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Alcohol WithdrawalPhase 1/2NCT07810946

Intravenous Acetate as an Adjunctive Treatment for Alcohol Withdrawal in Hospitalized Patients

A Phase 1/2 study testing Sodium Acetate in people with Alcohol Withdrawal and Alcohol Abstinence, run by University of Colorado, Denver at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Alcohol withdrawal syndrome is a highly morbid condition affecting a substantial percentage of patients hospitalized who have alcohol use disorders, estimated at 5-6% of all hospitalized patients. Read more about this study

Who is it for?
Ages 21 years and older
What is being tested?
Sodium Acetate
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
75 participants
Where
1 siteUnited States
Study dates
1 Nov 2026to 30 Jun 2029
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

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 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Active treatment for alcohol withdrawal (e.g. use of protocolized order set in an inpatient setting)
  • Inpatient admission ordered
  • Adult > 21 years old

Who cannot join

  • End-stage renal disease or likely need for renal replacement therapy in the next 12 hours
  • Heart failure with reduced ejection fraction (<30%)
  • Receipt of >2L crystalloids prior to randomization
  • Advanced liver disease (Child's C or D)
  • Uncontrolled mental health condition
  • >24 hours since ED arrival
  • Pregnant or incarcerated
  • Unable to consent and/or no proxy

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jeffrey McKeehan, AC-AGNP contact

303-724-6080

jeffrey.mckeehan@cuanschutz.edu

United States1 site
  • University of Colorado, Anshcutz Medical Campus

    Aurora, Colorado, 80045

    Jeffrey McKeehan, AC-AGNP, 303-724-6080, jeffrey.mckeehan@cuanschutz.edu

Other trials in United States

About this study

Alcohol withdrawal syndrome is a highly morbid condition affecting a substantial percentage of patients hospitalized who have alcohol use disorders, estimated at 5-6% of all hospitalized patients. Standard treatment paradigms for alcohol withdrawal syndrome have common and serious side effects, and do not fully address this condition's underlying pathophysiology.

This study will examine the feasibility and safety of administering intravenous acetate, an alcohol metabolite and alternative brain fuel, as an adjunctive treatment for alcohol withdrawal in hospitalized patients that will to set the stage for future investigations of its efficacy as an adjunctive treatment in the hospital setting.

Read the detailed description

Alcohol withdrawal syndrome manifests in up to 30% of hospitalized patients with severe alcohol use disorders (AUD), and is a potentially life-threatening, highly morbid condition. Standard medications to treat alcohol withdrawal (e.g. benzodiazepines) can induce respiratory depression and prolong hospitalization, while medications used as adjuncts (e.g. dexmedetomidine) are also sedating and necessitate intensive monitoring. Therefore, alternative treatments targeting novel pathways in alcohol withdrawal are needed to address this treatment gap and improve patient care. Although alcohol withdrawal symptoms arise from counterregulatory neuroadaptations in γ-aminobutyric acid (GABA) and glutamate signaling, homeostatic alterations in the brain's fuel preference and sudden changes in its fuel supply have also been implicated that are not addressed by current treatment paradigms. Longstanding AUD diminishes the brain's ability to metabolize glucose, enhancing its metabolic preference for the alcohol metabolite acetate. Acetate is converted to acetyl-CoA, which is used for fuel and neurotransmitter production. When a person with AUD is hospitalized, stopping alcohol consumption, acetate supply ceases at a time when the brain has a reduced preference for glucose, potentially driving withdrawal symptoms. Investigations in patients with alcohol withdrawal that administered alternative energy substrates via oral ketogenic diet (which also generates acetyl-CoA) reported symptom improvement; however, prominent gastrointestinal symptoms in acute, severe alcohol withdrawal limit their use in this setting. Notably, we have shown that intravenous (IV) acetate administration to participants with AUD was feasible and safe and had a demonstrable physiological effect on cerebral blood flow (CBF), measured by magnetic resonance arterial spin labeling, including increased CBF to thalami, cerebellum, and cortex, which was not observed in healthy controls. Since metabolism and blood flow are tightly linked in the brain, our results support metabolic adaptations in AUD, paving the way for future investigations of acetate's efficacy as an adjunctive treatment in alcohol withdrawal that will be refined in this R34 proposal. We will conduct a single- center, placebo-controlled randomized clinical trial (RCT) of IV acetate in patients hospitalized at a large academic university hospital who are receiving inpatient standard of care treatment for alcohol withdrawal syndrome.

Aim 1 will optimize screening, recruitment, informed consent, and enrollment strategies. Aim 2 will establish processes to ensure protocol fidelity, safety, and patient retention, to include collection of outcome variables reflecting patient symptoms and medication administration for alcohol withdrawal, and healthcare resource utilization. Aim 3 will use qualitative methods to incorporate the experiences and perceptions of patients hospitalized with alcohol withdrawal to improve study design and magnify the impact of the research.

Results of this study will inform the final protocol and procedures for a future multi-center RCT focused on determining efficacy of adjunctive acetate treatment in patients admitted for alcohol withdrawal syndrome.

Being tested
Sodium Acetate, Placebo
Keywords
Alcohol Withdrawal
Medical subject headings
Alcohol Abstinence, Alcoholism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sodium AcetateDrug

    Sodium acetate (82mg/mEq) will be mixed in solution with sterile water to create a 150 mEq/L (same as 150 mM) isotonic solution. Patients randomized to active drug will initially receive 300 mM (mEq) acetate in 2L fluid over a two-hour period. The study drug will be administered as an initial 6 mg/kg/min bolus (~250mL volume) over 10 min, followed by a 3 mg/kg/min infusion (1750ml volume) over 110 min to complete 2L total. After the two hours are completed, patients will continue to receive the acetate solution infusion at a reduced rate of 50 mL/hour (or 615 mg acetate/ hour) until alcohol withdrawal orders are discontinued, or up to 72 hours, whichever comes first.

  • PlaceboDrug

    Also called normal saline

    The placebo solution will be 0.9% saline, administered as a bolus/infusion in a manner identical to what would be administered for acetate.

Study groups in NCT07810946
Study groupRoleWhat they receive
Intervention (IV acetate)ExperimentalSodium acetate (82mg/mEq) will be mixed in solution with sterile water to create a 150 mEq/L (same as 150 mM) isotonic solution. Patients randomized to active drug will initially receive 300 mM (mEq) acetate in 2L fluid over a two-hour period. The study drug will be administered as an initial 6 mg/kg/min bolus (~250mL volume) over 10 min, followed by a 3 mg/kg/min infusion (1750ml volume) over 110 min to complete 2L total. After the two hours are completed, patients will continue to receive the acetate solution infusion at a reduced rate of 50 mL/hour (or 615 mg acetate/ hour) until alcohol withdrawal orders are discontinued, or up to 72 hours, whichever comes first.
Receives: Drug: Sodium Acetate
Placebo (normal saline)Placebo comparatorThe placebo solution will be 0.9% saline, administered as a bolus/infusion in a manner identical to what would be administered for acetate.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Consent Rate for Study Participation per Week

    Number and percentage of patients meeting all study eligibility criteria who provide informed consent for study participation among all eligible patients identified during each week of recruitment.

    Measured: Assessed weekly during the study recruitment period, pre-consent

  2. Proportion of Randomized Participants Receiving Greater Than or Equal to 2 L of Assigned Study Infusion

    Number and percentage of randomized participants who receive at least 2 L of their assigned study infusion (study drug or placebo), as a measure of study protocol fidelity.

    Measured: After consent and randomization, immediately before study infusion, through completion or discontinuation of the study infusion, up to 72 hours.

  3. Proportion of Randomized Participants Withdrawn from Study for Safety Concerns

    Number and percentage of randomized participants for whom study participation or study intervention is discontinued because of a safety concern.

    Measured: After consent, immediately before study infusion, through completion, withdraw or discontinuation of the study infusion during the index hospitalization, up to 72 hours.

  4. Alcohol Withdrawal Medications Administered, per Patient

    Alcohol withdrawal medication utilization will be characterized descriptively for each participant by the total dose administered and total number of treatment days. Medications will be summarized by prespecified treatment category: (1) GABAergic medications, including benzodiazepines and phenobarbital, and (2) adjunctive medications, including dexmedetomidine and ketamine. Individual medications and medication classes will be reported separately, as applicable.

    Measured: After consent and randomization, through hospital discharge from the index hospitalization or study completion at 18 months, what occurs first.

Secondary outcomes (12)
  1. Screening Volume

    Number of emergency department patients with an alcohol withdrawal pathway or order set initiated per week. Screening opportunities will also be characterized according to day of the week and time of day when the pathway or order set is initiated.

    Measured: Pre-consent. Assessed weekly during the study recruitment period

  2. Eligibility Rate

    Number and percentage of screened patients meeting all inclusion criteria and no exclusion criteria and therefore eligible to be approached for informed consent.

    Measured: Pre-consent. Assessed weekly during the study recruitment period

  3. Characteristics of Patients Who Do and Do Not Consent

    Characteristics of eligible patients who do and do not consent to study participation will be summarized descriptively, including age, gender, race, ethnicity, English versus Spanish language, comorbid conditions, availability of a proxy, and whether consent was provided by a proxy.

    Measured: Pre-consent through completion of the consent/enrollment attempt during the index hospitalization

  4. Time to Informed Consent

    Time from documented emergency department arrival to documentation of informed consent, determined using electronic medical record date and time stamps.

    Measured: Pre-consent. From emergency department arrival through documentation of informed consent

  5. Study Drug Receipt, per Patient

    Receipt of the assigned study intervention (either drug or placebo) will be characterized by total study drug dose received, total infusion volume received, total duration of infusion, and time between randomization and initiation of the study drug infusion.

    Measured: After consent and randomization. Assessed through completion or discontinuation of the study infusion, for up to 72 hours.

  6. Reasons for Study Withdrawal

    Reasons for study withdrawal will be characterized, with particular assessment of withdrawal related to acid-base and/or electrolyte abnormalities, and respiratory-related instability.

    Measured: After randomization through study completion, withdrawal, or hospital discharge, for up to 72 hours.

  7. Thiamine Dosing

    Total thiamine administration will be characterized descriptively based on the total dose received per randomized participant.

    Measured: At baseline, after hospital arrival, through hospital discharge or study conclusion, for up to 18 months, whichever occurs first.

  8. Modified Minnesota Detoxification Scale (mMINDS) Scores Over Time

    Serial mMINDS scores recorded by nurses will be used to characterize the severity and trajectory of alcohol withdrawal symptoms during the course of the hospitalization.

    Measured: At baseline, after hospital arrival, through hospital discharge or study conclusion, for up to 18 months, whichever occurs first.

  9. Requirement for Mechanical Ventilation

    Determined by wheter the patient required mechanical ventilation or not, for any reason.

    Measured: At baseline, after hospital arrival, through hospital discharge or study conclusion, for up to 18 months, whichever occurs first.

  10. In-hospital Mortality

    Number and percentage of participants who die during the index hospitalization and number and percentage who are discharged against medical advice. Each outcome will be reported separately.

    Measured: After consent and randomization, through discharge from the index hospitalization or study consluion, for up to 18 months, whichever occurs first.

  11. Upgrade in Level of Care

    Level of care will be recorded by whether or not the patient required transfer to higher level of care, for example if the patient was on a medical ward but was transferred to an Intensive Care Unit.

    Measured: After consent and randomization, thourgh the patient's hospital admission period or study conclusion, for up to 18 months, whichever occurs first.

  12. Duration and Intensity of Alcohol Withdrawal Monitoring

    Alcohol withdrawal monitoring will be characterized by the total duration that the alcohol withdrawal order set remains active and the total number of nursing alcohol withdrawal assessments, including mMINDS assessments, completed for each participant.

    Measured: After hospital arrival through hospital discharge, or study conclusion, for up to 18 months, whichever occurs first.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Sep 2026
  2. Study start1 Nov 2026 (estimated)
  3. Primary completion30 Jun 2029 (estimated)
  4. Study completion30 Jun 2029 (estimated)

Resources

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 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
75 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07810946
Sponsor's protocol ID
26-1125
Other IDs
1R34AA033528-01
Status last verified
Oct 2026
First submitted
26 Aug 2026
Last updated
30 Oct 2026
Results posted
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Sodium Acetate in people with Alcohol Withdrawal and Alcohol Abstinence, run by University of Colorado, Denver at 1 site in United States.

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 3 inclusion and 8 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: opening soon, as of the sponsor's last update on 30 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

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 combined 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.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jeffrey McKeehan, AC-AGNP (303-724-6080, jeffrey.mckeehan@cuanschutz.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Consent Rate for Study Participation per Week (time frame: Assessed weekly during the study recruitment period, pre-consent). The study lists 4 primary outcomes in all. 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 30 Oct 2026.

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