Clinical Trials of Multivalent Opioid Vaccine Components
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ClinicalTrials.gov Identifier: NCT04458545 |
Recruitment Status :
Recruiting
First Posted : July 7, 2020
Last Update Posted : January 31, 2024
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Tracking Information | |||||||||
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First Submitted Date ICMJE | June 16, 2020 | ||||||||
First Posted Date ICMJE | July 7, 2020 | ||||||||
Last Update Posted Date | January 31, 2024 | ||||||||
Actual Study Start Date ICMJE | October 8, 2020 | ||||||||
Estimated Primary Completion Date | December 30, 2024 (Final data collection date for primary outcome measure) | ||||||||
Current Primary Outcome Measures ICMJE |
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Original Primary Outcome Measures ICMJE | Same as current | ||||||||
Change History | |||||||||
Current Secondary Outcome Measures ICMJE | Not Provided | ||||||||
Original Secondary Outcome Measures ICMJE | Not Provided | ||||||||
Current Other Pre-specified Outcome Measures | Not Provided | ||||||||
Original Other Pre-specified Outcome Measures | Not Provided | ||||||||
Descriptive Information | |||||||||
Brief Title ICMJE | Clinical Trials of Multivalent Opioid Vaccine Components | ||||||||
Official Title ICMJE | Phase 1A/1B Clinical Trials of Multivalent Opioid Vaccine Components | ||||||||
Brief Summary | Currently, abuse of prescription opioid analgesics and heroin is a serious problem in the U.S. Although several medications, including methadone, buprenorphine, and naltrexone, are available and effective in treating opioid use disorder (OUD), long-term relapse rates remain high. The current study is designed to examine a new approach to treating OUD, namely use of a vaccine targeted against oxycodone [Oxy(Gly)4-sKLH], one of the most commonly abused prescription opioids. The vaccination approach to treating substance use disorders relies on the ability of the vaccine to produce antibodies that bind the target drug in blood and reduce its ability to enter the brain. The long-term goal of this research will be to develop a combined vaccine against oxycodone and heroin. However, in this trial the Oxy(Gly)4-sKLH vaccine will be studied separately. This is a multi-site study, being conducted at the New York State Psychiatric Institute and the Clinilabs clinical research unit (CRU) in Eatontown, New Jersey. The current study proposes to evaluate safety (Aim 1), degree of antibody production (Aim 2), and efficacy (i.e., ability to reduced drug liking following opioid administration) (Aim 3). The oxycodone vaccine (Oxy(Gly)4-sKLH) will be tested in participants with OUD (target # completers = 45 across two study sites). This study will provide a great deal of information about the safety and potential effectiveness of the Oxy(Gly)4-sKLH vaccine in reducing the abuse of opioids. | ||||||||
Detailed Description | Overview: The proposed study is designed as a Phase 1a/1b clinical trial of an oxycodone vaccine (Oxy(Gly)4-sKLH Conjugate Vaccine, Adsorbed). Healthy adults, aged 18 to 59 years, who meet DSM-5 criteria for OUD but are not seeking treatment for their drug use, and are physically dependent on opioids will be recruited. This study will employ a between-groups, placebo-controlled design (two active vaccine doses, 1 placebo). Immunization will occur at Weeks 0, 3, 6 and 18. The Oxy(Gly)4-sKLH vaccine adsorbed to aluminum adjuvant (Alhydrogel®) or aluminum adjuvant as placebo, will be injected intramuscularly (IM) into the deltoid muscle. Each subject completing the study will participate for 43 weeks including: One Screening Phase (Weeks -6 to -2), two Inpatient Phases (Weeks -2-8 and 18-20), two Outpatient Phases (Weeks 8-18, 20-21), and a Follow Up Phase (Week 21, 23, 30, 34, 38, and 42 (1-week, 1-month, 3-month, 4-month, 5-month, and 6-month follow up). Subjects will be immunized during Weeks 0, 3, 6 and 18 with either Oxy(Gly)4-sKLH (either 100 μg or 400 μg dose; different dose levels will be administered by varying the volume of the 400 μg/mL formulation) adsorbed on aluminum adjuvant or aluminum alone as placebo. Screening Phase (Weeks -6 thru -2): Eligibility for admission into the study will be based on a psychiatric evaluation, physical examination, blood and urine testing, electrocardiogram, drug history assessment, urine drug testing, and ascertainment of physical dependence on opioids via naloxone challenge and/or objective confirmation of opioid withdrawal signs/symptoms Inpatient Phases (Weeks -1-8 & 18-19) Opioid Maintenance and Testing Sessions: During the inpatient phases participants will be maintained on oral morphine 120 mg/day. During testing sessions, intranasal oxycodone (0, 25, 50, and 100 mg/70kg) will be administered during each inpatient phase to assess the ability of the vaccine to reduce positive subjective ratings (e.g., Drug Liking, High, etc.). Intranasal heroin (100 mg/70 kg) and lactose powder (placebo) will be used as positive and