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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04197921
Other study ID # OUD001
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date November 27, 2019
Est. completion date July 2025

Study information

Verified date March 2024
Source InSightec
Contact Huan Bien
Phone +1-657-550-9284
Email huanb@insightec.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this clinical trial is to investigate Low Intensity Focused Ultrasound (LIFU) using the Exablate® Model 4000 Type 2.0/2.1 as an adjunctive neuromodulatory treatment for OUD (Opioid Use Disorder) by assessing its safety and tolerability in subjects with OUD.


Recruitment information / eligibility

Status Recruiting
Enrollment 23
Est. completion date July 2025
Est. primary completion date December 31, 2024
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 60 Years
Eligibility Inclusion Criteria: 1. Males and non-pregnant females, age 18 - 60 years old 2. Subject meets DSM-5 criteria for OUD and/or other SUDs including alcohol (assessed via the SCID-5) of at least two years duration 3. Subject is currently receiving outpatient treatment from the WVU Comprehensive Opioid Addiction Treatment Program (COAT), Intensive Outpatient Program (IOP) or any other program which implements the COAT model; residential or inpatient treatment from the WVU Center for Hope and Healing or an affiliated WVU hospital; or receiving outpatient/inpatient/residential treatment from similar programs that are well known to the research team. If the subject is prescribed medication for AUD or OUD (e.g. buprenorphine-naloxone, naltrexone), they will be on a stable dose of the medication for the 7 days prior to the procedure. Stable is defined as within the therapeutic range but does not require same exact dose for 7 days. 4. Subject has been off opioids and other illicit substances, except for cannabis, confirmed via urine toxicology screen 5. The NAc is apparent on MRI such that treatment targeting can be performed directly (visible on MRI) and indirectly (using other anatomical structures for measurements) 6. Subject is able to communicate sensations during the Exablate Transcranial procedure 7. Subject is willing to cooperate with the study requirements including compliance with the regimen and completion of all study visits 8. Subject is able to make own medical decisions as determined by the clinical team 9. Subject has signed and received a copy of the approved informed consent form Exclusion Criteria: 1. Subjects who are taking medications which may adversely interact with MOUD (See Appendix B for full list). Being on one of these medications would not automatically exclude a participant from study participation, does not automatically exclude a prospective subject from study participation. If a prospective or current subject is taking any medication listed in Appendix B, the study investigator is responsible for determining whether the subject is eligible for inclusion or continued study participation." 2. Subject with standard contraindications for MR imaging such as non-MRI compatible implanted metallic devices 3. Subject with known intolerance or allergies to the MRI contrast agent gadolinium (GADOVIST®) 4. Subject who are unable or unwilling to tolerate the required prolonged stationary position during treatment (approximately 2-3 hours) 5. More than 30% of the skull area traversed by the sonication pathway is covered by scars, scalp disorders (e.g., eczema), or atrophy of the scalp 6. Subject with implanted objects in the skull or the brain 7. Subject diagnosed with advanced kidney disease or on dialysis 8. Subject with impaired renal function with estimated glomerular filtration rate <30 mL/min/1.73m2 9. Subject with known unstable cardiac status or severe hypertension including: 1. Documented myocardial infarction within six months of enrollment 2. Unstable angina on medication 3. Unstable or worsening congestive heart failure 4. Left ventricular ejection fraction below the lower limit of normal 5. History of a hemodynamically unstable cardiac arrhythmia 6. Cardiac pacemaker 7. Severe hypertension (diastolic BP > 100 on medication) 10. Subject with history of abnormal bleeding, hemorrhage, or coagulopathy 11. Subject receiving anticoagulant (e.g. warfarin) or antiplatelet (e.g. aspirin) therapy within one week of focused ultrasound procedure or drugs known to increase risk or hemorrhage (e.g. Avastin) within one month of focused ultrasound procedure 12. Abnormal coagulation profile (PLT < 100,000/µl), PT (>13.9 sec) or PTT (>37.5 sec), and INR > 1.2. If values are outside the range of normal limits, any clinically significant value may be excluded as determined by a study investigator. 13. Subject with cerebrovascular disease as determined by MRI according to the Fazekas criteria. Grades II and III on the Fazekas scale should be excluded 14. Past or present diagnosis of schizophrenia, psychotic disorder, bipolar disorder, or untreated depression other than one determined to be substance induced (assessed via SCID-5) 15. Score of greater than 17 on the Hamilton Depression Rating Scale (HAM-D) or increased risk of suicide based on any positive response regarding passive or active suicidal ideation with or without intent over the past 3 months or lifetime history of active suicidal ideation with intent on the Columbia-Suicide Severity Rating Scale (C-SSRS) at baseline 16. History of suicide attempt 17. Parental history of completed suicide 18. Subject meet the criteria for Cluster A or B Personality Disorders (assessed via SCID-5-PD) 19. Diagnosis of dementia or any other disorder which has led to a clinically significant cognitive impairment (assessed via NIHTB-CB) 20. Subject with brain tumors 21. Subject with chronic pulmonary disorders e.g. severe emphysema, pulmonary vasculitis, or other causes of reduced pulmonary vascular cross-sectional area 22. Any known CNS infection or infection with the Human Immunodeficiency Virus (HIV) or Hepatitis C (HCV). A diagnosis of Hepatitis C (HCV) alone is not exclusionary as long as hepatic function laboratory values are deemed not clinically significant by a study investigator and are = 1.5 times the upper limit of normal. 23. Subject who has had deep brain stimulation or a prior stereotactic ablation of the NAc, basal ganglia or thalamus 24. Subject who has been administered botulinum toxins into the arm, neck, or face for 5 months prior to baseline 25. Subject who is currently participating in another clinical investigation with an active treatment arm 26. Subject unwilling to abstain from illicit substance use during the course of the study 27. Subject is considered to be a poor surgical or study candidate, which may include, but is not limited to the following: any medical, social, or psychological problem that could complicate the required procedures and evaluations of the study in the judgment of the investigator 28. Subject is non-English speaking 29. Subject is pregnant or planning to be pregnant

Study Design


Intervention

Device:
Exablate Model 4000 Type 2.0/2.1
There are two treatment stages. In both stages, the subject will receive both the sham and active ExAblate treatment, and be evaluated for 90 days post-treatment for adverse events. During Stage 1 the subject will receive the moderate intensity Exablate LIFU procedure. During Stage2, the subject will receive the enhanced intensity ExAblate LIFU procedure. The subjects are blinded as to the order of the sham vs active treatment.

Locations

Country Name City State
United States West Virginia University: Rockefeller Neuroscience Institute Morgantown Virginia

Sponsors (1)

Lead Sponsor Collaborator
InSightec

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Occurrence of Treatment Emergent Adverse Events Safety will be assessed by recording all adverse events that are treatment related. Each Adverse Event will be documented for patterns of occurence. Post-ExAblate Procedure through 4 Month Follow-Up
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