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This was a Phase 3 multicenter randomized, open-label, safety study assessing the safety of repeat doses of Medisorb® naltrexone 380 mg (VIVITROL®) administered for up to 1 year to adults with alcohol and/or opioid dependence as defined by Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV) criteria. Eligible subjects were randomized in a 6:1 ratio to receive 1 of the following regimens: a single intramuscular (IM) injection of VIVITROL administered once every 4 weeks or oral naltrexone 50 mg administered daily.
Safety evaluations included physical examinations, electrocardiograms (ECGs), laboratory measures (including plasma concentrations of naltrexone and 6β-naltrexol), assessments of injection sites, and adverse events (AEs).
All subjects received psychosocial support at each study visit for the duration of the study, with interim telephone contact 2 weeks after each monthly visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Medisorb naltrexone 380 mg (VIVITROL) | Experimental |
| |
| Oral naltrexone 50 mg | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Medisorb naltrexone 380 mg | Drug | Administered via intramuscular (IM) injection once every 4 weeks for up to 1 year. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects Reporting at Least 1 Treatment-emergent Adverse Event (TEAE) While on Study | A TEAE was defined as any adverse event (AE) that started or worsened on or after the administration of the first dose of study medication through 30 days after the end of study treatment. | up to 1 year |
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Primary Inclusion Criteria:
Primary Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Bernard L. Silverman, MD | Alkermes, Inc. | Study Director |
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Enrollment was monitored to ensure adequate representation of alcohol-dependent and opioid-dependent patients as defined by Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV) criteria, and was stratified by alcohol dependence alone versus opioid or mixed substance abuse (ie, alcohol and opioid dependence).
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| ID | Title | Description |
|---|---|---|
| FG000 | Medisorb Naltrexone 380 mg (VIVITROL) | Administered once every 4 weeks via intramuscular (IM) injection for up to 1 year. |
| FG001 | Oral Naltrexone 50 mg | Oral tablet taken once each day for up to 1 year. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Medisorb Naltrexone 380 mg (VIVITROL) | Administered once every 4 weeks via intramuscular (IM) injection for up to 1 year. |
| BG001 | Oral Naltrexone 50 mg | Oral tablet taken once each day for up to 1 year. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 | Number of Subjects Reporting at Least 1 Treatment-emergent Adverse Event (TEAE) While on Study | A TEAE was defined as any adverse event (AE) that started or worsened on or after the administration of the first dose of study medication through 30 days after the end of study treatment. | All subjects who received at least 1 dose of study drug are included in the safety population. | Posted | Number | Participants | up to 1 year |
|
1 year
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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 | Medisorb Naltrexone 380 mg (VIVITROL) | Administered once every 4 weeks via intramuscular (IM) injection for up to 1 year. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Alcoholism | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Bernard L. Silverman | Alkermes, Inc. | 781-609-6000 | bernard.silverman@alkermes.com |
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| ID | Term |
|---|---|
| D000437 | Alcoholism |
| ID | Term |
|---|---|
| D019973 | Alcohol-Related Disorders |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| C000624616 | vivitrol |
| D009271 | Naltrexone |
| ID | Term |
|---|---|
| D009270 | Naloxone |
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006571 |
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| Oral naltrexone 50 mg | Drug | Tablet taken orally once daily for up to 1 year |
|
|
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| 49 |
| 371 |
| 336 |
| 371 |
| EG001 | Oral Naltrexone 50 mg | Oral tablet taken once each day for up to 1 year. | 5 | 65 | 53 | 65 |
| Drug dependence | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Suicidal ideation | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Suicide attempt | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Depression | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Mood disorder NOS | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Agitation | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Alcohol withdrawal syndrome | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Delirium | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Overdose NOS | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Heat exhaustion | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Laceration | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Lower limb fracture NOS | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Lumbar vertebral fracture | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Non-accidental overdose | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Postoperative fever | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Gastro-oesophageal reflux | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Haemorrhoids | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Ileus paralytic | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Rectal haemorrhage | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Reflux oesophagitis | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Convulsions NOS | Nervous system disorders | MedDRA (4.1) | Systematic Assessment |
|
| Ischaemic stroke NOS | Nervous system disorders | MedDRA (4.1) | Systematic Assessment |
|
| Transient ischaemic attack | Nervous system disorders | MedDRA (4.1) | Systematic Assessment |
|
| Chronic obstructive airways disease | Respiratory, thoracic and mediastinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Asthma NOS | Respiratory, thoracic and mediastinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Angina unstable | Cardiac disorders | MedDRA (4.1) | Systematic Assessment |
|
| Atrial fibrillation | Cardiac disorders | MedDRA (4.1) | Systematic Assessment |
|
| Chest pain | General disorders | MedDRA (4.1) | Systematic Assessment |
|
| Injection site necrosis | General disorders | MedDRA (4.1) | Systematic Assessment |
|
| Bunion | Musculoskeletal and connective tissue disorders | MedDRA (4.1) | Systematic Assessment |
|
| Lumbar disc lesion | Musculoskeletal and connective tissue disorders | MedDRA (4.1) | Systematic Assessment |
|
| Cervical adenitis | Blood and lymphatic system disorders | MedDRA (4.1) | Systematic Assessment |
|
| Gastroenteritis NOS | Infections and infestations | MedDRA (4.1) | Systematic Assessment |
|
| Dehydration | Metabolism and nutrition disorders | MedDRA (4.1) | Systematic Assessment |
|
| Breast cancer NOS | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (4.1) | Systematic Assessment |
|
| Abortion spontaneous NOS | Pregnancy, puerperium and perinatal conditions | MedDRA (4.1) | Systematic Assessment |
|
| Drug abuser NOS | Social circumstances | MedDRA (4.1) | Systematic Assessment |
|
| Coronary arterial stent insertion | Surgical and medical procedures | MedDRA (4.1) | Systematic Assessment |
|
| Hypertension NOS | Vascular disorders | MedDRA (4.1) | Systematic Assessment |
|
| Vomiting NOS | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Diarrhoea NOS | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Abdominal pain NOS | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA (4.1) | Systematic Assessment |
|
| Nasopharyngitis | Infections and infestations | MedDRA (4.1) | Systematic Assessment |
|
| Upper respiratory tract infection NOS | Infections and infestations | MedDRA (4.1) | Systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA (4.1) | Systematic Assessment |
|
| Sinusitis NOS | Infections and infestations | MedDRA (4.1) | Systematic Assessment |
|
| Urinary tract infection NOS | Infections and infestations | MedDRA (4.1) | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Depression | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Anxiety NEC | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Alcoholism | Psychiatric disorders | MedDRA (4.1) | Systematic Assessment |
|
| Headache NOS | Nervous system disorders | MedDRA (4.1) | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (4.1) | Systematic Assessment |
|
| Fatigue | General disorders | MedDRA (4.1) | Systematic Assessment |
|
| Injection site pain | General disorders | MedDRA (4.1) | Systematic Assessment |
|
| Influenza like illness | General disorders | MedDRA (4.1) | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (4.1) | Systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (4.1) | Systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (4.1) | Systematic Assessment |
|
| Blood creatinine phosphokinase increased | Investigations | MedDRA (4.1) | Systematic Assessment |
|
| Laceration | Injury, poisoning and procedural complications | MedDRA (4.1) | Systematic Assessment |
|
Should a PI wish to disclose results, the Sponsor will review the results communications prior to public release and can embargo results communications for a period of at least 30 days prior to the submission, for review and approval. Revisions will be negotiated in good faith by the Investigator and Sponsor and may be submitted for publication or disclosed by the Investigator only following receipt of written approval from the Sponsor.
| Heterocyclic Compounds |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |