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The primary purpose of this study is to compare the bioavailability of CTx-1301 (dexmethylphenidate) to the registered listed drug, Focalin XR and to evaluate dose proportionality of CTx-1301. In addition, this study seeks to characterize the pharmacokinetics of dexmethylphenidate and evaluate the safety and tolerability of CTx-1301.
The study will comprise of a randomized, single-dose, four-sequence, four-period, in-clinic crossover study in approximately 36 adult ADHD subjects. All subjects considered eligible at Screening will proceed to tolerability test day, dosing 40 mg Focalin XR to evaluate safety and tolerability of the higher dose of d-MPH. If subject is able to safely tolerate the test dose, and meets all inclusion/exclusion criteria, they will be considered eligible for randomization into the study. All subjects will be randomized to receive four treatments throughout the course of the study; one CTx-1301 trimodal d-MPH tablet containing 6.25 mg d-MPH, one Focalin 5 mg XR capsule, one CTx-1301 50 mg tablet, and one 40 mg Focalin XR capsule. Administration of study drug will occur only on Assessment Days; no study drug will be administered during screening or unscheduled days (USVs).
The lowest and highest doses of CTx-1301 (dexmethylphenidate, 6.25 and 50 mg) were selected to bridge to the lowest and highest doses of Focalin XR (dexmethylphenidate, 5 and 40 mg) in this comparative BA study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sequence 1 (ADBC) | Experimental | Subjects in sequence ADBC will receive study treatments in the following order: Focalin XR 5 mg capsule, CTx-1301 50 mg tablet, CTx-1301 6.25 mg tablet, Focalin XR 40 mg capsule. |
|
| Sequence 2 (BACD) | Experimental | Subjects in sequence BACD will receive study treatments in the following order: CTx-1301 6.25 mg tablet, Focalin XR 5 mg capsule, Focalin XR 40 mg capsule, CTx-1301 50 mg tablet. |
|
| Sequence 3 (CBDA) | Experimental | Subjects in sequence CBDA will receive study treatments in the following order: Focalin XR 40 mg capsule, CTx-1301 6.25 mg tablet, CTx-1301 50 mg tablet, Focalin XR 5 mg capsule. |
|
| Sequence 4 (DCAB) | Experimental | Subjects in sequence DCAB will receive study treatments in the following order: CTx-1301 50 mg tablet, Focalin XR 40 mg capsule, Focalin XR 5 mg capsule, CTx-1301 6.25 mg tablet. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmethylphenidate 5 Mg Oral Capsule, Extended Release | Drug | Reference listed drug (RLD) for comparative BA evaluation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cmax | d-MPH Plasma concentration | Hours 0 to 28 |
| AUC(0-infinity) | Area under the curve from time 0 extrapolated to infinite time | Hours 0 to 28 |
| AUC(Last) | AUC from time 0 to the last measurable concentration | Hours 0 to 28 |
| Measure | Description | Time Frame |
|---|---|---|
| Partial AUCs | AUC from Hours 0-3, 3-6, 6-9, 9-12, and 12 to 16 | Hours 0 to 28 |
| K | Rate at which a drug is removed from the system | Hours 0 to 28 |
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Inclusion Criteria:
Gender
a. Male or Female
Age
a. Aged between 18 and 55 years inclusive.
Weight and BMI
Compliance
Consent a. Demonstrates understanding of the study and willingness to participate as evidenced by voluntary written informed consent (signed and dated) obtained before any study-related activities are performed.
Indication
General Health
Smoking/Caffeine/Alcohol
ADHD Medication History
Exclusion Criteria:
Medical History
Medications
a. Subject has taken any medication that, in the opinion of an Investigator, has been shown to alter the PK of d-MPH.
b. Use of any prescription medication within 14 days prior to Day -3 (ADHD medications must be discontinued at least 96 hours prior to check-in at Day -4), and/or use of any OTC medications (such as antacids, vitamins, minerals, dietary/herbal preparations, and nutritional supplements) within 7 days prior to Day -3 unless jointly approved by an Investigator and Sponsor.
i. Subjects are permitted to take hormonal contraceptives and hormone replacement therapy at acceptable levels if stable at least 30 days prior to Day -4, through the duration of the study, and for 30 days after the study ends.
ii. Acetaminophen (up to 2 grams per day) may be used during the study under the direction of the Investigator.
iii. On a case-by-case basis, an Investigator is permitted to allow the use of certain concomitant medications, for example, to treat an AE, as long as an Investigator determines that the medication will not affect the subject's safety or study integrity (eg, topical medications).
Alcohol/Substance Abuse
Smoking
a. Subject regularly smokes more than 10 cigarettes/day (or other nicotine-containing products) or Subject has recently discontinued smoking (within the last 3 months)
Allergy/Intolerance
a. Subject has a history of allergy to d-MPH, to any component of the dosage form, or any other allergy, which, in the opinion of an Investigator, contraindicates their participation.
Clinical Studies
Personnel
a. An employee of the sponsor, study site, or members of their immediate family.
Blood
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| Name | Affiliation | Role |
|---|---|---|
| Matt Brams, MD | Sponsor Medical Officer | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vince & Associates | Overland Park | Kansas | 66212 | United States |
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Of 106 subjects who were screened, 45 (42.5%) were enrolled into the study and randomized to a sequence of treatment.
Subjects were recruited at a single site from November 22, 2019 to March 06, 2020.
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| ID | Title | Description |
|---|---|---|
| FG000 | Sequence 1 (ADBC) | Subjects in sequence ADBC received study treatments in the following order: Focalin XR 5 mg capsule, CTx-1301 50 mg tablet, CTx-1301 6.25 mg tablet, Focalin XR 40 mg capsule. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| FG001 | Sequence 2 (BACD) | Subjects in sequence BACD received study treatments in the following order: CTx-1301 6.25 mg tablet, Focalin XR 5 mg capsule, Focalin XR 40 mg capsule, CTx-1301 50 mg tablet. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| FG002 | Sequence 3 (CBDA) | Subjects in sequence CBDA received study treatments in the following order: Focalin XR 40 mg capsule, CTx-1301 6.25 mg tablet, CTx-1301 50 mg tablet, Focalin XR 5 mg capsule. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| FG003 | Sequence 4 (DCAB) | Subjects in sequence DCAB received study treatments in the following order: CTx-1301 50 mg tablet, Focalin XR 40 mg capsule, Focalin XR 5 mg capsule, CTx-1301 6.25 mg tablet. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Sequence 1 (ADBC) | Subjects in sequence ADBC will receive study treatments in the following order: Focalin XR 5 mg capsule, CTx-1301 50 mg tablet, CTx-1301 6.25 mg tablet, Focalin XR 40 mg capsule. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| 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 | Cmax | d-MPH Plasma concentration | PK Completer Population | Posted | Geometric Mean | 90% Confidence Interval | pg/mL | Hours 0 to 28 |
|
Day -4 to Day 10
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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 | Treatment A | Focalin XR 5 mg capsule Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Palpitations | Cardiac disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| VP of Clinical Operations and Regulatory Affairs | Cingulate Therapeutics | 913-942-2304 | hmitzel@cingulatetherapeutics.com |
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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 | Jan 16, 2020 | Mar 4, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Feb 12, 2020 | Mar 4, 2021 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D064699 | Dexmethylphenidate Hydrochloride |
| D002214 | Capsules |
| D013607 | Tablets |
| ID | Term |
|---|---|
| D008774 | Methylphenidate |
| D010648 | Phenylacetates |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
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|
|
| Dexmethylphenidate 6.25 mg Tablet | Drug | Experimental drug for comparative BA evaluation |
|
|
| Dexmethylphenidate 40 Mg Oral Capsule, Extended Release | Drug | Reference listed drug (RLD) for comparative BA evaluation |
|
|
| Dexmethylphenidate 50 mg Tablet | Drug | Experimental drug for comparative BA evaluation |
|
|
| Half-life | Time (Hours) it takes for the concentration of the drug in plasma to be reduced by 50% | Hours 0 to 28 |
| Tmax | Time (Hours) after administration of a drug when the maximum plasma concentration is reached | Hours 0 to 28 |
| Tlag | Delay (hours) between the time of dosing and time of appearance of concentration in the sampling | Hours 0 to 28 |
| Incidence of Treatment-Emergent Adverse Events | TEAEs will be measured from Day 0 to Day 10 (End of Study) | Day 0 to Day 10 |
| BG001 | Sequence 2 (BACD) | Subjects in sequence BACD will receive study treatments in the following order: CTx-1301 6.25 mg tablet, Focalin XR 5 mg capsule, Focalin XR 40 mg capsule, CTx-1301 50 mg tablet. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| BG002 | Sequence 3 (CBDA) | Subjects in sequence CBDA will receive study treatments in the following order: Focalin XR 40 mg capsule, CTx-1301 6.25 mg tablet, CTx-1301 50 mg tablet, Focalin XR 5 mg capsule. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| BG003 | Sequence 4 (DCAB) | Subjects in sequence DCAB will receive study treatments in the following order: CTx-1301 50 mg tablet, Focalin XR 40 mg capsule, Focalin XR 5 mg capsule, CTx-1301 6.25 mg tablet. Dexmethylphenidate 5 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 6.25 mg Tablet: Experimental drug for comparative BA evaluation Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation Dexmethylphenidate 50 mg Tablet: Experimental drug for comparative BA evaluation |
| BG004 | 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 | Number | participants |
|
| History of ADHD | Number | participants |
|
PK Comparison of 6.25 mg CTx-1301 (treatment B) to 5 mg Focalin XR (treatment A) |
| OG003 | Treatment C | Focalin XR 40 mg capsule Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation |
| OG004 | Treatment D | CTx-1301 50 mg tablet Dexmethylphenidate 50 Mg Oral Tablet, Extended Release: Investigational Medication for comparative BA evaluation |
| OG005 | Treatment D/C | PK Comparison of 50 mg CTx-1301 (treatment D) to 40 mg Focalin XR (treatment C). |
|
|
| Primary | AUC(0-infinity) | Area under the curve from time 0 extrapolated to infinite time | PK Completer Population | Posted | Geometric Mean | 90% Confidence Interval | ng/mL | Hours 0 to 28 |
|
|
|
| Primary | AUC(Last) | AUC from time 0 to the last measurable concentration | PK Completer Population | Posted | Geometric Mean | 90% Confidence Interval | pg/mL | Hours 0 to 28 |
|
|
|
| Secondary | Partial AUCs | AUC from Hours 0-3, 3-6, 6-9, 9-12, and 12 to 16 | Posted | Geometric Mean | 90% Confidence Interval | hr*pg/mL | Hours 0 to 28 |
|
|
|
| Secondary | K | Rate at which a drug is removed from the system | PK Completer Population | Posted | Geometric Mean | Standard Deviation | (1/hr) | Hours 0 to 28 |
|
|
|
| Secondary | Half-life | Time (Hours) it takes for the concentration of the drug in plasma to be reduced by 50% | Posted | Geometric Mean | Standard Deviation | hr*pg/mL | Hours 0 to 28 |
|
|
|
| Secondary | Tmax | Time (Hours) after administration of a drug when the maximum plasma concentration is reached | Posted | Median | Full Range | hr*pg/mL | Hours 0 to 28 |
|
|
|
| Secondary | Tlag | Delay (hours) between the time of dosing and time of appearance of concentration in the sampling | PK Completer Population | Posted | Median | Full Range | hr | Hours 0 to 28 |
|
|
|
| Secondary | Incidence of Treatment-Emergent Adverse Events | TEAEs will be measured from Day 0 to Day 10 (End of Study) | Safety Population | Posted | Number | participants | Day 0 to Day 10 |
|
|
|
| 0 |
| 41 |
| 0 |
| 41 |
| 7 |
| 41 |
| EG001 | Treatment B | CTx-1301 6.25 mg tablet Dexmethylphenidate 6.25 Mg Oral Tablet, Extended Release: Investigational Medication for comparative BA evaluation | 0 | 39 | 0 | 39 | 4 | 39 |
| EG002 | Treatment C | Focalin XR 40 mg capsule Dexmethylphenidate 40 Mg Oral Capsule, Extended Release: Reference listed drug (RLD) for comparative BA evaluation | 0 | 43 | 0 | 43 | 22 | 43 |
| EG003 | Treatment D | CTx-1301 50 mg tablet Dexmethylphenidate 50 Mg Oral Tablet, Extended Release: Investigational Medication for comparative BA evaluation | 0 | 42 | 0 | 42 | 14 | 42 |
| Tachycardia | Cardiac disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Eye Pain | Eye disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Euphoric mood | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Feeling Abnormal | General disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Pre-Existing Condition Improved | General disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Blood Pressure diastolic increased | Investigations | MedDRA (Unspecified) | Systematic Assessment |
|
| Heart Rate Increased | Investigations | MedDRA (Unspecified) | Systematic Assessment |
|
| Decreased Appetite | Metabolism and nutrition disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Pain in Jaw | Musculoskeletal and connective tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Akathisia | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Disturbance in attention | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Anxiety | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Change in Sustained Attention | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Frustration tolerance decreased | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Irritability | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Hyperhidrosis | Skin and subcutaneous tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Hot Flush | Vascular disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Phlebitis | Vascular disorders | MedDRA (Unspecified) | Systematic Assessment |
|
Institution/PI shall not have the right to use the results pertaining to Institution's/PI's activities for their own instructional or research publication objectives, unless provided written permission by Sponsor. Publication must not disclose Confidential Information. Institution and PI shall submit in writing to Sponsor review of any Publication. Sponsor shall advise Institution of information which is Confidential Information or which may impair Sponsor's ability to obtain patent protection.
| D009930 |
| Organic Chemicals |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
| AUC3-6 |
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| AUC6-9 |
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| AUC9-12 |
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| AUC12-16 |
|