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Stopped early due to inadequate separation on primary efficacy endpoint at Week 12 according to Interim Analysis conducted on the first 274 (50%) patients.
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| Name | Class |
|---|---|
| Premier Research | OTHER |
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This is a 12-week, multicenter, randomized, double-blind, placebo-controlled, fixed-dose study that will investigate the efficacy and safety of 5.6 mg TNX-102 SL (2 x 2.8 mg tablets)-a sublingual formulation of cyclobenzaprine. Following successful screening and randomization, eligible patients will have a telephonic visit at week 2 and then return regularly to the study clinic for monthly visits for assessments of efficacy and safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TNX-102 SL Tablet, 5.6 mg | Experimental | 2 x TNX-102 SL, 2.8 mg Tablets taken sublingually each day at bedtime for 12 weeks. |
|
| Placebo SL Tablet | Placebo Comparator | 2 x Placebo Tablet taken sublingually each day at bedtime for 12 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TNX-102 SL | Drug | Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change From Baseline in the Total Clinician Administered PTSD Scale (CAPS-5) for DSM-5 at Week 12. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the Clinician Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (CAPS-5) total symptom severity score in a 12-week study. Score ranges from 0 to 80 with lower scores indicating less severe PTSD symptoms. | Day 0 and Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Global Impression - Improvement From Initiation of Treatment (CGI-I) Score After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the CGI-I score after 12 weeks of treatment. Score ranges from 1 to 7. 1 = Very much improved. 2 = Much improved. 3 = Minimally improved. 4 = No change. 5 = Minimally worse. 6 = Much worse. 7 = Very much worse. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Greg Sullivan, MD | Tonix Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phoenix | Phoenix | Arizona | 85032 | United States | ||
| Little Rock |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38350291 | Result | Parmenter ME, Lederman S, Weathers FW, Davis LL, Vaughn B, Engels J, Sullivan GM. A phase 3, randomized, placebo-controlled, trial to evaluate the efficacy and safety of bedtime sublingual cyclobenzaprine (TNX-102 SL) in military-related posttraumatic stress disorder. Psychiatry Res. 2024 Apr;334:115764. doi: 10.1016/j.psychres.2024.115764. Epub 2024 Feb 1. | |
| 33587394 |
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| ID | Title | Description |
|---|---|---|
| FG000 | TNX-102 SL Tablet, 5.6 mg | 2 x TNX-102 SL, 2.8 mg Tablets taken sublingually each day at bedtime for 12 weeks. TNX-102 SL: Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks |
| FG001 | Placebo SL Tablet |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Oct 29, 2019 | Mar 6, 2024 |
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|
| Placebo SL Tablet | Drug | Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks |
|
|
| Week 12 |
| Change From Baseline in the Disruption of Social Life/Leisure Activities Assessed Using the Sheehan Disability Scale (SDS) After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the change from baseline in disruption of social life/leisure activities assessed with the SDS after 12 weeks of treatment. Score ranges from 0 to 10. Lower scores indicate less disruption to social life/leisure activities. | Day 0, Week 12. |
| Change From Baseline in the Disruption of Work/School Activities Assessed Using the Sheehan Disability Scale (SDS) After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the change from baseline in disruption of work/school activities assessed with the SDS after 12 weeks of treatment. Score ranges from 0 to 10. Lowers scores indicate less disruption to work/school activities. | Day 0, Week 12. |
| Change From Baseline in Patients' Quality of Sleep Using the Patient-Reported Outcome Measurement Information System (PROMIS) Sleep Disturbance Scale After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the change from baseline in quality of sleep using the PROMIS Sleep Disturbance scale after 12 weeks of treatment. Raw score is transformed to T-scores using published conversions. T-score ranges from 30 to 80 with lower scores indicating better sleep quality. | Day 0, Week 12. |
| Little Rock |
| Arkansas |
| 72211 |
| United States |
| Rogers | Rogers | Arkansas | 72758 | United States |
| Beverly hills | Beverly Hills | California | 90210 | United States |
| Glendale | Glendale | California | 91206 | United States |
| Oakland | Oakland | California | 94607 | United States |
| Oceanside | Oceanside | California | 92056 | United States |
| Orange | Orange | California | 92868 | United States |
| Riverside | Riverside | California | 92506 | United States |
| San Diego | San Diego | California | 92123 | United States |
| San Diego | San Diego | California | 92161 | United States |
| Temecula | Temecula | California | 92591 | United States |
| Colorado Springs | Colorado Springs | Colorado | 80910 | United States |
| Cromwell | Cromwell | Connecticut | 06416 | United States |
| Norwich | Norwich | Connecticut | 06360 | United States |
| Washington, D.C. | Washington D.C. | District of Columbia | 20018 | United States |
| Jacksonville | Jacksonville | Florida | 32256 | United States |
| Lake City | Lake City | Florida | 32607 | United States |
| Lauderhill | Lauderhill | Florida | 33319 | United States |
| Maitland | Maitland | Florida | 32751 | United States |
| Tampa | Tampa | Florida | 33609 | United States |
| Atlanta | Atlanta | Georgia | 30341 | United States |
| Chicago | Chicago | Illinois | 60640 | United States |
| New Bedford | New Bedford | Massachusetts | 02740 | United States |
| Flowood | Flowood | Mississippi | 39232 | United States |
| St. Louis | St Louis | Missouri | 63141 | United States |
| Missoula | Missoula | Montana | 59812 | United States |
| Las Vegas | Las Vegas | Nevada | 89102 | United States |
| Berlin | Berlin | New Jersey | 08009 | United States |
| Cedarhurst | Cedarhurst | New York | 11516 | United States |
| New York | New York | New York | 10128 | United States |
| Canton | Canton | Ohio | 44718 | United States |
| Cincinnati | Cincinnati | Ohio | 45219 | United States |
| Dayton | Dayton | Ohio | 45417 | United States |
| Oklahoma City | Oklahoma City | Oklahoma | 73103 | United States |
| Downingtown | Downingtown | Pennsylvania | 19335 | United States |
| Media | Media | Pennsylvania | 19063 | United States |
| Charleston | Charleston | South Carolina | 29407 | United States |
| Austin | Austin | Texas | 78754 | United States |
| Dallas | Dallas | Texas | 75231 | United States |
| Houston | Houston | Texas | 77098 | United States |
| San Antonio | San Antonio | Texas | 78229 | United States |
| Salem | Salem | Virginia | 24153 | United States |
| Everett | Everett | Washington | 98201 | United States |
| Dunlop BW, Rakofsky JJ, Newport DJ, Mletzko-Crowe T, Barone K, Nemeroff CB, Harvey PD. Efficacy of Vortioxetine Monotherapy for Posttraumatic Stress Disorder: A Randomized, Placebo-Controlled Trial. J Clin Psychopharmacol. 2021 Mar-Apr 01;41(2):172-179. doi: 10.1097/JCP.0000000000001363. |
2 x Placebo Tablet taken sublingually each day at bedtime for 12 weeks. Placebo SL Tablet: Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks |
| COMPLETED |
|
| NOT COMPLETED |
|
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | TNX-102 SL Tablet, 5.6 mg | 2 x TNX-102 SL, 2.8 mg Tablets taken sublingually each day at bedtime for 12 weeks. TNX-102 SL: Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks |
| BG001 | Placebo SL Tablet | 2 x Placebo Tablet taken sublingually each day at bedtime for 12 weeks. Placebo SL Tablet: Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | 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 | Mean Change From Baseline in the Total Clinician Administered PTSD Scale (CAPS-5) for DSM-5 at Week 12. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the Clinician Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (CAPS-5) total symptom severity score in a 12-week study. Score ranges from 0 to 80 with lower scores indicating less severe PTSD symptoms. | Posted | Least Squares Mean | Standard Error | units on a scale | Day 0 and Week 12 |
|
|
| |||||||||||||||||||||||||||||
