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Study on Thiamine Supplementation to REduce braiN Injury Associated With Chronic Alcohol Use in Outpatients With Alcohol Use Disorder (STRENA)

Randomised Open-label Pilot Study on Thiamine Supplementation to REduce braiN Injury Associated With Chronic Alcohol Use in Outpatients With Alcohol Use Disorder

Chronic alcohol use and alcohol use disorder (AUD) affect 10% of the population in France. They are associated with brain damage and cognitive impairment. These complications have a significant impact on patients' agency, autonomy, and ability to participate in their own care. The investigators need to improve our knowledge of medical treatments that can reduce these risks and harms, beyond providing support to quit drinking or reduce consumption. Nutritional and vitamin deficiencies, particularly thiamine deficiency, are involved in the onset of these complications. Thiamine deficiency causes Wernicke encephalopathy, which can lead to Korsakoff syndrome, a very severe episodic memory disorder. Blood tests to measure thiamine levels are not available in routine medical practice. And it is not currently covered by health insurance in France. However, the systematic prescription of thiamine is recommended during alcohol withdrawal by medical associations and health institutions in France and internationally. However, there are no clinical trial data in the international scientific literature demonstrating the medical benefits and required dosage of systematic supplementation outside the withdrawal period when alcohol use continues or when the patient does not seek alcohol abstinence. People who use multiple psychoactive substances, are in precarious situations, and are receiving treatment for substance use disorders at addiction treatment centers are particularly vulnerable to malnutrition and vitamin deficiencies. In this context, the place of systematic thiamine prescription arises with the aim of reducing risks and brain damage in patients who do not wish to or cannot stop their chronic alcohol use. One of the limitations of previous studies has been the lack of a suitable, reproducible, minimally invasive, inexpensive, and sensitive biomarker of therapeutic response. In this study, the investigators will use plasma neurofilament light chain (NFL) levels, an innovative biomarker. In two recent studies, the study team demonstrated the relevance of this biomarker and its effectiveness in measuring brain suffering in patients with AUD and its kinetics during during inpatient alcohol withdrawal.

The hypothesis the invastigators are working on is that, in a population at high risk of vitamin and nutritional deficiency and who are chronic alcohol users, systematic supplementation with thiamine (vitamin B1) would reduce the brain suffering associated with this deficiency and chronic alcohol use. To answer this question, the investigators conduct a randomized, open-label pilot study. The primary objective is to test the efficacy of thiamine supplementation in reducing brain suffering as measured by plasma NFL level in chronic alcohol users with alcohol use disorder. Secondary objectives are to perform analyses of potential moderating factors of the treatment effect (per-protocol analysis based on good adherence, presence of morning alcohol withdrawal symptoms, reported morning alcohol use) and to use plasma glial fibrillary acidic protein (GFAP) and total plasma total tau protein as alternative biomarkers.

the investigators include adult patients under the age of 65 with alcohol use disorder who are currently chronic active alcohol users reporting daily intake of at least 40g of alcohol, who are being treated in outpatient addiction treatment center, and who may have another substance use disorder as a comorbidity.

This pilot study compares a group receiving 500 mg of thiamine supplementation in the morning and evening (1000 mg/day) over a period of 14 days with a control group receiving no supplementation. In order to measure the brain injury induced and its reduction, the investigators will measure plasma NFL level. Two measurements are performed, before supplementation begins (baseline, on day 0) and after two weeks of supplementation (follow-up visit, on days 14, 15, or 16).

