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This study is designed to explore the safety and tolerability, and to compare the activity of SRX246 against placebo, in adults with Intermittent Explosive Disorder (IED).
Adult Male and Female subjects with a current diagnosis of IED will be enrolled. After a two-week baseline lead-in phase, study subjects who continue to meet enrollment criteria will be randomized to either SRX246 or Placebo treatment groups.
Study subjects will be examined and asked to answer questionnaires at weekly scheduled visits throughout the trial. The study results will be determined based on any changes observed over the study period.
This exploratory Phase II study has been designed to examine the safety and tolerability profile, and to compare the activity of the novel V1a vasopressin antagonist (SRX246) against placebo, in adults with DSM-5 Intermittent Explosive Disorder (IED).
Adult Male and Female subjects with a current DSM-5 diagnosis of IED will be enrolled. All subjects will undergo systematic diagnostic assessment for DSM-5 Axis I and II disorders. Subjects with DSM-5 IED (without current, co-morbid, DSM-5 Major Depression) whose: (a) Life History of Aggression (LHA) score is > 12, (b) Overt Aggression Scale Modified (OAS-M) "Irritability" score is > 6 and, (c) screening OAS-M "Aggression" score is > 15, will be entered into a two-week baseline lead-in phase.
After the lead-in phase, study subjects who continue to meet OAS-M criteria will be randomized to one of the two (2) treatment conditions and stratified by gender so that equal numbers of males and females are assigned to SRX246 and Placebo Groups. Those who do not meet the criteria will exit the protocol at that time. Treatment Conditions: (a) 8-week course of SRX246 (4 weeks at 120 mg bid, and 4 weeks at 160 mg bid) or (b) 8-week course of Placebo, followed by a one-week "taper" to withdraw subjects from study medication.
IED subjects in all conditions will have structured diagnostic interview sessions and questionnaires administered throughout the trial. Blinding to treatment condition will be maintained by using different personnel for these activities. Analysis of a change from baseline in the diagnostic measures will be performed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SRX246 | Experimental | SRX246 capsules, 120mg bid for 4 weeks followed by 160mg bid for 4 weeks |
|
| Placebo | Placebo Comparator | Placebo capsules to match the amount of SRX246 capsules for 8 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SRX246 | Drug | capsules |
| |
| Placebo |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability | measured as the number of participants with adverse events | from initial dose of intervention until completion of the study up to 8 weeks |
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| Measure | Description | Time Frame |
|---|---|---|
| Overt Aggression Scale Modified (OAS-M) Total Aggression Score | Change from Baseline OAS-M Score. Higher values represent a worse outcome. The OAS-M contains 3 scales: Aggression (Questions [Q]1 to 4), Irritability (Q5 to 6), and Suicidality (Q7 to 7b). Aggression total score was calculated by summing the weighted scores in Q1 to 4. Scores for each question ranged from 0 (no events) to 5 (very severe events). Total scores ranged from 0 (no aggression) to any number with no upper limit depending on the frequency of aggressive behavior in a week. |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atlanta Center for Medical Research | Atlanta | Georgia | 30331 | United States | ||
| University of Chicago, Department of Psychiatry |
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One additional subject was enrolled than planned, due to timing of screening and notification to sites of ceasing planned enrollment.
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| ID | Title | Description |
|---|---|---|
| FG000 | SRX246 | SRX246 capsules, 120mg bid for 4 weeks followed by 160mg bid for 4 weeks SRX246: capsules |
| FG001 | Placebo | Placebo capsules to match the amount of SRX246 capsules for 8 weeks Placebo |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | SRX246 | SRX246 capsules, 120mg bid for 4 weeks followed by 160mg bid for 4 weeks SRX246: capsules |
| BG001 | Placebo | Placebo capsules to match the amount of SRX246 capsules for 8 weeks Placebo |
| 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 | Safety and Tolerability | measured as the number of participants with adverse events | Intent to treat | Posted | Number | participants | from initial dose of intervention until completion of the study up to 8 weeks |
|
from first dose of study drug to last follow-up visit, up to 8 weeks
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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 | SRX246 | SRX246 capsules, 120mg bid for 4 weeks followed by 160mg bid for 4 weeks SRX246: capsules |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Neal Simon, CEO | Azevan Pharmaceuticals, Inc. | (610) 419-1057 | ngsimon@azevan.com |
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| ID | Term |
|---|---|
| D007174 | Disruptive, Impulse Control, and Conduct Disorders |
| D000374 | Aggression |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D000096762 | Aberrant Motor Behavior in Dementia |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| C584649 | SRX246 |
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| Drug |
|
| Comparison of baseline score to score at end of treatment period of 8 weeks |
| Chicago |
| Illinois |
| 60637 |
| United States |
| Psychiatric Care and Research Center | O'Fallon | Missouri | 63368 | United States |
| SPRI Clinical Trials, LLC | Brooklyn | New York | 11235 | United States |
| Icahn School of Medicine at Mount Sinai | New York | New York | 10029 | United States |
| Lindner Center of HOPE | Mason | Ohio | 45040 | United States |
| Rhode Island Hospital, Department of Psychiatry | Providence | Rhode Island | 02903 | United States |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Units | Counts |
|---|
| Participants |
|
|
| Other Pre-specified | Overt Aggression Scale Modified (OAS-M) Total Aggression Score | Change from Baseline OAS-M Score. Higher values represent a worse outcome. The OAS-M contains 3 scales: Aggression (Questions [Q]1 to 4), Irritability (Q5 to 6), and Suicidality (Q7 to 7b). Aggression total score was calculated by summing the weighted scores in Q1 to 4. Scores for each question ranged from 0 (no events) to 5 (very severe events). Total scores ranged from 0 (no aggression) to any number with no upper limit depending on the frequency of aggressive behavior in a week. | those that took study drug and had sufficient data for analysis | Posted | Mean | Standard Deviation | score on a scale | Comparison of baseline score to score at end of treatment period of 8 weeks |
|
|
|
| 0 |
| 49 |
| 0 |
| 49 |
| 9 |
| 49 |
| EG001 | Placebo | Placebo capsules to match the amount of SRX246 capsules for 8 weeks Placebo | 0 | 48 | 0 | 48 | 7 | 48 |
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
|
| Dry Mouth | Gastrointestinal disorders | Systematic Assessment |
|
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| D012919 |
| Social Behavior |