| Secondary | Clinical Global Impression - Improvement From Initiation of Treatment (CGI-I) Score After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the CGI-I score after 12 weeks of treatment. Score ranges from 1 to 7. 1 = Very much improved. 2 = Much improved. 3 = Minimally improved. 4 = No change. 5 = Minimally worse. 6 = Much worse. 7 = Very much worse. | Posted | Least Squares Mean | Standard Error | score on a scale | Week 12 |
|
| ||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in the Disruption of Social Life/Leisure Activities Assessed Using the Sheehan Disability Scale (SDS) After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the change from baseline in disruption of social life/leisure activities assessed with the SDS after 12 weeks of treatment. Score ranges from 0 to 10. Lower scores indicate less disruption to social life/leisure activities. | Posted | Least Squares Mean | Standard Error | units on a scale | Day 0, Week 12. |
|
| ||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in the Disruption of Work/School Activities Assessed Using the Sheehan Disability Scale (SDS) After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the change from baseline in disruption of work/school activities assessed with the SDS after 12 weeks of treatment. Score ranges from 0 to 10. Lowers scores indicate less disruption to work/school activities. | Posted | Least Squares Mean | Standard Error | units on a scale | Day 0, Week 12. |
|
| ||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Patients' Quality of Sleep Using the Patient-Reported Outcome Measurement Information System (PROMIS) Sleep Disturbance Scale After 12 Weeks of Treatment. | To evaluate the efficacy of the TNX-102 SL (cyclobenzaprine HCl sublingual tablets) using the change from baseline in quality of sleep using the PROMIS Sleep Disturbance scale after 12 weeks of treatment. Raw score is transformed to T-scores using published conversions. T-score ranges from 30 to 80 with lower scores indicating better sleep quality. | Posted | Least Squares Mean | Standard Error | units on a scale | Day 0, Week 12. |
|
|
12 weeks
The denominator used for calculating adverse event frequencies was the number of patients confirmed to have taken at least one dose of study medication. Therefore, the denominator used for calculating the frequency differs from the total number of enrolled patients.
All-cause mortality was calculated using all patients as the denominator.
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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 | TNX-102 SL Tablet, 5.6 mg | 2 x TNX-102 SL, 2.8 mg Tablets taken sublingually each day at bedtime for 12 weeks. TNX-102 SL: Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks | 0 | 179 | 3 | 175 | 93 | 175 |
| EG001 | Placebo SL Tablet | 2 x Placebo Tablet taken sublingually each day at bedtime for 12 weeks. Placebo SL Tablet: Patients will take 2 tablets of randomly assigned study drug sublingually each day at bedtime starting on Day 0 for 12 weeks | 0 | 179 | 5 | 176 | 21 | 176 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Suicidal Ideation | Psychiatric disorders | Systematic Assessment |
| ||
| Alcohol Withdrawal Syndrome | Psychiatric disorders | Non-systematic Assessment |
| ||
| Suicide Attempt | Psychiatric disorders | Systematic Assessment |
| ||
| Amaurosis fugax | Eye disorders | Non-systematic Assessment |
| ||
| Cholangitis | Hepatobiliary disorders | Non-systematic Assessment |
| ||
| Femur Fracture | Injury, poisoning and procedural complications | Non-systematic Assessment |
| ||
| Rhabdomyolysis | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hypoaesthesia Oral | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Paraesthesia Oral | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Somnolence | Nervous system disorders | Non-systematic Assessment |
| ||
| Product Taste Abnormal | Product Issues | Non-systematic Assessment |
|
An industry standard NDA is in place with all study investigators.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gregory Sullivan, MD | Tonix Pharmaceuticals | (862) 904-0355 | greg.sullivan@tonixpharma.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | May 16, 2018 | Mar 6, 2024 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D013313 | Stress Disorders, Post-Traumatic |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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