Analyzing Female Trauma Exposed Responses to a Medication (AFTER)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
This purpose of this study is to look at the safety of the experimental drug GSK561679 as well as its effects on PTSD symptoms, thinking and memory, startle reaction, stress hormones, and mental health symptoms in comparison to placebo (an inactive substance).
| Condition | Intervention | Phase |
|---|---|---|
|
Stress Disorders, Post-traumatic |
Drug: GSK561679 Drug: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | CRF Receptor Antagonist for PTSD and Related Sleep Disturbances in Women |
- CAPS score after 6 weeks of treatment [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 40 |
| Study Start Date: | March 2013 |
| Estimated Study Completion Date: | October 2014 |
| Estimated Primary Completion Date: | July 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: GSK561679
GSK561679, oral administration, 350mg/day, 6 week administration
|
Drug: GSK561679
GSK561679, oral administration, 350mg/day, 6 week administration
Other Name: CRF1 antagonist
|
|
Placebo Comparator: Placebo
Placebo compound treatment for comparison with IP
|
Drug: Placebo
Placebo compound treatment for comparison with IP
Other Name: Sugar pill
|
Detailed Description:
A growing body of literature suggests that stress-related disorders such as PTSD are associated with chronically increased activity of CNS circuits that utilize corticotropin-releasing factor (CRF), a neuropeptide involved in mediating the neuroendocrine, immune, autonomic, and behavioral responses to stress. CRF1 receptor antagonists exert significant dampening effects on this system, but have never been investigated in patients with PTSD. The investigators at Mount Sinai School of Medicine (MSSM) and the National Institute of Mental Health (NIMH) Intramural Research Program have conducted a Phase II proof-of-concept clinical trial of a neurokinin-1 antagonist provided by GlaxoSmithKline (GSK). In this investigation, we will conduct a 2-site (Emory and MSSM), 6-week, randomized, double-blind, placebo-controlled, parallel-arm, fixed dose trial evaluating the efficacy, safety, and tolerability of GSK561679 for 154 female adult outpatients with PTSD. The San Francisco Department of Veterans Affairs Medical Center (SFVAMC) was added as a site in July 2012. SFVAMC will enroll 40 female adult outpatients with PTSD.
We propose to investigate the efficacy of the highly specific CRF1 antagonist GSK561679 in PTSD in a placebo-controlled clinical trial. GSK561679 has not been approved by the Food and Drug Administration for the treatment of any condition. Furthermore, we propose to longitudinally investigate whether certain biological surrogate markers (neuroendocrine, neurophysiology, genotyping) are predictive of treatment response. If a patient is already taking medication for PTSD and has achieved therapeutic response, she will not be tapered off effective medication(s) to participate in this study, and will not be eligible for the study. Taper and discontinuation of medications in preparation for this study will only occur in those patients who are not responding to medication treatment for PTSD.
Preclinical and clinical literature also exists which implicates both hypothalamic and extra hypothalamic CRF in stress-related insomnia and the regulation of non-rapid eye movement delta sleep. There is preliminary evidence that blocking CRF signaling results in an immediate improvement in stress-related sleep disturbances. Disturbed sleep is the most prevalent symptom endorsed by PTSD patients. It is potentially debilitating in many domains of functioning, and it is an outcome that can be objectively and precisely measured with sleep EEG. Therefore, an exploratory aim of this study will be to investigate the impact of GSK561679 on objective measures of sleep continuity and quantitative sleep EEG using ambulatory polysomnography. All subjects enrolled at SFVAMC who meet inclusion and exclusion criteria for the study will be given the option of having their sleep monitored throughout the study
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Female between 18-65 years of age
- Able to provide consent and willing to participate in research
- Fulfills DSM-IV criteria for primary diagnosis of PTSD
- PTSD duration of illness at least 3 months
- Able to provide consent and willing to participate in research
- CAPS score of 50 at Screening and Visit 3 (randomization)
- Negative Urine toxicology test
- Agrees to use protocol-defined effective birth control method
- If the patient has a history of peptic ulcer disease (PUD), there is documentation of the etiology of the PUD and that effective treatment was provided with full eradication of ulcers and symptoms
Exclusion Criteria:
- Lifetime or current diagnosis of schizophrenia or other psychotic disorder, bipolar disorder, OCD, or current Axis I disorder [(except for major depression secondary to the PTSD, dysthymia, depression NOS and anxiety disorders (panic disorder, social phobia, GAD, specific phobia)]
- Subject is currently participating in another clinical trial in which she is or will be exposed to an investigational or non-investigational drug or device, or has done so within the preceding month for studies unrelated to PTSD, or 1 month for studies related to PTSD
- Current evidence or history of significant unstable medical illness or organic brain impairment, including stroke, CNS tumor, demyelinating disease, cardiac, pulmonary, gastrointestinal, renal or hepatic impairment that would likely interfere with the action, absorption, distribution, metabolism, or excretion of GSK561679.
