Neuropathic PainPhase 1NCT03638869
Safety, Tolerability, and Pharmacokinetics of Multiple Ascending Doses of REL-1017 (d-Methadone)
A Phase 1 study testing REL-1017 in people with Neuropathic Pain, run by Relmada Therapeutics, Inc..
Trial summary
This study evaluated the safety, tolerance, and pharmacokinetics (PK) of d-methadone in a limited dose range, in multiple administrations in humans. Read more about this study
- Who is it for?
- Ages 18 to 55 yearsHealthy volunteers can take part
- Conditions the study is for
- Neuropathic Pain
- What is being tested?
- REL-1017
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 24 participants
- Where
- No sites listed yet
- Study dates
- 31 Aug 2015to 16 Nov 2015
- Phase
- Phase 1
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 55 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- healthy male or female subjects, 18 to 55 years of age, inclusive
- body mass index (BMI) within the range of 18.0 to 30.0 kg/m2, inclusive, and a minimum weight of 50.0 kg
- non-smoker for at least 3 months and tested negative on a breath carbon monoxide (CO) test
- male subjects of reproductive potential must have been using and willing to continue using medically acceptable contraception from screening and for at least 2 months after the last study drug administration
- female subjects of childbearing potential must have been using and willing to continue using medically acceptable contraception for at least 1 month prior to screening (at least 3 months for oral, transdermal, vaginal ring contraceptives) and for at least 2 months after last study drug administration
- female subjects of non-childbearing potential must have met the criteria defined in the clinical protocol
- able to speak, read, and understand English sufficiently to allow completion of all study assessments
- must have understood and provided written informed consent, prior to the initiation of any protocol-specific procedures
Who cannot join
- self-reported substance or alcohol dependence (excluding nicotine and caffeine) within the past 2 years, and/or subjects who had ever been in a substance or alcohol rehabilitation program to treat their substance or alcohol dependence
- subject-reported family history of substance abuse in an immediate family member (i.e., parent, sibling, or child)
- history or presence of clinically significant abnormality as assessed by physical examination, medical history, 12-lead ECG, vital signs, or laboratory values, which in the opinion of the investigator would jeopardize the safety of the subject or the validity of the study results
- chronic use of prescribed opioids (i.e., >120 days in a 6-month period) or any recreational use of opioids
- evidence of clinically significant hepatic or renal impairment, including alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >1.5× upper limit of normal (ULN) or bilirubin >1× ULN
- history or family history of sudden unexplained death or long QT syndrome
Show all 22Show fewer
- QT interval corrected using Fridericia's formula (QTcF) >450 ms in females or >430 ms in males
- history of hypotension
- history or presence of any condition in which an opioid was contraindicated (e.g., significant respiratory depression, acute or severe bronchial asthma or hypercarbia, bronchitis, or had/was suspected of having paralytic ileus)
- history of status asthmaticus, chronic pulmonary disease, or severe allergic reaction (including anaphylaxis) to any substance
- use of an opioid within the 6 months prior to screening
- use of a prohibited medication
- positive urine drug screen
- positive breath alcohol test; subjects with a positive result may have been rescheduled at the investigator's discretion
- female subjects who were currently pregnant (had a positive pregnancy test)
- history of allergy or hypersensitivity to methadone or related drugs (e.g., opioids)
- positive for hepatitis B, hepatitis C, or human immunodeficiency virus (HIV)
- donation or loss of more than 500 mL of whole blood within 30 days prior to first drug administration
- difficulty with venous access or unsuitable or unwilling to undergo catheter insertion
- treatment with an investigational drug within 5 times the elimination half-life, if known (e.g., a marketed product) or within 30 days (if the elimination half-life is unknown) prior to first drug administration or was concurrently enrolled in any research judged not to be scientifically or medically compatible with this study
- an employee of the sponsor or research site personnel directly affiliated with this study or their immediate family member, defined as a spouse, parent, sibling, or child, whether biological or legally adopted
- a subject who, in the opinion of the investigator or designee, was considered unsuitable or unlikely to comply with the study protocol for any reason
About this study
Official title: A Phase 1 Study to Investigate the Safety, Tolerability, and Pharmacokinetic Profile of Multiple Ascending Doses of REL-1017 (d-Methadone) in Healthy Subjects
This study evaluated the safety, tolerance, and pharmacokinetics (PK) of d-methadone in a limited dose range, in multiple administrations in humans.