negative controls, respectively. In addition to assessing subjective effects, vital signs and other physiological measures are collected throughout the testing period (4.5 hours). The order ofthe different doses will be randomized and one dose of either oxycodone, heroin, or placebo will be given each day on 5 consecutive days. During testing sessions a physician or nurse practitioner will be on the floor for the first hour after IN dosing, and on-call throughout the session. Outpatient Phases (Weeks 9-17, 20-21): Participants will return to the laboratory weekly during the outpatient phases in order to assess titer levels, maintain good contact and to assess drug use, adverse events, and concomitant medication use. Blood tests (hematology, chemistry) and urinalysis will be performed repeatedly throughout the study: just prior to each inpatient phase and during the follow up visits at the end of the study (Weeks 8, 12, 17, 21, 23, and 30). In addition, the following assessments will be completed weekly throughout the study: Physical exam, 12-lead ECG, body weight, vital signs, and standard assessments of depression and suicidal thoughts/behaviors, along with cognitive functioning. The Columbia Suicide Severity Rating Scale (CSSRS) and clinical interviews will be used to provide ongoing assessments of this risk throughout the inpatient and outpatient phases of the study. Discharge (Week 19) and Follow-Up (Weeks 21, 23, 30, 34, 38, and 42): During the last week of the study and/or prior to each inpatient discharge, participants will receive counseling about different treatment options for opioid use disorder. For those participants requesting treatment, appropriate arrangements will be made. |
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Study Type ICMJE | Interventional | ||||||||
Study Phase ICMJE | Phase 1 Phase 2 |
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Study Design ICMJE | Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description: Participants are randomized among three arms i.e., to one of three doses of the opioid vaccine: Placebo, Low and High dose. Under each vaccine condition, the participant is administered 5 intranasal drugs. Masking: Triple (Participant, Investigator, Outcomes Assessor)Primary Purpose: Treatment |
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Condition ICMJE | Opioid-use Disorder | ||||||||
Intervention ICMJE |
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Study Arms ICMJE |
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Publications * | Not Provided | ||||||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||||||
Recruitment Status ICMJE | Recruiting | ||||||||
Estimated Enrollment ICMJE |
45 | ||||||||
Original Estimated Enrollment ICMJE | Same as current | ||||||||
Estimated Study Completion Date ICMJE | April 30, 2025 | ||||||||
Estimated Primary Completion Date | December 30, 2024 (Final data collection date for primary outcome measure) | ||||||||
Eligibility Criteria ICMJE | All participants in Group 1 must meet all of the following Inclusion Criteria to be enrolled:
The lower limit ensures that participants are physically dependent on opioids and are able to tolerate the proposed dosing. The upper limit is consistent with our current experience in recruiting this population (where use of 30-50 bags/day is commonly reported because of the shorter duration of psychoactive effects produced by fentanyl compared to heroin).
A participant will not be enrolled in Group 1 if he/she meets any of the following Exclusion Criteria:
All participants in Group 2 must meet all of the following Inclusion Criteria to be enrolled:
A participant will not be enrolled in Group 2 if he/she meets any of the following Exclusion Criteria:
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Sex/Gender ICMJE |
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Ages ICMJE | 18 Years to 59 Years (Adult) | ||||||||
Accepts Healthy Volunteers ICMJE | Yes | ||||||||
Contacts ICMJE |
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Listed Location Countries ICMJE | United States | ||||||||
Removed Location Countries | |||||||||
Administrative Information | |||||||||
NCT Number ICMJE | NCT04458545 | ||||||||
Other Study ID Numbers ICMJE | 7712 | ||||||||
Has Data Monitoring Committee | Yes | ||||||||
U.S. FDA-regulated Product |
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IPD Sharing Statement ICMJE |
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Current Responsible Party | Sandra D. Comer, New York State Psychiatric Institute | ||||||||
Original Responsible Party | Same as current | ||||||||
Current Study Sponsor ICMJE | New York State Psychiatric Institute | ||||||||
Original Study Sponsor ICMJE | Same as current | ||||||||
Collaborators ICMJE | Clinilabs, Inc. | ||||||||
Investigators ICMJE |
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PRS Account | New York State Psychiatric Institute | ||||||||
Verification Date | January 2024 | ||||||||
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP |