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The primary objective of this study is to find the tolerable dose and characterize the safety and pharmacokinetics/ pharmacodynamics (PK/PD) of single and repeated dose of CMND-100 in Healthy Volunteers (HV) and Subjects with Alcohol Use Disorder (AUD).
The secondary objective of this study is to preliminarily evaluate the efficacy of CMND-100 in reduction of drinking patterns and craving in subjects with moderate to severe AUD.
This is a Phase I/II, four-parts study (Parts A to D) in HVs and subjects with AUD, evaluating the tolerability, safety, and pharmacokinetics/ pharmacodynamics (PK/PD) of single and repeated doses of CMND-100. Parts A and B are open-label, non-controlled parts, in which HVs and subjects with AUD respectively will be treated with single, ascending dose cohorts of CMND-100, for evaluation of tolerability, safety and PK/PD. Parts C and D are randomized, double-blind, placebo-controlled part, in which HVs and subjects with AUD respectively will be treated with repeated doses of CMND-100, for evaluation of safety, PK/PD and preliminary efficacy. Below is a short description of each part of the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy Subjects - Part A | Other | Part A: Single dose (~ 24 ) Healthy Volunteers: At least four consecutive ascending dose cohorts (20 mg, 40, 80 and 160 mg) will be included in this part of the study in accordance with a pre-defined dose escalating scheme. In each cohort, 6 HVs will receive a single dose of investigation medicine product (CMND-100) starting with the lowest dose of 20 mg. Once dosed, the subjects will be sampled for PK for 24 hours following dosing and will be monitored for drug effects with a physical examination at the end of 24 hours after dosing and daily monitored for safety for a period of 1 week following dosing. Assuming no serious adverse reactions or limiting toxicity (grade 2 and higher) in up to 2, subjects are observed in this dose level, then the next 6 subjects are treated with the next escalated dose, in accordance with a pre-defined dose escalating scheme. The DSMB will review results after each cohort and guide doses to be studied in Parts B, C and D. |
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| AUD Subjects - Part B | Other | Single dose (~12): After DSMB review of part A, AUD subjects will be enrolled in at least 2 consecutive ascending single dose cohorts using the highest tolerable doses from Part A. The first cohort (n=6) will start with the lower ascending dose and sampled for PK for 24 hours following dosing and will be monitored for drug effects with a physical examination at the end of 24 hours after dosing and daily monitored for safety for a period of 1 week following dosing. Assuming no serious adverse reactions or limiting toxicity are observed in this dose level, then the next 6 subjects are treated with the next escalated dose. At the end of this part, real time PK data from the dose cohorts will be collected and analyzed. PK and safety information from this part of the study and from Part A will be reviewed by the DSMB and will guide the dose to be studied in Part D. |
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| AUD Subjects - Part C | Placebo Comparator |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CMND-100 | Drug | The investigational product CMND-100 consists of gelatin capsules, each containing the active ingredient (either 20 or 60 mg) 5-methoxy-2-aminoindane (MEAI) and excipients (stabilizers). MEAI is a psychoactive compound of the aminoindane class |
| Measure | Description | Time Frame |
|---|---|---|
| Safety as Adverse Events Profile | Incidence of adverse events and classification in terms of severity, causality and outcome | up to 31 days |
| Tmax | Time to maximum plasma concentration | up to 31 days |
| Cmax | Maximum plasma concentration | up to 31 days |
| AUC0-∞ | Area under the concentration-time curve from 0 minutes extrapolated to infinity | up to 31 days |
| t1/2 | Terminal elimination phase half-life expressed in time units | up to 31 days |
| Cl | The volume of plasma cleared of the drug per unit time | up to 31 days |
| Vd | The volume in which a drug is distributed | up to 31 days |
| Measure | Description | Time Frame |
|---|---|---|
| Part D only - Alcohol craving assessment using the Visual Analogue Scale of Craving (VAS) | VAS was adapted from the Alcohol Craving Questionnaire (ACQ) - Assessment of craving for alcohol based on a 10-point VAS response to the questions "How strong is your craving for alcohol now" where 1 indicates "not at all" and 10 indicates "the most I've ever felt". | The change from pre-dose to Day 5 and Day 17. |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of subjective level of sleepiness using the Karolisnka Sleepiness Scale (KSS). (Exploratory Endpoint - 1) | The KSS measures the subjective level of sleepiness at a particular time during the day. On this scale subjects indicate which level best reflects the psycho-physical sate experienced in the last 10 min. The KSS is a 9- point scale (1 = extremely alert, 3 = alert, 5 = neither alert nor sleepy, 7 = sleepy - but no difficulty remaining awake, and 9 = extremely sleepy - fighting sleep). |
Inclusion Criteria:
All Subjects
Additional Criteria for AUD Subjects
Treatment seeking subjects with AUD meeting DSM-5 criteria as assessed by SCID by qualified medical staff and:
Exclusion Criteria All Subjects
Additional Criteria for Healthy Subjects
• Subject is unable to abstain from ingesting alcohol for 72 hours prior to dosing.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Connecticut Mental Health Center | Recruiting | New Haven | Connecticut | 06519 | United States |
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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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Single and repeated doses of CMND-100. Parts A and B are open-label, non-controlled parts, in which HVs and subjects with AUD respectively will be treated with single, ascending dose cohorts of CMND-100, for evaluation of tolerability, safety and PK/PD. Parts C and D are randomized, double-blind, placebo-controlled parts, in which HVs and subjects with AUD respectively will be treated with repeated doses of CMND-100, for evaluation of safety, PK/PD and preliminary efficacy.
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Parts C and D are randomized, double-blind, placebo-controlled.
Multiple dose (18) HVs: Once Part A has been completed, the data analysed and approved by the DSMB, Part C will be initiated. This part will consist of a repeated-dose cohort based on the higher tolerable dose found in Part A. HVs will be randomized into either the treatment or the placebo arm at a ratio of 2:1 (12 subjects treated with the investigation product and 6 subjects receiving placebo) and will receive the drug/placebo at a daily basis for a total of 5 consecutive days. Each subject will be sampled for PK for 24 hours after first and last dosing and will be daily monitored for drug effects and safety throughout the study period and until 1 week after the last dosing. Real time PK data will be collected and results analysed (as defined in Section 5.2). The PK and safety information gathered from in this part of the study will be evaluated by the DSMB and will guide the dose to be studied in Part D of this study. |
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| AUD Subjects - Part D | Other | Multiple dose (18) subjects with AUD: Once Part B and Part C has been completed, the data analyzed and approved by the DSMB, Part D will be initiated. This part will consist of a repeated-dose cohort, based on the higher tolerable dose found in Part C and considering the dose effects found in Part B. Subjects will be randomized into either the treatment or the placebo arm at a ratio of 2:1 (12 subjects treated with the investigation product and 6 subjects receiving placebo) and will receive the drug/placebo at a daily basis for a total of 5 consecutive days. Each subject will be sampled for PK for 24 hours after first and last dosing and will be daily monitored for drug effects and safety throughout the study period and until 1 week after the last dosing. The PK and safety information gathered from in this part of the study will be evaluated by the DSMB. |
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| Part D only - Assessment of craving for alcohol using the Penn Alcohol Craving Scale (PACS) | PACS is a questionnaire that includes 5 questions where each question is scored 0 to 6, ranging from the lowest craving-related response (0) to the highest craving-related response (6). | The change from pre-dose to Day 5 and Day 17 of the total score will be evaluated. |
| The change from pre-dose to Day 5 and Day 17. |
| Assessment of depression symptoms using the Beck Depression Inventory (BDI-II) (Exploratory Endpoint - 2) | The BDI-II is a widely used, 21- item, self-report measure of depression symptoms. It uses a two-week timeframe to assess the presence of symptoms that include, among others, sadness, guilt, suicidal thoughts, loss of interest, changes in sleep and appetite. Responses are scored from 0 to 3, with 0 representing the absence of the symptom and 4 representing the most severe symptom. | The change from pre-dose to Day 5 and Day 17. |
| Evaluation of alcohol consumption using Alcohol Timeline Follow-Back (TLFB) (Exploratory Endpoint - 3) | TLFB has shown to be a useful tool in the collection of retrospective self-reports of daily alcohol consumption. | The change from pre-dose to post-dose Day 5 and Day 17. |
| Johns Hopkins Bayview Medical Center | Recruiting | Baltimore | Maryland | 21224 | United States |
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| Hadassah Medical Center | Recruiting | Jerusalem | 91120 | Israel |
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| Tel-Aviv Sourasky Medical Center (TASMC) | Recruiting | Tel Aviv | 6423906 | Israel |
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