Study to Evaluate the Relative Abuse Potential of Almorexant in Recreational Drug Users

NCT01987739 | Completed Phase 1

• 1 other identifier: AC-057-116
• Study Type: interventional
• Target: 42
• Locations: 0 countries
• Sites: N/A

Brief Summary

This was a six-way crossover study with six single-dose treatment sessions. The profile of acute effects on abuse potential measures of different almorexant doses was compared to that of placebo and two doses of zolpidem

Conditions

Abuse Potential Study

Keywords

Almorexant; Zolpidem

Outcome Measures

Primary Outcomes (1)

• Maximum effect (Emax) over 24 h post-dose for "At the moment" Drug Liking Visual Analogue Scale (VAS) score during each Treatment Visit

  Emax was determined on a Drug Liking VAS which assessed positive and negative drug effects (Griffiths 2003, Milovan 2009, Schoedel 2008). VAS items were displayed on two screen images. Using a mouse, the subject positioned the cursor over the small vertical box ("slider") and clicked on it to move it left or right on a scale of 0-100. To register the response, the subject then pressed the "OK" button that appeared below the horizontal line. A score of '0' represented a 'Strong disliking' and a score of '100' represented a 'Strong liking'.

  24 hours

Secondary Outcomes (16)

• Minimum Effect (Emin) and Time-weighted mean effect (TWMean) over 24 h post-dose for "At the moment" Drug Liking VAS score during each Treatment Visit

  24 hours

• Overall Drug Liking VAS score (Emax, Emin, and arithmetic mean effect of 8 h and 24 h post-dose assessments during each Treatment Visit)

  24 hours

• Good/Bad Drug Effects VAS score (Emax, Emin, and TWMean over 24 h post-dose during each Treatment Visit)

  24 hours

• Take Drug Again VAS score (Emax and arithmetic mean of 8 h and 24 h post-dose assessments during each Treatment Visit)

  24 hours

• Subjective Drug Value (SDV) (Emax and arithmetic mean of 8 h and 24 h post-dose assessment during each Treatment Visit)

  24 hours

Study Arms (6)

Arm 1

EXPERIMENTAL

Subjects were randomized to receive single, oral doses of study medication in the sequence ABFCED, where, Treatment A was: 200 mg almorexant; Treatment B was 400 mg almorexant; Treatment C was 1000 mg almorexant; Treatment D was 20 mg zolpidem; Treatment E was 40 mg zolpidem; and Treatment F was placebo. The duration of each Treatment Visit was 1 day/2 nights. Study drug was administered on Day 1 of each Treatment Visit. Each treatment was separated by a washout period of at least 10 days.

Drug: 200 mg almorexant; Drug: 400 mg almorexant; Drug: 1000 mg almorexant; Drug: 20 mg zolpidem; Drug: 40 mg zolpidem; Drug: placebo

Arm 2

EXPERIMENTAL

Subjects were randomized to receive single, oral doses of study medication in the sequence BCADFE, where, Treatment A was: 200 mg almorexant; Treatment B was 400 mg almorexant; Treatment C was 1000 mg almorexant; Treatment D was 20 mg zolpidem; Treatment E was 40 mg zolpidem; and Treatment F was placebo. The duration of each Treatment Visit was 1 day/2 nights. Study drug was administered on Day 1 of each Treatment Visit. Each treatment was separated by a washout period of at least 10 days.

Drug: 200 mg almorexant; Drug: 400 mg almorexant; Drug: 1000 mg almorexant; Drug: 20 mg zolpidem; Drug: 40 mg zolpidem; Drug: placebo

Arm 3

EXPERIMENTAL

Subjects were randomized to receive single, oral doses of study medication in the sequence CDBEAF, where, Treatment A was: 200 mg almorexant; Treatment B was 400 mg almorexant; Treatment C was 1000 mg almorexant; Treatment D was 20 mg zolpidem; Treatment E was 40 mg zolpidem; and Treatment F was placebo. The duration of each Treatment Visit was 1 day/2 nights. Study drug was administered on Day 1 of each Treatment Visit. Each treatment was separated by a washout period of at least 10 days.

Drug: 200 mg almorexant; Drug: 400 mg almorexant; Drug: 1000 mg almorexant; Drug: 20 mg zolpidem; Drug: 40 mg zolpidem; Drug: placebo

Arm 4

EXPERIMENTAL

Subjects were randomized to receive single, oral doses of study medication in the sequence DECFBA, where, Treatment A was: 200 mg almorexant; Treatment B was 400 mg almorexant; Treatment C was 1000 mg almorexant; Treatment D was 20 mg zolpidem; Treatment E was 40 mg zolpidem; and Treatment F was placebo. The duration of each Treatment Visit was 1 day/2 nights. Study drug was administered on Day 1 of each Treatment Visit. Each treatment was separated by a washout period of at least 10 days.

Drug: 200 mg almorexant; Drug: 400 mg almorexant; Drug: 1000 mg almorexant; Drug: 20 mg zolpidem; Drug: 40 mg zolpidem; Drug: placebo

Arm 5

EXPERIMENTAL

Subjects were randomized to receive single, oral doses of study medication in the sequence EFDACB, where, Treatment A was: 200 mg almorexant; Treatment B was 400 mg almorexant; Treatment C was 1000 mg almorexant; Treatment D was 20 mg zolpidem; Treatment E was 40 mg zolpidem; and Treatment F was placebo. The duration of each Treatment Visit was 1 day/2 nights. Study drug was administered on Day 1 of each Treatment Visit. Each treatment was separated by a washout period of at least 10 days.

Drug: 200 mg almorexant; Drug: 400 mg almorexant; Drug: 1000 mg almorexant; Drug: 20 mg zolpidem; Drug: 40 mg zolpidem; Drug: placebo

Arm 6

EXPERIMENTAL

Subjects were randomized to receive single, oral doses of study medication in the sequence FAEBDC, where, Treatment A was: 200 mg almorexant; Treatment B was 400 mg almorexant; Treatment C was 1000 mg almorexant; Treatment D was 20 mg zolpidem; Treatment E was 40 mg zolpidem; and Treatment F was placebo. The duration of each Treatment Visit was 1 day/2 nights. Study drug was administered on Day 1 of each Treatment Visit. Each treatment was separated by a washout period of at least 10 days.

Drug: 200 mg almorexant; Drug: 400 mg almorexant; Drug: 1000 mg almorexant; Drug: 20 mg zolpidem; Drug: 40 mg zolpidem; Drug: placebo

Interventions

200 mg almorexant DRUG

Arm 1; Arm 2; Arm 3; Arm 4; Arm 5; Arm 6

400 mg almorexant DRUG

Arm 1; Arm 2; Arm 3; Arm 4; Arm 5; Arm 6

1000 mg almorexant DRUG

Arm 1; Arm 2; Arm 3; Arm 4; Arm 5; Arm 6

20 mg zolpidem DRUG

Arm 1; Arm 2; Arm 3; Arm 4; Arm 5; Arm 6

40 mg zolpidem DRUG

Arm 1; Arm 2; Arm 3; Arm 4; Arm 5; Arm 6

placebo DRUG

Arm 1; Arm 2; Arm 3; Arm 4; Arm 5; Arm 6

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Healthy male or female subjects 18 to 55 years of age, inclusive.
• Recreational drug use with a history of CNS depressant use, defined as at least 10 lifetime occasions of non-medical use of drugs with depressant/sedative properties (e.g., benzodiazepines, barbiturates, gammahydroxybutyric acid (GHB), zopiclone, zolpidem, cannabis, etc.), and at least one instance of non-medical use in the past year.
• Body mass index (BMI) within the range of 18 to 32 kg/m\^2, inclusive, and a minimum weight of 50 kg.
• Female subjects of childbearing potential must have been practicing strict sexual abstinence or using a medically acceptable and reliable form of birth control with a failure rate of \< 1% per year from at least 1 month prior to Screening (at least 3 months for oral contraceptives) and for at least 1 month after the last study drug administration. Accepted methods of contraception included implants, injectables, combined oral hormonal contraceptives, some intrauterine devices, sexual abstinence, tubal ligation, or vasectomized partner.
• Female subjects of non-childbearing potential must have been amenorrheic for at least 1 year following natural menopause or had a hysterectomy and/or bilateral oophorectomy (as determined by subject medical history).
• Female subjects must have had a negative pregnancy test at Screening and at each admission.
• Must have passed Qualification Visit eligibility criteria.
• Must have been able to speak, read, and understand English sufficiently to understand the nature of the study, to provide written informed consent, and to allow completion of all study assessments.
• Willing and able to abide by all study requirements and restrictions.
• Give voluntary written informed consent to participate in the study.

You may not qualify if:

• Received an investigational drug in a clinical trial within 30 days prior to the Screening Visit.
• Drug or alcohol dependence (except nicotine or caffeine) in the past 2 years as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), including subjects who had ever been in a drug rehabilitation program (other than treatment for smoking cessation).
• Unwillingness or inability to abstain from recreational drug use as required for the study.
• Positive breath alcohol test at Screening or at any admission.
• Clinically significant abnormalities on physical examination, medical history, 12-lead electrocardiogram (ECG), vital signs, or laboratory tests, including a history or presence of psychiatric, cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurologic, or oncologic disease or any other condition, which in the opinion of the investigator would have jeopardized the safety of the subject or the validity of the study results.
• Previous history of fainting, collapses, syncope, orthostatic hypotension, or vasovagal reactions.
• Use of non-prescription medication, prescription medication, or natural health products (except vitamin or mineral supplements, acceptable forms of birth control, and hormone replacement) within 7 days prior to first drug administration in the Qualification Visit and throughout the study. Up to 1 g per day of acetaminophen was allowed at the discretion of the investigator. Concomitant medication known to inhibit or induce the cytochrome P3A4 isoenzyme was not allowed. Treatment with drugs metabolized by the cytochrome P2D6 isoenzyme was not allowed.
• History of allergy or hypersensitivity to study drugs, related drugs (e.g., benzodiazepines or gamma-aminobutyric acid related drugs) or excipients (including lactose).

Sponsors & Collaborators

• Midnight Pharma, LLC: lead

MeSH Terms

Interventions

almorexant; Zolpidem

Intervention Hierarchy (Ancestors)

Pyridines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Study Officials

• Edward M Sellers, MD, PhD

  Kendle Early Stage - Toronto

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Intervention Model: CROSSOVER
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 13, 2013
• First Posted: November 19, 2013
• Study Start: September 1, 2009
• Primary Completion: February 1, 2010
• Study Completion: February 1, 2010
• Last Updated: February 12, 2016

Record last verified: 2016-02