- Patients who in the investigator's judgment pose a current suicidal or homicidal risk
- DSM-IV substance abuse or dependence within the past 90 days. Subject has a positive test for illegal substances.
- Diagnosis of anorexia nervosa or bulimia in the past year.
- Subject has a documented history of hepato-biliary disease including a history of, or positive laboratory results for hepatitis (hepatitis B surface antigen and/or hepatitis C antibody), and/or clinically significant hepatic enzyme elevation including any one of the following enzymes greater than 1.5 times the upper limit of normal (ULN) value (ALT, AST, ALP, total or direct bilirubin > 1.5 x ULN, unless consistent with presumed or diagnosed Gilbert's disease
- Subject has taken systemic corticosteroids within 2 weeks of the Randomization Visit
- Treatment with any other psychoactive medication within 2 weeks of Visit 1, including all antidepressants, psychoactive herbal or nutritional treatment (St Johns Wort, SAM-e), lithium, other mood stabilizers, oral antipsychotics, depot antipsychotics within 12 weeks, beta blockers, thioridazine, pimozide, opiates, anxiolytics, and sedatives (with the exception of zolpidem, eszopiclone, and zaleplon). Also any treatment with any medication that the PI judges not acceptable for this study.
- Subject who is likely to require the use of the following medications: Chronic (for more than 2 weeks), regular NSAID use. Any use of aspirin (including low dose)
- Subject has taken non-psychoactive (prescription or non-prescription), dietary, or herbal products, with a narrow therapeutic index, that are metabolized via the cytochrome P450 3A4 or 2C9 pathway (warfarin), or transported via OATP1B1 or P-gp, within 2 weeks (or 5 half-lives, whichever is longer) prior to the Randomization Visit.
- Subject has taken other (non-psychoactive) prescription, non-prescription, dietary, or herbal products that are potent inducers or inhibitors of the cytochrome P450 3A4 pathway for 2 weeks (or 5 half lives, whichever is longer) prior to the Randomization Visit.
- Subject has a stool positive for occult blood.
- Pregnancy or lactation*
- Subjects who, in the opinion of the investigator, would be noncompliant with the visit schedule or study procedures (e.g. illiteracy, planned vacations, or planned hospitalizations during the study).
- Previous treatment with CRF1 receptor antagonist
- Patients who are receiving exposure-based psychotherapy that targets PTSD symptoms
- Current or planned litigation or other actions related to secondary gain regarding the traumatic event
Contacts and Locations| Contact: Timothy Riel | (415) 221-4810 ext 3085 | timothy.riel@va.gov |
| Contact: Lindsey E Smith, MPH | (415) 221-4810 ext 3940 | lindsey.smith2@va.gov |
| United States, California | |
| San Francisco VA Medical Center, San Francisco, CA | Recruiting |
| San Francisco, California, United States, 94121 | |
| Contact: Timothy Riel 415-221-4810 ext 3085 timothy.riel@va.gov | |
| Principal Investigator: Thomas C. Neylan, MD | |
| Principal Investigator: | Thomas C. Neylan, MD | San Francisco VA Medical Center, San Francisco, CA |
More Information
Additional Information:
No publications provided
| Responsible Party: | Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT01814332 History of Changes |
| Other Study ID Numbers: | 09S-NIMH-002 |
| Study First Received: | March 11, 2013 |
| Last Updated: | March 28, 2013 |
| Health Authority: | United States: Federal Government |
Keywords provided by Department of Veterans Affairs:
|
Stress disorders, Post-traumatic Sleep |
Additional relevant MeSH terms:
|
Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Anxiety Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 19, 2013