Cocaine Dependence Clinical Trial
Official title:
A Double-Blind, Placebo-Controlled Pilot Study to Evaluate the Safety, Tolerability, and Efficacy of D-Serine for Cocaine Dependence
The primary objective of this study is to collect pilot data on the efficacy of D-serine, relative to placebo, as a cocaine dependence treatment. Secondary objectives include evaluating D-serine, relative to placebo, on: 1. safety in treating cocaine-dependent adults and 2. tolerability.
STUDY DESIGN. This is a 12 week, 2 group randomized controlled trial that will be completed
in an outpatient setting. Eligible participants will be randomized to D-serine or matching
placebo and will be scheduled to attend three research visits per week throughout the active
treatment phase which begins with randomization and ends on day 7 of study week 12. A single
visit will be scheduled in week 13 to complete retrospective data for week 12. Participants
will receive D-serine or placebo throughout the 12-week active treatment phase.
Randomization will be in a 1:1 ratio, stratified by cocaine use frequency (<10 days or ≥ 10
days in the 28 days prior to consent).
STUDY POPULATION. Approximately 80 participants recruited from a single site will be
randomized. The study population will include adults who meet Diagnostic and Statistical
Manual-IV-Text Revision (DSM-IV-TR) criteria for cocaine dependence who have used cocaine in
the 30 days prior to consent and who provide at least one benzoylecgonine (BE) positive
urine during screening/baseline.
TREATMENTS. Study participants will be randomly assigned to receive either D-serine (target
~60 mg/kg per day) or matching placebo. All participants will receive once weekly
manual-guided cognitive behavioral therapy during the 12 week treatment period. Medication
adherence will be assessed with the Medication Events Monitoring System (MEMS).
EFFICACY ASSESSMENTS. The primary outcome measure will be cocaine abstinence for three or
more consecutive weeks, with abstinence during a week defined as self-report of no cocaine
use during the week as well as negative urine BE (BE<300 ng/mL) results during the week with
at least two urine samples provided. Key secondary efficacy measures include the proportion
of urine BE negative results obtained and cocaine abstinence during study weeks 11 and 12 as
measured by self-report and urine BE. Other efficacy measures include drug attention bias,
cocaine craving, drug compulsivity, cocaine withdrawal symptoms, and treatment retention.
SAFETY ASSESSMENTS. Safety measures include urinalysis, adverse events (AEs), vitals,
electrocardiogram (ECG), and laboratory tests. Tolerability will be assessed by the
proportion of participants needing a dose reduction and being discontinued from study
medication.
ANALYSIS. Each outcome variable will be analyzed using appropriate statistical methods for
the intention-to-treat (ITT) population and the evaluable population. All participants who
have taken at least one study medication dose will be included in the safety analysis. Data
will be summarized by treatment group. Summary statistics will include the mean, sample
size, standard deviation, median, minimum and maximum values for continuous variables, and
frequencies and percentages for categorical variables.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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