Combinatietherapie voor Alcoholgebruiksstoornis
Voorlopige Veiligheid en Werkzaamheid van Combinatietherapie met Semaglutide en Naltrexone voor Alcoholgebruiksstoornis
This human laboratory study will collect preliminary safety and efficacy data from a sample of participants enrolled in a 4-week in-patient treatment program for alcohol use disorder.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Approximately 29 million persons in the United States aged 12 and older experienced a form of Alcohol Use Disorder (AUD) in 2023. Currently, only three pharmacotherapies are FDA-approved to treat AUD: acamprosate, naltrexone, and disulfiram. As monotherapies, these have shown moderate efficacy in reducing alcohol consumption and increasing abstinence. There is some evidence that therapeutic effects can be enhanced when combined with other medications. Recently, emerging preclinical evidence suggests that endogenous GLP-1 signaling plays a role in alcohol-mediated behaviors. Further, growing clinical data suggest that GLP-1 agonists (e.g., Wegovy, Rybelsus, Mounjaro) may be effective for the treatment of AUD. Studies evaluating the efficacy of GLP-1 agonists in combination with FDA-approved medications for AUD have yet to be conducted. The investigators hypothesize that combining a GLP-1 agonist and naltrexone may be more effective for reducing dimensions of AUD than naltrexone alone. The goal of this study is to collect preliminary safety and efficacy data from a sample of participants enrolled in a 4-week in-patient treatment program for AUD. Following one week of in-patient enrollment, participants will be randomized to one of three conditions in a double dummy design: placebo + placebo, GLP-1 + placebo, or GLP-1 + naltrexone. All study medications will be administered orally. Participants randomized to active GLP-1 conditions will receive 3 mg during study week 1 and can increase to 7 mg during week 2. Participants will attend study visits in a 14-day period to complete assessments of alcohol craving, alcohol demand, anhedonia, eating behaviors, and subjective effects. Participants will also provide vitals and biosamples to evaluate health outcomes.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 2
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Andrew S Huhn, Ph.D.
- Telefoonnummer: 410-550-1971
- E-mail: ahuhn1@jhu.edu
Studie Contact Back-up
- Naam: Breanna Labos, B.A.
- E-mail: blabos1@jhmi.edu
Studie Locaties
-
-
Maryland
-
Havre de Grace, Maryland, Verenigde Staten, 21078
- Ashley Addiction Treatment
-
Contact:
- Andrew S Huhn, Ph.D.
- Telefoonnummer: 410-550-1971
- E-mail: ahuhn1@jhu.edu
-
-
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Aged 21-65 years old
- Enrolled at Ashley Addiction Treatment center at least one week prior to beginning study participation.
- Meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria for Alcohol Use Disorder
- Willing to comply with the study protocol
Exclusion Criteria:
- Score 9 or greater on the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) at randomization
- Currently pregnant, breastfeeding
- Unwilling to use contraceptives (e.g., condoms and/or hormonal birth control)
- Meet criteria for another substance use disorder other than AUD, Tobacco Use Disorder, or Caffeine use disorder
- History of pancreatitis
- History or current diagnosis of gallbladder disease, hepatic disease, renal disease, hyperparathyroidism, or any physical health condition that would be contraindicated with GLP-1 agonists or naltrexone.
- Unmanaged diabetes diagnosis or history or current diagnosis of diabetic retinopathy
- Levels of amylase, lipase, aspartate aminotransferase (AST), and/or alanine transferase (ALT) greater than 2x upper limit of normal
- Personal or family history of medullary thyroid carcinoma given FDA box warning for semaglutide
- Diagnosis of cancer within past 5 years
- History of multiple endocrine neoplasia syndrome type 2 (MEN2)
- Currently taking any medications contraindicated with GLP-1 agonists and/or naltrexone.
- BMI <18.5
- Current elevated suicide risk as assessed by clinic staff or the Columbia Suicide Severity Rating Scale (C-SSRS)
- Any other medical or psychological condition that is judged by the investigators to impede ability to safely complete study requirements.
- Legal problems or living situation judged by the investigators as a factor that could interfere with study completion (e.g., impending jail time).
- Allergies to semaglutide and/or naltrexone
- Use of opioids within the past 10 days as indicated by self-report or a positive urine drug screen
- Prescribed or taking the following medications in the past four weeks:
- The following medications will be prohibited during study participation due to interactions with semaglutide: other GLP-1 agonists (e.g. Exenatide, liraglutide, dulaglutide), insulin, insulin-secreting medications (e.g. sulfonylureas, meglitinides), tirzepetide, dipeptidyl peptidase-4 (DPP-4) inhibitors (e.g. sitagliptin, saxagliptin, linagliptin, alogliptin, evogliptin, and gemigliptin).
- The following medications will be prohibited during study participation due to interactions with naltrexone: bremelanotide, peripherally-acting mu-opioid receptor antagonists (e.g. methylnaltrexone, naldemedine), and opioid agonist medications.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Placebo-vergelijker: Placebo+Placebo
Placebo+Placebo |
Over-encapsulated non-active microcrystalline cellulose |
|
Experimenteel: Placebo+GLP-1
Placebo+GLP-1 |
Over-encapsulated non-active microcrystalline cellulose Over-encapsulated Glucagon-Like Peptide-1 Agonist (GLP-1) oral tablets |
|
Experimenteel: GLP-1+Naltrexone
GLP-1+Naltrexone |
Over-encapsulated Glucagon-Like Peptide-1 Agonist (GLP-1) oral tablets Over-encapsulated Naltrexone (oral tablets) |
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Participant-reported Adverse Events
Tijdsspanne: 14 days
|
Participant-reported adverse events during the course of the trial |
14 days
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Andrew S. Huhn, Ph.D., Johns Hopkins University
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Psychische aandoening
- Middelgerelateerde aandoeningen
- Chemisch veroorzaakte aandoeningen
- Aan alcohol gerelateerde aandoeningen
- Compulsief gedrag
- Impulsief gedrag
- Gedrag
- Alcoholisme
- Gedrag, verslavend
- Heterocyclische verbindingen
- Heterocyclische verbindingen, gefuseerd ring
- Alkaloïden
- Polycyclische aromatische koolwaterstoffen
- Polycyclische verbindingen
- Heterocyclische verbindingen, 4 of meer ringen
- Naloxon
- Morphinans
- Opiaat alkaloïden
- Heterocyclische verbindingen, overbrugde ring
- Fenanthrenes
- Naltrexon
Andere studie-ID-nummers
Andere studie-ID-nummers
- IRB00531545
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Data may be shared upon request.
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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