Read the detailed description
This was a phase 1, single-center study carried out in healthy male and female subjects to investigate the safety, tolerability, and PK of multiple doses (25mg, 50mg, and 75mg once daily) of d-methadone for 10 days. It was a double-blind, randomized, placebo-controlled study in sequential cohorts of healthy subjects. Subjects participated in the study for approximately 7 weeks. Eligible subjects were randomized within 30 days of screening. Of the 8 subjects in each cohort, 2 subjects received placebo and 6 subjects received d-methadone. The duration of dosing ensured that steady-state plasma concentrations were achieved.
A single ascending dose study previously conducted by Relmada Therapeutics, Inc. demonstrated that the maximum tolerated single dose for oral d-methadone in healthy opiate-naive subjects was 150 mg. The single doses of d-methadone appeared to be safe, with no indication of respiratory depression or clinically significant QTc prolongation, and minimal subjective pharmacodynamic (PD) effects.
The following assessments and procedures ensured the safety of the subjects during the study:
- continuous cardiac telemetry for 8 hours post-dose to detect any potential cardiac issues
- continuous pulse oximetry monitoring for 8 hours post-dose to detect any potential respiratory distress
- presence of a safety catheter to administer rescue medication (naloxone), if needed
The following signs of opioid toxicity were deemed to be of special interest:
- sustained respiratory depression that results in oxygen saturation below 92%
- QTc prolongation (>500 ms or >70 ms above the baseline)
- protracted nausea and vomiting
- any AE deemed by the investigator to be dose-limiting Safety Analysis Safety and tolerability parameters were listed by treatment and subject and displayed in summary tables using descriptive statistics. Original terms used to identify AEs were coded using the Medical Dictionary for Regulatory Activities (MedDRA), version 17.1. The number and percentage of subjects with treatment emergent AEs (TEAEs) were summarized by system organ class, preferred term, and treatment and for each treatment by maximum intensity and maximum relationship to study treatment.
Descriptive statistics for vital signs were calculated and presented for each time point by treatment group (absolute values and change from baseline). Safety ECG results were summarized using descriptive statistics; frequencies (numbers and percentages) were calculated for the overall evaluation by scheduled time and treatment group. Laboratory data were summarized by the type of test and scheduled visit. Descriptive statistics and number of subjects with laboratory test results below, within, and above normal ranges were tabulated by scheduled time. Abnormal findings in laboratory data were listed with a flag for clinical significance. Medical history abnormalities were coded to MedDRA terms and listed. Physical examination abnormalities were also listed. Data collected from the C-SSRS were classified into the Columbia Classification Algorithm of Suicide Assessment (C-CASA) categories and were listed. Frequency tables were used to summarize the total score from the COWS questionnaire, by treatment group. The original verbatim terms for concomitant medications were coded into drug class and preferred term. These data were listed.
Pharmacokinetic Analysis The PK parameters for d-methadone determined by non-compartmental analysis were summarized by dose. Graphs of concentration (linear and log-linear) vs time were generated. Descriptive statistics were calculated by dose and time point for all d-methadone concentrations. Concentrations below the limit of quantification (BLQ) were analyzed as outlined in the statistical analysis plan (SAP). Concentrations of l-methadone were analyzed only if the majority of values were not BLQ.
For the calculation of the PK parameters, concentration-time data were treated as follows: BLQ concentrations prior to the first quantifiable concentration were set to zero; BLQ concentrations after the first quantifiable concentration were treated as missing; pre-dose sampling times relative to dosing were set to zero. Descriptive statistics were calculated by dose. The dose proportionality of Cmax and AUC was assessed by the Hummel method. Tmax and t½ for different doses were compared using the Kruskal-Wallis test.
Pharmacodynamic Analysis The PD data at each time point were summarized by descriptive statistics and presented graphically (as appropriate). Derived endpoints were summarized using descriptive statistics. Pupillometry constriction was listed and grouped by treatment group and subject with descriptive statistics for changes from baseline for different time points.
Holter ECG Analysis (Cardiodynamic Analysis) The analysis of the Holter ECG data was performed using SAS®. The average of the 3 pre-dose time points on Day 1 was used as baseline for all post-dose time points. Heart rate and the PR, QRS, QT, and QTcF intervals collected from all randomized subjects were presented in data listings with the same precision as in the database. Data listings were sorted by treatment, subject number, day, and time point. Both absolute and change from baseline values for each subject were provided.
- Conditions
- Neuropathic Pain
- Being tested
- REL-1017, Placebo
- Medical subject headings
- Neuralgia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
REL-1017Drug
Also called (d-Methadone)
The investigational product, REL-1017 is prepared as a solution with Ocean Spray® Diet Cranberry Juice on site to obtain a final volume of 100 mL for dosing. The study drug will be administered as a solution of 25 mg, 50 or 75 mg REL-1017 for 10 days, based on randomization prepared in Ocean Spray® Diet Cranberry Juice with a final volume of 100 mL.
PlaceboDrug
| Study group | Role | What they receive |
|---|---|---|
| Arm 1 | Placebo comparator | 100 mL Ocean Spray® Diet Cranberry Juice Receives: Drug: Placebo |
| Arm 2 | Experimental | REL-1017 25 mg in 100 mL of Ocean Spray® Diet Cranberry Juice Receives: Drug: REL-1017 |
| Arm 3 | Experimental | REL-1017 50 mg in 100 mL of Ocean Spray® Diet Cranberry Juice Receives: Drug: REL-1017 |
| Arm 4 | Experimental | REL-1017 75 mg in 100 mL of Ocean Spray® Diet Cranberry Juice Receives: Drug: REL-1017 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Adverse Events (AEs)
Spontaneously reported and observed AEs were recorded throughout the study, and AEs were elicited using a non-leading question at designated time points. Regardless of seriousness, intensity, or presumed relationship to study drug, all AEs were recorded in the source documentation from the time of first contact with the subject (e.g., screening) until the end of the follow-up period of the study. AEs that occurred after medical screening and prior to administration of the first dose of study drug were recorded in the source documentation as baseline signs and symptoms.
Measured: Change from pre-dose, Days 1 through 13, and Days 14, 16±1, and 18±1
Secondary outcomes (1)
Plasma levels
Blood samples were collected to determine the plasma levels of d-methadone and l-methadone.
Measured: Days 1 through 13, and Days 14, 16±1, and 18±1
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Aug 2018
- Study start31 Aug 2015
- Primary completion16 Nov 2015
- Study completion16 Nov 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Neuropathic PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 24 participants (actual)
Sponsor and investigators
- Lead sponsor
- Relmada Therapeutics, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03638869
- Sponsor's protocol ID
- REL-1017-112
- Status last verified
- Aug 2018
- First submitted
- 10 Aug 2018
- Last updated
- 20 Aug 2018
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Aug 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1 Study to Investigate the Safety, Tolerability, and Pharmacokinetic Profile of Multiple Ascending Doses of REL-1017 (d-Methadone) in Healthy Subjects
- ClinicalTrials.gov ID
- NCT03638869
- Acronym / sponsor ID
- REL-1017-112
- Conditions
- Neuropathic Pain
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 24 participants (actual)
- Lead sponsor
- Relmada Therapeutics, Inc.Industry (pharma, biotech, devices)
- Study start
- 31 Aug 2015 (actual)
- Primary completion
- 16 Nov 2015 (actual)
- Study completion
- 16 Nov 2015 (actual)
- First posted
- 20 Aug 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluated the safety, tolerance, and pharmacokinetics (PK) of d-methadone in a limited dose range, in multiple administrations in humans.