The primary judgment criterion is the change in plasma NFL level between baseline and follow-up, comparatively between the treatment group and the control group (time x treatment interaction). A repeated measures analysis of variance (ANOVA) test, adjusted for age and sex, is used.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Estimado)

60

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Ubicaciones de estudio

    • Île-de-France Region
      • Paris, Île-de-France Region, Francia, 75010
        • Hospital Lariboisière Fernand-Widal
        • Contacto:

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 65 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Patient with moderate to severe alcohol use disorder
  • Reported daily consumption of at least 40g of alcohol
  • Patients aged 18 to 65
  • Urine pregnancy test performed prior to inclusion for women of childbearing age
  • Contraceptive method (with a Pearl index ≤10) for women of childbearing age who are sexually active
  • Covered by a health insurance plan or medical aid program

Non-inclusion Criteria:

  • Thiamine intake during the previous month
  • Planned hospitalization during the study period
  • Surgery with general anesthesia planned during the study period
  • History of Wernicke encephalopathy, delirium tremens or severe cognitive impairment
  • Epileptic seizure, stroke or severe head injury in the last three months
  • Active infection with HIV, hepatitis C virus, or syphilis
  • Severe hepatic impairment (prothrombin ratio below 50%)
  • Severe renal impairment (glomerular filtration rate <30 mL/min/1.73 m²)
  • Persons subject to legal protection measures or under guardianship
  • Pregnant women and breastfeeding women
  • Known or suspected allergy to any of the components of the experimental drug Bevitine (thiamine)
  • Known or suspected wheat allergy (other than celiac disease)
  • Fructose intolerance, glucose-galactose malabsorption syndrome, or sucrase/isomaltase deficiency

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Sin intervención: Control
Experimental: Thiamine

Thiamine 500mg twice daily for 14 days

Thiamine 500mg twice daily for 14 days

Otros nombres:
  • Bevitine

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in plasma NFL between the two arms, in ITT analysis
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in plasma neurofilament light chain (NFL) level between baseline (measured on day 0) and after 14 days of thiamine treatment or no intervention (measured on days 14, 15, or 16), comparatively between the two arms (time x treatment interaction in a repeated measures analysis of variance (ANOVA)), in an intention-to-treat analysis (ITT), adjusted for sex (phenotype, assigned at birth) and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in plasma NFL between the two arms, in PP analysis
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in plasma NFL level between the two arms (time x treatment interaction in a repeated measures ANOVA), in per protocol analysis (PP), using the threshold of reported intake of 80% of thiamine tablets as the criterion for good adherence (45 tablets out of 56), adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with the presence of morning alcohol withdrawal symptoms on plasma NFL change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between the presence of morning alcohol withdrawal symptoms and the treatment in NFL level change (time x treatment x symptom interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with reported alcohol use in the morning on plasma NFL change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between reported alcohol use in the morning and the treatment in plasma NFL level change (time x treatment x morning alcohol use interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Change in plasma GFAP level between the two arms
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in plasma glial fibrillary acidic protein (GFAP) level between the two arms (time x treatment interaction in a repeated ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Change in plasma total tau level between the two arms
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in plasma total tau level between the two arms (time x treatment interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Interaction with self-reported daily alcohol intake on plasma NFL change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between the self-reported daily alcohol intake and the treatment in plasma NFL level change (time x treatment x alcohol intake interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with self-reported use of cocaine or psychostimulants during the treatment period on plasma NFL change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between self-reported use of cocaine or psychostimulants during the treatment period and the treatment in plasma NFL level change (time x treatment x alcohol intake interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with opioid agonist therapy on plasma NFL change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between currently undergoing opioid agonist therapy (OAT) and the treatment in plasma NFL level change (time x treatment x OAT interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Association between plasma NFL change and alcohol intake change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

The association test in linear regression between plasma NFL level change and self-reported daily alcohol intake change, adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Plasma NFL level at baseline
Periodo de tiempo: Baseline

Associations in linear regression, adjusted on age and sex, of plasma NFL level with:

  • age and sex,
  • morning alcohol withdrawal symptoms, self-reported at baseline,
  • cocaine or psychostimulant use disorder with active use in the previous month, self-reported at baseline
  • OAT
  • precarity score on questionnaire "EPICES", at baseline
  • homeless status, having slept on the street at least once in the last month, self-reported at baseline
  • MoCA score, at baseline
  • subscale score for "impulsivity" on Difficulties in Emotion Regulation Scale (DERS), at baseline
  • score on Obsessive Compulsive Drinking Scale (OCDS) at baseline Univariate analyses then multivariate analysis (if p-value <.10 in univariate)
Baseline
Adherence to thiamine treatment
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Associations in linear regression of good adherence to thiamine treatment (taking at least 45 of 56 tablets) with:

  • age and sex
  • self-reported daily alcohol intake at baseline
  • morning alcohol withdrawal symptoms, self-reported at baseline
  • alcohol use in the morning, self-reported at baseline
  • cocaine or psychostimulant use disorder with active use in the previous month, self-reported at baseline
  • OAT
  • precarity score on questionnaire "EPICES", at baseline
  • MoCA score, at baseline
  • homeless status, having slept on the street at least once in the last month, self-reported at baseline
  • subscale score for "impulsivity" on Difficulties in Emotion Regulation Scale (DERS), at baseline
  • score on Obsessive Compulsive Drinking Scale (OCDS) at baseline Univariate analyses then multivariate analysis (if p-value <.10 in univariate)
baseline (day 0) and follow-up (on days 14, 15, or 16)
Montreal Cognitive Assessment (MoCA) at baseline
Periodo de tiempo: Baseline

Associations in linear regression of MoCA with:

  • age and sex
  • morning alcohol withdrawal symptoms
  • cocaine or psychostimulant use disorder with active use in the previous month
  • OAT
  • precarity score on questionnaire "EPICES"
  • homeless status, having slept on the street at least once in the last month
  • subscale score for "impulsivity" on Difficulties in Emotion Regulation Scale (DERS)
  • score on Obsessive Compulsive Drinking Scale (OCDS) at baseline Univariate analyses then multivariate analysis (if p-value <.10 in univariate)
Baseline
Change in plasma GFAP between the two arms, in PP analysis
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in plasma GFAP level between the two arms (time x treatment interaction in a repeated measures ANOVA), in PP, using the threshold of reported intake of 80% of thiamine tablets as the criterion for good adherence (45 tablets out of 56), adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with the presence of morning alcohol withdrawal symptoms on plasma GFAP change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between the presence of morning alcohol withdrawal symptoms and the treatment in GFAP level change (time x treatment x symptom interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with reported alcohol use in the morning on plasma GFAP change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between reported alcohol use in the morning and the treatment in plasma GFAP level change (time x treatment x morning alcohol use interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with self-reported daily alcohol intake on plasma GFAP change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between the self-reported daily alcohol intake and the treatment in plasma GFAP level change (time x treatment x alcohol intake interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with self-reported use of cocaine or psychostimulants during the treatment period on plasma GFAP change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between self-reported use of cocaine or psychostimulants during the treatment period and the treatment in plasma GFAP level change (time x treatment x alcohol intake interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with opioid agonist therapy on plasma GFAP change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between currently undergoing opioid agonist therapy (OAT) and the treatment in plasma GFAP level change (time x treatment x OAT interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Association between plasma GFAP change and alcohol intake change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

The association test in linear regression between plasma GFAP level change and self-reported daily alcohol intake change, adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Plasma GFAP level at baseline
Periodo de tiempo: Baseline

Associations in linear regression, adjusted on age and sex, of plasma GFAP level with:

  • age and sex,
  • morning alcohol withdrawal symptoms, self-reported at baseline,
  • cocaine or psychostimulant use disorder with active use in the previous month, self-reported at baseline
  • OAT
  • precarity score on questionnaire "EPICES", at baseline
  • homeless status, having slept on the street at least once in the last month, self-reported at baseline
  • MoCA score, at baseline
  • subscale score for "impulsivity" on Difficulties in Emotion Regulation Scale (DERS), at baseline
  • score on Obsessive Compulsive Drinking Scale (OCDS) at baseline Univariate analyses then multivariate analysis (if p-value <.10 in univariate)
Baseline
Change in plasma total tau between the two arms, in PP analysis
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in plasma total tau level between the two arms (time x treatment interaction in a repeated measures ANOVA), in PP, using the threshold of reported intake of 80% of thiamine tablets as the criterion for good adherence (45 tablets out of 56), adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with the presence of morning alcohol withdrawal symptoms on plasma total tau change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between the presence of morning alcohol withdrawal symptoms and the treatment in total tau level change (time x treatment x symptom interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with reported alcohol use in the morning on plasma total tau change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between reported alcohol use in the morning and the treatment in plasma total tau level change (time x treatment x morning alcohol use interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with self-reported daily alcohol intake on plasma total tau change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between the self-reported daily alcohol intake and the treatment in plasma total tau level change (time x treatment x alcohol intake interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with self-reported use of cocaine or psychostimulants during the treatment period on plasma total tau change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between self-reported use of cocaine or psychostimulants during the treatment period and the treatment in plasma total tau level change (time x treatment x alcohol intake interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Interaction with opioid agonist therapy on plasma total tau change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Interaction between currently undergoing opioid agonist therapy (OAT) and the treatment in plasma total tau level change (time x treatment x OAT interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Association between plasma total tau change and alcohol intake change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

The association test in linear regression between plasma total tau level change and self-reported daily alcohol intake change, adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Plasma total tau level at baseline
Periodo de tiempo: Baseline

Associations in linear regression, adjusted on age and sex, of plasma total tau level with:

  • age and sex,
  • morning alcohol withdrawal symptoms, self-reported at baseline,
  • cocaine or psychostimulant use disorder with active use in the previous month, self-reported at baseline
  • OAT
  • precarity score on questionnaire "EPICES", at baseline
  • homeless status, having slept on the street at least once in the last month, self-reported at baseline
  • MoCA score, at baseline
  • subscale score for "impulsivity" on Difficulties in Emotion Regulation Scale (DERS), at baseline
  • score on Obsessive Compulsive Drinking Scale (OCDS) at baseline Univariate analyses then multivariate analysis (if p-value <.10 in univariate)
Baseline
Proteome analysis
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Changes in plasma proteome between the two arms (time x treatment interaction in a repeated measures ANOVAs), ITT adjusted on sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Change in alcohol craving between the two arms
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

Change in Obsessive Compulsive Drinking Scale score between the two arms (time x treatment interaction in a repeated measures ANOVA), in ITT adjusted for sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Association between plasma NFL change and alcohol craving change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

The association test in linear regression between plasma NFL level change and self-reported OCDS change, adjusted on sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Association between plasma GFAP change and alcohol craving change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

The association test in linear regression between plasma GFAP level change and self-reported OCDS change, adjusted on sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)
Association between plasma total tau change and alcohol craving change
Periodo de tiempo: baseline (day 0) and follow-up (on days 14, 15, or 16)

The association test in linear regression between plasma total tau level change and self-reported OCDS change, adjusted on sex and age.

baseline (day 0) and follow-up (on days 14, 15, or 16)

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Investigadores

  • Investigador principal: Virgile Clergue-Duval, MD PhD, Assistance Publique - Hôpitaux de Paris
  • Director de estudio: Florence Vorspan, MD PhD, Inserm UMR-S 1144 Therapeutic optimization in neuropharmacology

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

23 de octubre de 2026

Finalización primaria (Estimado)

22 de octubre de 2027

Finalización del estudio (Estimado)

22 de octubre de 2027

Fechas de registro del estudio

Enviado por primera vez

15 de septiembre de 2026

Primero enviado que cumplió con los criterios de control de calidad

22 de septiembre de 2026

Publicado por primera vez (Actual)

28 de septiembre de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

28 de septiembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

22 de septiembre de 2026

Última verificación

1 de abril de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • C25-96
  • 2025 (Subvención/contrato del NIH de EE. UU.)
  • 2025-524148-36-00 (Ctis)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

producto fabricado y exportado desde los EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .