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オピオイド研究からの回復のための補助カンナビジオール (ACROS)

2026年9月29日 更新者:Yasmin Hurd、Icahn School of Medicine at Mount Sinai

オピオイド研究からの回復のための補助カンナビジオール(acros)

The long-term goal of the project is to determine whether cannabidiol (CBD) can reduce craving and relapse in individuals with opioid use disorder (OUD). The first phase of this project was an open cross-over design study in healthy individuals to confirm the safety and pharmacokinetic (PK) effects of CBD (BSPG CBD; Brains Bioceutical). The second phase was a double-blinded randomized controlled trial to determine whether CBD reduces craving and anxiety in individuals with OUD maintained on opioid agonist therapy. This phase 3 trial will determine whether CBD can serve as a potential adjunct treatment to reduce illicit opioid use in individuals with OUD maintained on opioid agonist therapy.

調査の概要

詳細な説明

Responding to the urgent calls for developing non-opioid therapeutics to address the opioid addiction epidemic, we have been investigating the therapeutic potential of cannabidiol (CBD), a non-intoxicating cannabinoid as a possible strategy. Our preclinical animal studies demonstrated that CBD decreases cue-induced heroin seeking behavior during drug abstinence, associated with the incubation of craving. Moreover, the effects of CBD to reduce heroin-seeking behavior was still evident even in animals that were maintained on methadone. We also showed in randomized, double-blind placebo- controlled design human clinical trials that acute CBD (Epidiolex) administration (400 mg and 800mg) decreased craving and anxiety associated with heroin cues in abstinent individuals with heroin use disorder, an effect that persisted even a week after the last CBD dose (given daily for 3 days). Moreover, another of our human studies showed that CBD was safe even in combination with a potent opioid agonist (fentanyl) to address a potential relapse condition suggesting negligible negative interaction with opioids. Building on those studies, we next set out to investigate the potential for CBD as an adjunctive treatment to methadone or buprenorphine in opioid use disorder (OUD). To that end, we first conducted Phase 1 pharmacokinetic studies with a CBD formulation in oral capsules (BSPG CBD; Brains Bioceutical) in healthy participants that showed that oral administration of BSPG CBD (400 mg) led to comparable pharmacokinetic parameters of the CBD plasma levels and its active metabolite as Epidiolex (400 mg), an FDA-approved comparator CBD product that previously reduced craving. In the Phase 2 clinical trial, we evaluated the effect of 200mg CBD (vs placebo) twice daily for 4 weeks and an additional 4 weeks of 400 mg CBD, twice daily, on cue-induced craving and anxiety in individuals with OUD who are maintained on methadone or buprenorphine. In the next phase of this IND application, we will extend the Phase 2 study to evaluate the effects of 200mg CBD, 400 mg CBD and placebo, taken twice daily, over a 24-week period in the OUD individuals maintained on methadone or buprenorphine. Our goals in this double-blinded randomized controlled clinical trial (RCT) are to investigate the potential of CBD to 1) decrease illicit opioid use and 2) reduce craving.

研究の種類

介入

入学 (推定)

450

段階

  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

    • New York
      • New York、New York、アメリカ、10029
        • 募集
        • Icahn School of Medicine at Mount Sinai
        • 主任研究者:
          • Yasmin Hurd
        • コンタクト:
    • Oregon
      • Portland、Oregon、アメリカ、97214
        • 募集
        • CODA Treatment Recovery
        • コンタクト:
        • 主任研究者:
          • Tara Chowdhury

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~65年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Individuals between 18 and 65 years old.

  • Ability to understand and give informed consent.

  • Current opioid use disorder (OUD) or OUD in remission while on maintenance therapy with OAT, as determined by DSM-5 with the M.I.N.I. interview (Mini-International Neuropsychiatric Interview).

  • Current opioid agonist maintenance treatment with methadone or buprenorphine for at least 14 days prior to consent. With the following more specific criteria for each of these two medications:

    • Current methadone maintenance treatment with a dose of ≥ 10mg/day, (maximum: 250mg/day), AND urinary toxicology positive for methadone and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP).
    • Current buprenorphine maintenance treatment with a dose of ≥ 2mg/day (maximum: 32mg/day), AND urinary toxicology positive for buprenorphine.

Exclusion Criteria:

  • Participants who are non-English speaking.
  • Psychiatric conditions under DSM-5 (examined with the MINI) that would make study participation unsafe, or which would prevent adherence to study procedure; examples include: suicidal (i.e. high risk for suicide on the Columbia suicide severity rating scale (C-SSRS) screen version) or homicidal ideation requiring immediate attention, inadequately-treated mental health disorder (e.g., active psychosis, uncontrolled bipolar disorder).
  • Current diagnosis of a severe substance use disorder (except for opioid and nicotine/tobacco) in the past 3 months, based on the MINI interview, that would preclude safe participation in the study as determined by the study medical clinician.
  • Signs of acute drug intoxication when arriving at the study site as determined by clinician assessment.
  • Medical or psychiatric contraindications for CBD administration (e.g., history of hypersensitivity to cannabinoids); or any of the ingredients in the product (gelatin or sesame oil).
  • Showing signs of acute opioid withdrawal symptoms (as determined by the result of the Clinical Opiate Withdrawal Scale (COWS). A Score of ≥ 5 or as interpreted by the investigator will be considered a positive result for withdrawal symptoms).
  • Have a medical condition that would make study participation unsafe, which would make treatment compliance difficult, or would prevent adherence to study procedure. This includes but is not limited to the following criteria: • < 30mL/min/1.73m2 eGFR. •QTc Fridericia > 500ms at screening. •Elevated liver enzymes at screening. The exclusionary lab values are: >4x the upper limit of normal (ULN) per laboratory criteria for AST or ALT or >1.5x ULN for bilirubin.
  • Participating in another pharmacotherapeutic trial in the past 3 months.
  • Participants who have used (within 14 days prior to consent) or plan to use (during the 24-week treatment period) any medications, dietary supplements (and/or grapefruit juice), or combination of medications and supplements known to alter the metabolism of, or interact with CBD (buproprion, rifampin, barbiturates, phenothiazines, cimetidine, anticoagulants, antiplatelets, etc.).
  • For women: being pregnant (positive urine test for pregnancy) or breastfeeding.
  • Not using an appropriate method of contraception such as hormonal contraception (oral hormonal contraceptives, Depo-Provera, Nuva-Ring), intrauterine device (IUD), sterilization, or double barrier method (combination of any two barrier methods used simultaneously, i.e. condom, spermicide, diaphragm).
  • Participants who have been court mandated to attend treatment centers

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:トリプル

武器と介入

参加者グループ / アーム
介入・治療
実験的:1 capsule CBD (200 mg)

1 capsule 200 mg CBD 2x per day

1 capsule CBD 200mg

他の名前:
  • CBD
実験的:2 capsules CBD (400 mg)

2 capsules 400 mg CBD 2x per day

1 capsule CBD 200mg

他の名前:
  • CBD
プラセボコンパレーター:1 capsule placebo and 2 capsules placebo

1 capsule 200 mg placebo 2x per day or 2 capsules 400 mg placebo 2x per day

Bovine Gel Placebo capsule

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Percentage of study participants with negative urine toxicology for illicit opioid use
時間枠:24 weeks

Percentage of study participants with negative urine toxicology for illicit opioid use over the course of 24 weeks.

24 weeks

二次結果の測定

結果測定
メジャーの説明
時間枠
Concentration of illicit opioids
時間枠:Duration of the trial, 24 weeks

Concentration of illicit opioids in quantitative plasma toxicology (plasma every four weeks)

Duration of the trial, 24 weeks
Weeks of abstinence
時間枠:Duration of the trial, 24 weeks

Weeks of abstinence of illicit opioid use

Duration of the trial, 24 weeks
Use of non-opioid illicit substances
時間枠:Duration of the trial, 24 weeks

Number of weeks using other non-opioid illicit substances

Duration of the trial, 24 weeks
Duration of first opioid abstinence
時間枠:Duration of the trial, 24 weeks

Duration of first opioid abstinence, defined as the number of weeks from randomization to first opioid test positive or urine test missed.

Duration of the trial, 24 weeks
Cue-induced Visual Analog Scale for craving (VASC)
時間枠:At 12 and 24-week time points

Cue-induced Visual Analog Scale for craving (VASC)

Cue-induced Visual Analog Scale for craving is used to measure subjective craving responses to a drug and neutral video cues evaluated in the clinic. Total scale ranges from 0-10, with higher scores indicating extreme cravings.

At 12 and 24-week time points
Cue-induced Visual Analog Scale for anxiety (VASA)
時間枠:At 12 and 24-week time points

Cue-induced Visual Analog Scale for anxiety (VASA)

Cue-induced Visual Analog Scale Anxiety is used to measure subjective anxiety responses to a drug and neutral video cue evaluated in the clinic. Total scale from 0-10, with higher score indicating extreme anxiety.

At 12 and 24-week time points
Change in illicit opioids in plasma toxicology
時間枠:24 weeks

Change in illicit opioids in plasma toxicology

24 weeks
Change in illicit opioids in urine toxicology
時間枠:24 weeks

Change in illicit opioids in urine toxicology

24 weeks
Study Retention
時間枠:24 weeks

Number of participants remaining in the study

24 weeks
Opioid Craving Questionnaire (OCQ)
時間枠:Every 4 weeks up to 24 weeks

General craving self-report using Opioid Craving Questionnaire (OCQ)

Total scale from 0-9, with higher score indicating more severe craving

Every 4 weeks up to 24 weeks
Generalized Anxiety Disorder Scale (GAD7)
時間枠:Every 4 weeks up to 24 weeks

General anxiety self-report using the Generalized Anxiety Disorder Scale (GAD7).

The General Anxiety Disorder 7-item questionnaire (GAD-7) is a 7-item questionnaire that asks user to rank how often they have been bothered by seven problems over the past two weeks from "0" (not at all) to "3" (nearly every day). The items that users are asked to rank levels of nervousness, anxiousness, relaxing, restlessness, irritability and fearfulness. Full scale from 0-21, with higher score indicating more symptoms.

Every 4 weeks up to 24 weeks
Substance use other than opioids
時間枠:Duration of the trial, 24 weeks

Proportion of substance use other than opioids

Duration of the trial, 24 weeks
Methadone plasma concentrations
時間枠:Duration of the trial, 24 weeks

Methadone plasma concentrations

Duration of the trial, 24 weeks
Buprenorphine and metabolite plasma concentrations
時間枠:Duration of the trial, 24 weeks

Buprenorphine and metabolite plasma concentrations

Duration of the trial, 24 weeks
Retention in opioid agonist therapy
時間枠:Duration of the trial, 24 weeks

Proportion of participants who remained in treatment with opioid agonist therapy

Duration of the trial, 24 weeks

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Yasmin Hurd, PhD、Icahn School of Medicine at Mount Sinai

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2025年6月13日

一次修了 (推定)

2027年7月15日

研究の完了 (推定)

2027年8月15日

試験登録日

最初に提出

2025年4月15日

QC基準を満たした最初の提出物

2025年4月15日

最初の投稿 (実際)

2025年4月23日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月1日

QC基準を満たした最後の更新が送信されました

2026年9月29日

最終確認日

2026年9月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • STUDY-24-01494
  • UH3DA050323 (米国 NIH グラント/契約)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

All of the individual participant data collected during the trial, after deidentification.

IPD 共有時間枠

Data will be shared no later than 6 months after study completion or as soon as any necessary cleaning and validation procedures are performed.

IPD 共有アクセス基準

There are no major factors affecting the access, distribution or reuse of the scientific data to be generated. All research participants will be consented for broad data sharing. All data will be made publicly available once the study is completed, following the timeline outlined in Element 4. The data will be de-identified to ensure study participant confidentiality. Access to the scientific data will not be controlled other than the requirements imposed by the NDA and IRB as mentioned above. Data will be distributed via publicly accessible platforms, including the HEAL Data Commons and ClinicalTrials.gov. These repositories ensure that the data is accessible to the broader scientific community. Data reuse will be encouraged as long as it adheres to the HEAL Data Commons' data use and citation policies as well as any requirements imposed by the IRB. Data users must acknowledge the original study and its investigators in any publications or other outputs based on the shared data.

IPD 共有サポート情報タイプ

  • SAP
  • ANALYTIC_CODE
  • CSR

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

はい

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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