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A Study of Adult Outpatients With Opioid Dependence Transitioned From a Daily SL Buprenorphine to Probuphine® Subdermal Implants (PRO-814)

27 décembre 2018 mis à jour par: Titan Pharmaceuticals

A Randomized, Double-Blind, Double-Dummy, Active-Controlled Multicenter Study of Adult Outpatients With Opioid Dependence Transitioned From a Daily Maintenance Dose of 8 mg or Less of Sublingual Buprenorphine or Buprenorphine/Naloxone to Four Probuphine® Subdermal Implants

The primary objective of the study is to demonstrate maintenance of treatment efficacy when transferring adult outpatients with opioid dependence, who are clinically stabilized on 8 mg or less of sublingual (SL) buprenorphine (BPN), to 4 Probuphine implants compared to SL BPN.

The secondary objective of the study is to confirm safety of 4 Probuphine implants in adult outpatients with opioid dependence who are clinically stabilized on 8 mg or less of SL BPN.

Aperçu de l'étude

Description détaillée

This is a randomized, double-blind, double-dummy, active-controlled multi-center study to evaluate the efficacy of transition to four 80 mg Probuphine implants in adult outpatients with opioid dependence, who are clinically stabilized on 8 mg or less of SL BPN. The study will include 3 Phases; Screening, Maintenance and Follow-up.

Medical and eligibility screening should occur within 2 weeks of the first Maintenance Phase visit. The Screening Visit will include standard medical screening procedures, complete medical/psychosocial history, urine toxicology and detailed substance use and treatment history.

All subjects who have provided written informed consent and have met the other study entry criteria will be eligible for randomization. Following confirmation of eligibility, subjects will be randomized to one of two treatment groups in a 1:1 ratio:

  • Treatment Group A: Daily SL BPN tablets (≤8 mg/daily) + four placebo implants
  • Treatment Group B: Four 80 mg Probuphine implants + daily SL placebo tablets

Implants will be surgically inserted on Day 1 (Baseline and Initiation of Study Drugs Visit). On Post-Implant Visit, additional follow-up safety and implant assessment procedures will be conducted. Subjects will return for monthly study visits on Weeks 4, 8, 12, 16, 20, and 24 (End of Treatment Visit). In addition to the monthly scheduled visits, subjects will provide 4 random urine toxicology samples throughout the 24-week treatment period.

A total of 10 urine toxicology samples will be collected; 6 at scheduled visits (1 per month) and 4 at random urine toxicology visits throughout the 24-week treatment period. At the scheduled visits, other assessments of efficacy and safety will be collected. Implants will be removed at the End of Treatment Visit on Week 24.

Following Week 24, subjects will be re-transitioned back to usual care (pre-trial), as needed. During Week 25, telephone contact will be made with all subjects. and Week 26 will include an on-site visit to the clinic for final follow-up assessments (Follow-up Visit).

Type d'étude

Interventionnel

Inscription (Réel)

177

Phase

  • Phase 3

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 65 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Subject must provide written informed consent prior to the conduct of any study-related procedures.
  2. Male or female, 18-65 years of age, inclusive.
  3. Primary diagnosis of opioid dependence (DSM-IV-TR).
  4. Subject is considered clinically stable by their treating healthcare provider and confirmed by the following:

    1. Subject must be on SL BPN treatment for at least 6 months.
    2. Subject must have been on a SL BPN dose of 8 mg or less daily for at least the last 90 days prior to Screening.
    3. No positive urine toxicology results for illicit opioids in the last 90 days.
  5. Free from significant withdrawal symptoms (score of ≤ 5 on the Clinical Opiate Withdrawal Scale [COWS]), as measured at the Screening Visit.
  6. Female subjects of childbearing potential must be willing to use a reliable method of contraception during the entire study (Screening Visit to Follow-Up Visit).

Exclusion Criteria:

  1. Current diagnosis of Acquired Immune Deficiency Syndrome (AIDS).
  2. Current diagnosis of chronic pain syndrome requiring chronic opioid treatment, or conditions associated with acute episodic flares that require opioid treatment.
  3. Pregnant or lactating or planning to become pregnant during the study.
  4. Hypersensitivity or allergy to ethylene vinyl acetate (EVA)-containing substances or naloxone.
  5. Recent scarring or tattoos on their upper arms, or a history of keloid scarring.
  6. Requires current use of agents metabolized through CYP 3A4 such as azole antifungals (e.g., ketoconazole), macrolide antibiotics (e.g., erythromycin), or protease inhibitors (e.g., ritonavir, indinavir, and saquinavir).
  7. History of coagulopathy within the past 90 days, and/or current anti-coagulant therapy such as warfarin.
  8. Current DSM-IV-TR diagnosis for substance dependence on any other psychoactive substances other than opioids or nicotine (e.g., alcohol, cocaine).
  9. Significant symptoms or other factors which in the opinion of the Investigator would preclude compliance with the protocol, subject safety, adequate cooperation in the study, or obtaining informed consent.
  10. Current medical conditions such as severe respiratory insufficiency that may prevent the subject from safely participating in study.
  11. Any pending legal action that could prohibit participation or compliance in the study.
  12. Exposure to any investigational drug within the 8 weeks prior to Screening.
  13. Aspartate aminotransferase levels ≥3 X the upper limit of normal, alanine aminotransferase levels ≥ 3 X the upper limit of normal, total bilirubin ≥ 1.5 X the upper limit of normal, or creatinine ≥ 1.5 X upper limit of normal on the Screening laboratory assessments.
  14. Clinically significant low platelet count on the Screening laboratory assessments, according to the Investigator.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Quadruple

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: buprenorphine implants + placebo tablets
Four 80 mg Probuphine implants + daily SL placebo tablets
Comparateur actif: buprenorphine tablets + placebo implants
Daily SL BPN tablets (≤8 mg/daily) + four placebo implants

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
The Primary Efficacy Endpoint is a Responder Rate Analysis, Where a Responder is Defined as a Patient With no More Than 2 of 6 Months With Any Evidence of Illicit Opioid Use.
Délai: 24 weeks
The primary efficacy endpoint is a responder analysis. A subject will be designated as a responder (meaning they have maintained stability) if they have no more than 2 of 6 months with any evidence of illicit opioid use. Evidence of illicit opioid use is defined as a positive opioid urine toxicology result or self-reported illicit opioid use.
24 weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Percent of Subjects With no Urine Illicit Opioid Use by Month;
Délai: 24 weeks
The secondary outcome is the percent of subjects with no urine illicit opioid use by month.
24 weeks
Number of Participants With Evidence of Urine Illicit Opioid Use by Month
Délai: 24 weeks
Secondary efficacy endpoint measures number of participants with evidence of urine illicit opioid use by month.
24 weeks
Percent of Subjects With no Self-reported Illicit Drug Use by Month
Délai: 24 weeks
Subjects in the ITT population with no self-reported use of any illicit drugs (opioid or non-opioid) by month of evaluation
24 weeks
Measures of Craving: Desire to Use Visual Analogue Scale (VAS)
Délai: 24 weeks
The secondary outcome of measures of craving: desire to use is a change from Day 1 (baseline) in the unipolar visual analogue scale (VAS), which is a 0-100 mm scale, where 0 mm is no desire, and 100 mm is strongest possible desire.
24 weeks
Measures of Withdrawal: Clinical Opiate Withdrawal Scale (COWS)
Délai: 24 weeks
The secondary outcome measures the change in baseline in the Clinical opiate withdrawal scale (COWS), which is a scale consisting of 11 common opiate withdrawal signs or symptoms, rated on a numeric scale with higher scores associated with greater withdrawal symptoms. A total score was calculated as the sum of the responses to the 11 signs/symptoms for a total range of 0-48. Withdrawal severity was classified, based on the total score, as follows: 0-4=none/normal, 5-12=mild, 13-24=moderate, 25-36=moderately severe, more than 36=severe withdrawal.
24 weeks
Measures of Withdrawal: Subjective Opioid Withdrawal Scale (SOWS) (ITT Population)
Délai: 24 weeks
The secondary outcome measures the change in baseline in the subjective opioid withdrawal scale (SOWS), which is a scale which is a subject self-assessment of withdrawal symptoms. The scale consists of 16 questions that rate the intensity of withdrawal from 0 (not at all) to 4 (extremely) with a cumulative score ranging from 0-64 (0 =not at all, 64=extremely)
24 weeks
Measures of Craving: Need to Use Visual Analogue Scale (VAS)
Délai: 24 weeks
The secondary outcome of measures of craving: Need to use is a change from Day 1 (baseline) in the unipolar visual analogue scale (VAS), which is a 0-100 mm scale, where 0 mm is no need, and 100 mm is strongest possible need.
24 weeks

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 juillet 2014

Achèvement primaire (Réel)

1 mai 2015

Achèvement de l'étude (Réel)

1 mai 2015

Dates d'inscription aux études

Première soumission

1 juillet 2014

Première soumission répondant aux critères de contrôle qualité

1 juillet 2014

Première publication (Estimation)

3 juillet 2014

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

11 janvier 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

27 décembre 2018

Dernière vérification

1 novembre 2018

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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