Detailed description
This was a phase 1, single-center study carried out in healthy male and female subjects to investigate the safety, tolerability, and PK of multiple doses (25mg, 50mg, and 75mg once daily) of d-methadone for 10 days. It was a double-blind, randomized, placebo-controlled study in sequential cohorts of healthy subjects. Subjects participated in the study for approximately 7 weeks. Eligible subjects were randomized within 30 days of screening. Of the 8 subjects in each cohort, 2 subjects received placebo and 6 subjects received d-methadone. The duration of dosing ensured that steady-state plasma concentrations were achieved.
A single ascending dose study previously conducted by Relmada Therapeutics, Inc. demonstrated that the maximum tolerated single dose for oral d-methadone in healthy opiate-naive subjects was 150 mg. The single doses of d-methadone appeared to be safe, with no indication of respiratory depression or clinically significant QTc prolongation, and minimal subjective pharmacodynamic (PD) effects.
The following assessments and procedures ensured the safety of the subjects during the study:
- continuous cardiac telemetry for 8 hours post-dose to detect any potential cardiac issues
- continuous pulse oximetry monitoring for 8 hours post-dose to detect any potential respiratory distress
- presence of a safety catheter to administer rescue medication (naloxone), if needed
The following signs of opioid toxicity were deemed to be of special interest:
- sustained respiratory depression that results in oxygen saturation below 92%
- QTc prolongation (>500 ms or >70 ms above the baseline)
- protracted nausea and vomiting
- any AE deemed by the investigator to be dose-limiting Safety Analysis Safety and tolerability parameters were listed by treatment and subject and displayed in summary tables using descriptive statistics. Original terms used to identify AEs were coded using the Medical Dictionary for Regulatory Activities (MedDRA), version 17.1. The number and percentage of subjects with treatment emergent AEs (TEAEs) were summarized by system organ class, preferred term, and treatment and for each treatment by maximum intensity and maximum relationship to study treatment.
Descriptive statistics for vital signs were calculated and presented for each time point by treatment group (absolute values and change from baseline). Safety ECG results were summarized using descriptive statistics; frequencies (numbers and percentages) were calculated for the overall evaluation by scheduled time and treatment group. Laboratory data were summarized by the type of test and scheduled visit. Descriptive statistics and number of subjects with laboratory test results below, within, and above normal ranges were tabulated by scheduled time. Abnormal findings in laboratory data were listed with a flag for clinical significance. Medical history abnormalities were coded to MedDRA terms and listed. Physical examination abnormalities were also listed. Data collected from the C-SSRS were classified into the Columbia Classification Algorithm of Suicide Assessment (C-CASA) categories and were listed. Frequency tables were used to summarize the total score from the COWS questionnaire, by treatment group. The original verbatim terms for concomitant medications were coded into drug class and preferred term. These data were listed.
Pharmacokinetic Analysis The PK parameters for d-methadone determined by non-compartmental analysis were summarized by dose. Graphs of concentration (linear and log-linear) vs time were generated. Descriptive statistics were calculated by dose and time point for all d-methadone concentrations. Concentrations below the limit of quantification (BLQ) were analyzed as outlined in the statistical analysis plan (SAP). Concentrations of l-methadone were analyzed only if the majority of values were not BLQ.
For the calculation of the PK parameters, concentration-time data were treated as follows: BLQ concentrations prior to the first quantifiable concentration were set to zero; BLQ concentrations after the first quantifiable concentration were treated as missing; pre-dose sampling times relative to dosing were set to zero. Descriptive statistics were calculated by dose. The dose proportionality of Cmax and AUC was assessed by the Hummel method. Tmax and t½ for different doses were compared using the Kruskal-Wallis test.
Pharmacodynamic Analysis The PD data at each time point were summarized by descriptive statistics and presented graphically (as appropriate). Derived endpoints were summarized using descriptive statistics. Pupillometry constriction was listed and grouped by treatment group and subject with descriptive statistics for changes from baseline for different time points.
Holter ECG Analysis (Cardiodynamic Analysis) The analysis of the Holter ECG data was performed using SAS®. The average of the 3 pre-dose time points on Day 1 was used as baseline for all post-dose time points. Heart rate and the PR, QRS, QT, and QTcF intervals collected from all randomized subjects were presented in data listings with the same precision as in the database. Data listings were sorted by treatment, subject number, day, and time point. Both absolute and change from baseline values for each subject were provided.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Arm 1 | Placebo comparator | Drug: Placebo100 mL Ocean Spray® Diet Cranberry Juice |
| Arm 2 | Experimental | Drug: REL-1017REL-1017 25 mg in 100 mL of Ocean Spray® Diet Cranberry Juice |
| Arm 3 | Experimental | Drug: REL-1017REL-1017 50 mg in 100 mL of Ocean Spray® Diet Cranberry Juice |
| Arm 4 | Experimental | Drug: REL-1017REL-1017 75 mg in 100 mL of Ocean Spray® Diet Cranberry Juice |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- healthy male or female subjects, 18 to 55 years of age, inclusive
- body mass index (BMI) within the range of 18.0 to 30.0 kg/m2, inclusive, and a minimum weight of 50.0 kg
- non-smoker for at least 3 months and tested negative on a breath carbon monoxide (CO) test
- male subjects of reproductive potential must have been using and willing to continue using medically acceptable contraception from screening and for at least 2 months after the last study drug administration
- female subjects of childbearing potential must have been using and willing to continue using medically acceptable contraception for at least 1 month prior to screening (at least 3 months for oral, transdermal, vaginal ring contraceptives) and for at least 2 months after last study drug administration
Key exclusion criteria (22 listed)
- self-reported substance or alcohol dependence (excluding nicotine and caffeine) within the past 2 years, and/or subjects who had ever been in a substance or alcohol rehabilitation program to treat their substance or alcohol dependence
- subject-reported family history of substance abuse in an immediate family member (i.e., parent, sibling, or child)
- history or presence of clinically significant abnormality as assessed by physical examination, medical history, 12-lead ECG, vital signs, or laboratory values, which in the opinion of the investigator would jeopardize the safety of the subject or the validity of the study results
- chronic use of prescribed opioids (i.e., >120 days in a 6-month period) or any recreational use of opioids
- evidence of clinically significant hepatic or renal impairment, including alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >1.5× upper limit of normal (ULN) or bilirubin >1× ULN
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| REL-1017Also: (d-Methadone)The investigational product, REL-1017 is prepared as a solution with Ocean Spray® Diet Cranberry Juice on site to obtain a final volume of 100 mL for dosing. The study drug will be administered as a solution of 25 mg, 50 or 75 mg REL-1017 for 10 days, based on randomization prepared in Ocean Spray® Diet Cranberry Juice with a final volume of 100 mL. | Drug | Arm 2, Arm 3, Arm 4 |
| Placebo | Drug | Arm 1 |
Primary outcome
Adverse Events (AEs)
Time frame: Change from pre-dose, Days 1 through 13, and Days 14, 16±1, and 18±1
Spontaneously reported and observed AEs were recorded throughout the study, and AEs were elicited using a non-leading question at designated time points. Regardless of seriousness, intensity, or presumed relationship to study drug, all AEs were recorded in the source documentation from the time of first contact with the subject (e.g., screening) until the end of the follow-up period of the study. AEs that occurred after medical screening and prior to administration of the first dose of study drug were recorded in the source documentation as baseline signs and symptoms.
1 secondary outcome
Plasma levels
Time frame: Days 1 through 13, and Days 14, 16±1, and 18±1
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Aug 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing REL-1017 in people with Neuropathic Pain, run by Relmada Therapeutics, Inc..
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 20 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Adverse Events (AEs) (time frame: Change from pre-dose, Days 1 through 13, and Days 14, 16±1, and 18±1). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Aug 2018.