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VIVITROL as a Treatment for Cocaine and Alcohol Dependence

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00777062
Recruitment Status : Completed
First Posted : October 22, 2008
Results First Posted : January 29, 2014
Last Update Posted : January 26, 2018
Sponsor:
Collaborators:
Alkermes, Inc.
National Institute on Drug Abuse (NIDA)
Information provided by (Responsible Party):
Kyle Kampman, University of Pennsylvania

Brief Summary:
To evaluate the efficacy of VIVITROL (naltrexone for extended-release injectable suspension) for the treatment of co-occurring cocaine and alcohol dependence

Condition or disease Intervention/treatment Phase
Cocaine Dependence Alcohol Dependence Drug: VIVITROL (Naltrexone extended-release injectable suspension) Drug: Placebo Phase 2

Detailed Description:

This is a Phase II double-blind randomized controlled clinical pilot study. The exploratory objectives in the proposed study will be examined with a 2-group design to assess the efficacy of naltrexone extended-release injectable suspension (VIVITROL™) as compared to placebo. Safety measures will be collected weekly through medical management (MM) by medical practitioners, including adverse events and concomitant meds. The psychosocial treatment will be Cognitive Behavioral Coping Skills Therapy (CBT). Subjects will be 80 men and women with current DSM-IV diagnoses of alcohol dependence and cocaine dependence that will be randomized to receive either VIVITROL or placebo (40 subjects per group). All subjects will receive weekly sessions of CBT and MM. The study length for each subject is comprised of 1-3 weeks of screening, an 8-week double-blind, placebo-controlled trial with MM and CBT (medication phase), and an end of medication visit.

Primary Exploratory Objectives:

  • To compare medication groups' rates of cocaine abstinence, as determined by urine assay for benzoylecgonine (BE), the primary metabolite of cocaine. This will be cross-checked against participants' self-reports of cocaine use through Time-Line Follow Back (TLFB)(Sobell & Sobell, 1992).
  • To compare medication groups' rates of abstinence from drinking, and of clinically significant drinking, as measured by the TLFB.

Secondary Exploratory Objectives:

  • To evaluate medication groups' reports of craving for cocaine and alcohol, as measured by scores on the Penn Alcohol Craving Scale and the Minnesota Cocaine Craving Scale during the medication treatment phase.
  • To compare women's reports of medication tolerance of naltrexone extended-release injectable suspension versus high dose oral naltrexone that was reported in our recently published pilot trial of high dose naltrexone for dual cocaine and alcohol dependence (Pettinati et al., 2008).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 80 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: A Phase II, Randomized, Double-Blind Pilot Trial of VIVITROL® (Naltrexone for Extended-Release Injectable Suspension) for the Treatment of Cocaine and Alcohol Dependence
Study Start Date : July 2009
Actual Primary Completion Date : July 2012
Actual Study Completion Date : September 2013

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: 1
VIVITROL (Naltrexone extended-release injectable suspension), 380 mg injection at the start of weeks 2 and 6
Drug: VIVITROL (Naltrexone extended-release injectable suspension)
VIVITROL (Naltrexone extended-release injectable suspension), 380 mg injection at the start of weeks 2 and 6.
Other Name: Vivitrol

Placebo Comparator: 2
Placebo injection, 380 mg injection at the start of weeks 2 and 6.
Drug: Placebo
Placebo injection at the start of weeks 2 and 6.




Primary Outcome Measures :
  1. Urine Assay for Benzoylecgonine (BE), the Primary Metabolite of Cocaine. [ Time Frame: 8 week medication phase ]
    Percentage of subjects with no cocaine use for at least 3 weeks

  2. Time Line Follow Back -Reported Days of Abstinence From Drinking [ Time Frame: 8 week medication phase ]
    Percentage of participants who were abstinent from drinking



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  1. Males and females, 18 to 65 years old.
  2. Meets DSM-IV criteria for Cocaine Dependence, as determined by the Structured Clinical Interview for DSM-IV (SCID).
  3. Meets DSM-IV criteria for Alcohol Dependence, as determined by the Structured Clinical Interview for DSM-IV (SCID).
  4. Meets the following drinking criteria as measured by the Timeline Followback (TLFB) (Sobell, 1995)

    1. drank within 30 days of intake day,
    2. reports a minimum of XX standard alcoholic drinks in a consecutive 30-day period over the 90-day period prior to starting intake, and
    3. has 2 or more days of heavy drinking
  5. In the past 30 days prior to consent, used no less than $ of cocaine.
  6. Live within a commutable distance of the Treatment Research Center (TRC) at the Penn/VA Center for Studies of Addiction, University of Pennsylvania. We define this to be a distance within the service area of Septa, within an hour drive, or a distance that both the patient and Principal Investigator (PI) find acceptable.
  7. Understands and signs the informed consent.
  8. Three consecutive days of abstinence from alcohol, and a Clinical Institute Withdrawal Scale for Alcohol (CIWA-AR) (Sullivan, 1989) score below eight.

4.2 Exclusion Criteria:

  1. Positive urine drug screen and/or current DSM-IV diagnosis of any psychoactive substance dependence other than cocaine, alcohol, or nicotine dependence, as determined by the SCID.
  2. Concomitant treatment with psychotropic medications, including opioid analgesics.
  3. Patients mandated to treatment based upon a legal decision or as a condition of employment.
  4. Current severe psychiatric symptoms, e.g., psychosis, dementia, suicidal or homicidal ideation, mania or depression requiring antidepressant therapy in the opinion of the Principal Investigator (PI).
  5. Taken any investigational medication within the past 30 days.
  6. History within the six months prior to randomization of significant heart disease (an arrhythmia which required medication, Wolff-Parkinson-White Syndrome, angina pectoris, documented history of myocardial infarction, heart failure). These are to be reviewed on a case-by-case basis: EKG 1st degree heart block, sinus tachycardia, left axis deviation, and nonspecific ST or T wave changes are allowed; liver function tests [LFTs] <3 x ULN are acceptable).
  7. Known hypersensitivity to naltrexone, PLG, carboxymethylcellulose, or any other components of the diluent.
  8. Subjects with a BMI of 40 and above, as determined by the Body Mass Index Table, or that have distribution of adipose tissue such that they would be at greater risk of serious injection site reaction, based on clinical judgment. Participants with a BMI over 30 will have additional screening procedures conducted to determine inclusion in the study. These procedures include an additional screening measurement of waist-hip ratio for those participants with a BMI over 30. Males with a waist to hip ratio of >0.9 and females with a waist to hip ratio of >0.85 will be referred to the investigator for final decision of study inclusion. If the ratio is <0.9 for men or <0.85 for women they will be eligible for study inclusion without further action.
  9. Patients with any serious illnesses that may require hospitalization during the study.
  10. Female subjects who are pregnant or lactating, or female subjects of child-bearing potential who are not using acceptable methods of birth control. Acceptable methods of birth control include:
  11. Clinical laboratory tests (CBC, blood chemistries, urinalysis) outside normal limits that are clinically unacceptable to the Principal Investigator.
  12. Current physiological opioid dependence.
  13. Experiencing acute opiate withdrawal.
  14. Likely to receive scheduled surgery, which may require treatment with opioid analgesics.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00777062


Locations
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United States, Pennsylvania
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of Pennsylvania
Alkermes, Inc.
National Institute on Drug Abuse (NIDA)
Investigators
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Principal Investigator: Helen Pettinati, Ph.D. University of Pennsylvania

Additional Information:
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Responsible Party: Kyle Kampman, Principal Investigator, University of Pennsylvania
ClinicalTrials.gov Identifier: NCT00777062    
Other Study ID Numbers: 808641
5P50DA012756-10 ( U.S. NIH Grant/Contract )
DPMC ( Other Identifier: NIDA )
First Posted: October 22, 2008    Key Record Dates
Results First Posted: January 29, 2014
Last Update Posted: January 26, 2018
Last Verified: January 2018
Keywords provided by Kyle Kampman, University of Pennsylvania:
alcohol
cocaine
addiction
alcoholism
substance dependence
substance abuse
Additional relevant MeSH terms:
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Alcoholism
Cocaine-Related Disorders
Alcohol-Related Disorders
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders
Ethanol
Cocaine
Naltrexone
Anti-Infective Agents, Local
Anti-Infective Agents
Central Nervous System Depressants
Physiological Effects of Drugs
Alcohol Deterrents
Narcotic Antagonists
Sensory System Agents
Peripheral Nervous System Agents
Anesthetics, Local
Anesthetics
Vasoconstrictor Agents
Dopamine Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Dopamine Agents
Neurotransmitter Agents