resources; Drug: Placebo Comparator; 1.5 mg cellulose powder to match final weight of the cytisine tablet
Experimental: 1.5 mg Cytisine, TID Schedule; 1.5 mg cytisine dose for 25 days using a simplified 3 times daily (TID) schedule + behavioral support	Drug: Cytisine; film coated tablet containing 1.5 mg cytisine in a single tablet; Behavioral: Behavioral support; 12 behavioral support sessions by a qualified staff member plus supportive literature and online resources
Experimental: 3.0 mg Cytisine, TID Schedule; 3.0 mg cytisine dose for 25 days using a simplified TID schedule + behavioral support	Drug: Cytisine; film coated tablet containing 1.5 mg cytisine in a single tablet; Behavioral: Behavioral support; 12 behavioral support sessions by a qualified staff member plus supportive literature and online resources
Placebo Comparator: Placebo, TID Schedule; Placebo tablets for 25 days using a simplified TID schedule + behavioral support	Behavioral: Behavioral support; 12 behavioral support sessions by a qualified staff member plus supportive literature and online resources; Drug: Placebo Comparator; 1.5 mg cellulose powder to match final weight of the cytisine tablet

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Primary Efficacy Analysis of Primary Outcome Measure: Percentage of Expected Cigarettes Smoked Per Participant During Study Treatment	The daily cigarette counts (number of cigarettes smoked in the past 24 hours) were self-reported by participants in the diary. Percentage of expected cigarettes smoked was computed for each participant at the end of treatment (cigarette score), based on daily cigarette counts during treatment vs the screening period. The percentage of expected cigarettes smoked was computed as Y = (100 x N) / (T x R) where N represents total number of cigarettes smoked each day over the treatment period from Day 1 to Day 25; T represents number of post-randomization days where number of cigarettes smoked is recorded; and R represents the average number of cigarettes smoked daily over the 7-day screening period as baseline. T*R represents the total number of cigarettes that would have been smoked without intervention over the number of recorded days. Separate statistical analyses were performed for the two cytisine administration schedules (commercial and TID).	Day 1 through Day 25
Sensitivity Analysis of Primary Outcome Measure: Analysis for Percentage of Expected Cigarettes Smoked Versus Pooled Placebo Arms, Commercial Schedule	The daily cigarette counts (number of cigarettes smoked in the past 24 hours) were self-reported by participants in the diary. Percentage of expected cigarettes smoked was computed for each participant at the end of treatment (cigarette score), based on daily cigarette counts during treatment vs the screening period. (See Outcome Measure 1 description for details.) The sensitivity analysis of the primary outcome measure was only performed if results of "Statistical Analysis 5" for Outcome Measure 1 demonstrated the placebo treatment arms (commercial and TID) were not significantly different, and so could be pooled. Separate statistical analyses were performed for the two cytisine administration schedules (commercial and TID).	Day 1 through Day 25
Sensitivity Analysis of Primary Outcome Measure: Analysis for Percentage of Expected Cigarettes Smoked Versus Pooled Placebo Arms, TID Schedule	The daily cigarette counts (number of cigarettes smoked in the past 24 hours) were self-reported by participants in the diary. Percentage of expected cigarettes smoked was computed for each participant at the end of treatment (cigarette score), based on daily cigarette counts during treatment vs the screening period. (See Outcome Measure 1 description for details.) The sensitivity analysis of the primary outcome measure was only performed if results of "Statistical Analysis 5" for Outcome Measure 1 demonstrated the placebo treatment arms (commercial and TID) were not significantly different, and so could be pooled. Separate statistical analyses were performed for the two cytisine administration schedules (commercial and TID).	Day 1 through Day 25

Collaborators and Investigators

• Sponsor: Achieve Life Sciences
• Investigators: Principal Investigator: Mitchell Nides, PhD, Los Angeles Clinical Trials

Study record dates

Study Major Dates

• Study Start (Actual): November 13, 2018
• Primary Completion (Actual): April 23, 2019
• Study Completion (Actual): April 23, 2019

Study Registration Dates

• First Submitted: October 15, 2018
• First Submitted That Met QC Criteria: October 15, 2018
• First Posted (Actual): October 17, 2018

Study Record Updates

• Last Update Posted (Actual): May 18, 2020
• Last Update Submitted That Met QC Criteria: May 14, 2020
• Last Verified: May 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: ACH-CYT-09

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No