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A single center, double blind, randomized, placebo controlled, two-treatments, two-period crossover study conducted in adult smokers.
The main objective of this study is to use blood oxygen level-dependent (BOLD) functional Magnetic Resonance Imaging (fMRI) in abstinent smokers to directly evaluate the effect of the 4 milligrams (mg) nicotine lozenge on brain activation associated with visual attention. The experimental task featured 3 conditions: 1. a highly demanding cognitive/attention task, 2. a simple cognitive/attention task, and 3. simply look at a '+' symbol. During the experiment these conditions are each presented a number of times in an alternating manner while acquiring images.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nicotine lozenge | Experimental | Nicotine lozenge containing 4 mg of nicotine to be placed in mouth and suck to dissolution. |
|
| Placebo lozenge | Placebo Comparator | Placebo lozenge to be placed in mouth and suck to dissolution. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nicotine | Drug | Nicotine lozenge containing 4 mg of nicotine |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Percent Mean Change in Blood Oxygen-level Dependent (BOLD) Scores During Rapid Visual Information Processing (RVIP) Task | In RVIP task, participant responded to consecutive sequences of three odd or three even numbers by pressing the corresponding response button as quickly and accurately as possible. During a control task, participant responded to single occurrences of the number "0". BOLD fMRI signals evaluated different brain regions of interest (ROI) during RVIP task. Brain ROIs identified were right and left anterior insula, anterior putamen, parietal cortex, premotor cortex, visual cortex, dorsal anterior cingulate cortex, substantia nigra and thalamus. | Approximately 2 hours post dose administration |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Response Time for Correct Responses During RVIP Task | During the RVIP task, participants responded to consecutive sequences of three odd or three even numbers by pressing the corresponding response button as quickly and accurately as possible. During a control task, participants responded to single occurrences of the number "0". Mean response time for correct responses was determined. | Approximately 2 hours post dose administration |
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Inclusion Criteria:
Weight and size
Smoking Status
Females of childbearing potential who are, in the opinion of the investigator, practicing a reliable method of contraception.
Understands and is willing, able and likely to comply with all study procedures and restrictions.
Good general health with (in the opinion of the examining study doctor) no clinically significant and relevant abnormalities of medical history, physical examination or clinical laboratory test.
Demonstrates understanding of the study and willingness to participate as evidenced by voluntary written informed consent and has received a signed and dated copy of the informed consent form.
Exclusion Criteria:
Women who are pregnant or who have a positive urine pregnancy test or
who are breast-feeding.
Disease/Illness
Contraindications to MR scanning
Prior/Concomitant Medication
Clinical Study/Experimental Medication
Known or suspected intolerance or hypersensitivity to the study materials (or closely related compounds) or any of their stated ingredients.
Substance abuse
Consumption of any alcoholic beverages within 24 hours of the treatment visits (as indicated by either a positive breath alcohol test or in the opinion of the Investigator).
Consumption of large quantities of xanthine containing beverages (e.g., coffee, tea, cola, chocolate etc, more than an average of five cups or glasses per day).
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| Name | Affiliation | Role |
|---|---|---|
| GSK Clinical Trials | GlaxoSmithKline | Study Director |
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A total of 45 participants were screened, 22 were considered screen failures. Investigators identified brain regions showing significant blood oxygen-level dependent (BOLD) activation associated with attention in each participant using Functional Magnetic Resonance Imaging (fMRI). Hence, participants categorized into high/low attention conditions.
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| ID | Title | Description |
|---|---|---|
| FG000 | 4 mg Nicotine Lozenge Then Placebo Lozenge | Participants received nicotine lozenge containing 4 milligrams (mg) of nicotine in Period I and placebo lozenge in Period II. |
| FG001 | Placebo Lozenge Then 4 mg Nicotine Lozenge | Participants received placebo lozenge in Period I and nicotine 4 mg lozenge in Period II. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PERIOD 1 |
|
| ||||||||||||||||||
| PERIOD 2 |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | All Randomized Participants | All randomized participants who receive study treatments. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent Mean Change in Blood Oxygen-level Dependent (BOLD) Scores During Rapid Visual Information Processing (RVIP) Task | In RVIP task, participant responded to consecutive sequences of three odd or three even numbers by pressing the corresponding response button as quickly and accurately as possible. During a control task, participant responded to single occurrences of the number "0". BOLD fMRI signals evaluated different brain regions of interest (ROI) during RVIP task. Brain ROIs identified were right and left anterior insula, anterior putamen, parietal cortex, premotor cortex, visual cortex, dorsal anterior cingulate cortex, substantia nigra and thalamus. | Number of participants with complete imaging data on both treatments (nicotine and placebo). | Posted | Mean | Standard Deviation | Percentage change in BOLD signal | Approximately 2 hours post dose administration |
|
All adverse events encountered or spontaneously reported following administration of any investigational product (including washout product), or for up to 5 days after the last administration of investigational product were recorded.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Nicotine Lozenge | Participants in safety population received 4 mg of nicotine lozenge. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hiccups | Respiratory, thoracic and mediastinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| GSK Response Center | GlaxoSmithKline | 866-435-7343 |
| ID | Term |
|---|---|
| D012907 | Smoking |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D009538 | Nicotine |
| ID | Term |
|---|---|
| D012991 | Solanaceous Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D011725 | Pyridines |
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| Placebo |
| Drug |
Placebo lozenge |
|
| Mean Percentage of Correct Responses During RVIP Task | Percentage of correct responses during RVIP task was determined | Approximately 2 hours post dose administration |
| Percent Mean Change in BOLD Scores During Divided Attention (DIA) Task | BOLD fMRI signals evaluated different brain ROIs during DIA task which comprised of three conditions: i) Sustained visual attention wherein participant responded to letter "s" every time it appeared in a continuous stream of letters on a screen; ii) Sustained auditory attention wherein participant responded to the number "8" each time in appeared in a continuous stream of numbers presented through headphones; iii) Divided attention task auditory and visual stimuli wherein participant responded to occurrences of "s" (visual) and "8" (auditory) simultaneously. Brain ROIs were right and left parietal cortex, visual cortex, superior occipital cortex and right premotor cortex. | Approximately 2 hours post dose admininstration |
| Mean Response Time for Correct Responses During DIA Task | DIA task comprised of three conditions: i) Sustained visual attention wherein participant responded to letter "s" every time it appeared in a continuous stream of letters on a screen; ii) Sustained auditory attention wherein participant responded to the number "8" each time in appeared in a continuous stream of numbers presented through headphones; iii) Divided attention task auditory and visual stimuli wherein participant responded to occurrences of "s" (visual) and "8" (auditory) simultaneously. Mean response time for correct responses was determined. | Approximately 2 hours post dose administration |
| Mean Percentage of Correct Responses During DIA Task | Mean percentage of correct responses during DIA task was determined. | Approximately 2 hours post dose administration |
| NOT COMPLETED |
|
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Number | participants |
|
Participants in low attention condition and received 4 mg of nicotine lozenge.
| OG001 | Placebo Lozenge 1 | Participants in low attention condition and received placebo lozenge. |
| OG002 | Nicotine Lozenge 2 | Participants in high attention condition and received 4 mg of nicotine lozenge. |
| OG003 | Placebo Lozenge 2 | Participants in high attention condition and received placebo lozenge. |
|
|
|
| Secondary | Mean Response Time for Correct Responses During RVIP Task | During the RVIP task, participants responded to consecutive sequences of three odd or three even numbers by pressing the corresponding response button as quickly and accurately as possible. During a control task, participants responded to single occurrences of the number "0". Mean response time for correct responses was determined. | Number of participants with complete imaging data on both treatments (nicotine and placebo). | Posted | Mean | Standard Deviation | milliseconds (msec) | Approximately 2 hours post dose administration |
|
|
|
|
| Secondary | Mean Percentage of Correct Responses During RVIP Task | Percentage of correct responses during RVIP task was determined | Number of participants with complete imaging data on both treatments (nicotine and placebo). | Posted | Mean | Standard Deviation | Percentage of responses correct | Approximately 2 hours post dose administration |
|
|
|
|
| Secondary | Percent Mean Change in BOLD Scores During Divided Attention (DIA) Task | BOLD fMRI signals evaluated different brain ROIs during DIA task which comprised of three conditions: i) Sustained visual attention wherein participant responded to letter "s" every time it appeared in a continuous stream of letters on a screen; ii) Sustained auditory attention wherein participant responded to the number "8" each time in appeared in a continuous stream of numbers presented through headphones; iii) Divided attention task auditory and visual stimuli wherein participant responded to occurrences of "s" (visual) and "8" (auditory) simultaneously. Brain ROIs were right and left parietal cortex, visual cortex, superior occipital cortex and right premotor cortex. | Number of participants with complete imaging data on both treatments (nicotine and placebo). | Posted | Mean | Standard Deviation | Percentage change in BOLD signal | Approximately 2 hours post dose admininstration |
|
|
|
|
| Secondary | Mean Response Time for Correct Responses During DIA Task | DIA task comprised of three conditions: i) Sustained visual attention wherein participant responded to letter "s" every time it appeared in a continuous stream of letters on a screen; ii) Sustained auditory attention wherein participant responded to the number "8" each time in appeared in a continuous stream of numbers presented through headphones; iii) Divided attention task auditory and visual stimuli wherein participant responded to occurrences of "s" (visual) and "8" (auditory) simultaneously. Mean response time for correct responses was determined. | Number of participants with complete imaging data on both treatments (nicotine and placebo). | Posted | Mean | Standard Deviation | msec | Approximately 2 hours post dose administration |
|
|
|
|
| Secondary | Mean Percentage of Correct Responses During DIA Task | Mean percentage of correct responses during DIA task was determined. | Number of subjects with complete imaging data on both treatments (nicotine and placebo) | Posted | Mean | Standard Deviation | Percentage of responses correct | Approximately 2 hours post dose administration |
|
|
|
|
| 0 |
| 22 |
| 4 |
| 22 |
| EG001 | Placebo Lozenge | Participants in safety population received placebo lozenge. | 0 | 23 | 0 | 23 |
| Nausea | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
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| D006573 |
| Heterocyclic Compounds, 1-Ring |
| ANOVA |
| 0.1811 |
| 95 |
| No |
| Superiority or Other |
| 0.0106 |
| 95 |
| No |
| Superiority or Other |
| Left Superior Occipital Cortex |
|
| Left Visual Cortex |
|
| Right Parietal Cortex |
|
| Right Premotor Cortex |
|
| Right Superior Occipital Cortex |
|
| Right Visual Cortex |
|
| 0.6716 |
| 95 |
| No |
| Superiority or Other |
| Region of interest is left superior occipital cortex. | ANOVA | 0.7511 | 95 | No | Superiority or Other |
| Region of interest is left superior occipital cortex. | ANOVA | 0.7959 | 95 | No | Superiority or Other |
| Region of interest is left visual cortex. | ANOVA | 0.6418 | 95 | No | Superiority or Other |
| Region of interest is left visual cortex. | ANOVA | 0.2205 | 95 | No | Superiority or Other |
| Region of interest is right parietal cortex. | ANOVA | 0.5135 | 95 | No | Superiority or Other |
| Region of interest is right parietal cortex. | ANOVA | 0.9781 | 95 | No | Superiority or Other |
| Region of interest is right premotor cortex. | ANOVA | 0.3755 | 95 | No | Superiority or Other |
| Region of interest is right premotor cortex. | ANOVA | 0.2612 | 95 | No | Superiority or Other |
| Region of interest is right superior occipital cortex. | ANOVA | 0.8486 | 95 | No | Superiority or Other |
| Region of interest is right superior occipital cortex. | ANOVA | 0.8318 | 95 | No | Superiority or Other |
| Region of interest is right visual cortex. | ANOVA | 0.7554 | 95 | No | Superiority or Other |
| Region of interest is right visual cortex. | ANOVA | 0.5421 | 95 | No | Superiority or Other |
| ANOVA |
| 0.0959 |
| 95 |
| No |
| Superiority or Other |
| 0.1800 |
| 95 |
| No |
| Superiority or Other |