Smoking
Conditions
Brief summary
A Randomized, Double-Blind, Placebo-Controlled, Crossover Design Study of CERC-501 in a Human Laboratory Model of Stress-precipitated Smoking Behavior.
Detailed description
The study will be performed in subjects who are heavy cigarette smokers currently not seeking treatment for tobacco use disorder. The study is a crossover design study (within-subject analysis), which allows for subjects to be their own control. Each period of the crossover consists of a 7-day out-patient treatment period followed by a single out-patient testing day on Day 8. Subjects will participate in a laboratory session following the McKee Stress-Smoking Lapse Test. Upon completion, subjects will undergo a 7 day washout period followed by the second period of the crossover design and a 7-day follow-up visit.
Interventions
CERC-501
Placebo
Sponsors
Study design
Eligibility
Inclusion criteria
1. Provides written informed consent and agrees to complete required clinic visits 2. Male or female 21 to 60 years of age inclusive 3. Body mass index (BMI) 18.5 to 40 kg/m2 inclusive 4. Smokes at least 10 cigarettes per day on average for the past 6 months 5. Fagerstrom score ≥3 at screening 6. Currently not seeking smoking cessation therapy 7. Urine dip test for cotinine concentration \>150 ng/mL 8. In otherwise good general health without any unstable medical conditions (as determined by medical history, medication history, physical examination, 10- or 12 lead ECG, vital signs, and clinical laboratory testing) 9. Able to read, write, and speak English 10. Females must be either: 1. Post-menopausal (amenorrhea for at least 12 consecutive months), surgically sterile -or- 2. Women of childbearing potential (WOCBP) must meet the criteria below: i. Uses an acceptable double-barrier method of contraception as determined by the Investigator -and- ii. Is not lactating, has a negative serum beta human chorionic gonadotropin pregnancy test at screening and a negative urine pregnancy test prior to dosing on Days 1 and 8 of each treatment period. 11. Male subjects must agree to use a condom if partner is of childbearing potential
Exclusion criteria
1. Have used tobacco or other nicotine containing products other than cigarettes (e.g., nicotine patches, pipe, cigars, snuff, chewing tobacco or e-cigarettes) within the past 30 days 2. Any substance use disorder other than nicotine or caffeine as assessed by the Structured Clinical Interview-IV Axis I Disorders (SCID) for Diagnostic and Statistical Manual of Mental Disorders (DSM) 3. Current neurological conditions that interfere with study conduct, assessment or treatment in any significant fashion 4. Any lifetime history of bipolar I, II; schizophrenia or any other psychotic disorders; personality disorders, impulse control disorders as assessed by the SCID-IV 5. Current psychiatric conditions that interfere with study conduct, assessment, or treatment in any significant fashion, such as major depressive disorder (MDD), eating disorders, post-traumatic stress disorder, etc. We will screen for worsening of symptoms of depression and/or suicidality at each medication appointment and lab sessions by having participants complete the Beck Depression Inventory (BDI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). If there is a worsening of symptoms of depression and/or suicidality, the participants will speak a licensed psychologist for evaluation. 6. Recent active or past history of gastric disease such as peptic ulcer disease, gastritis, upper gastrointestinal bleeding, or any gastrointestinal malignancy or precancerous condition 7. Active, comorbid disease that might limit the ability of the subject to participate in the study as determined by the Study MD (i.e., poorly controlled diabetes mellitus, congestive heart failure, etc.) 8. Clinically significant clinical laboratory test taken during screening 9. Elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥2 times the upper limit of normal (ULN) 10. Human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C positive as determined by serology testing at Screening 11. Positive ethanol breath test at screening or prior to dosing on Days 1 and 8 of each treatment period 12. Positive urine drug test at screening or and/or prior to dosing on Days 1 and 8 of each treatment period except for cannabis 13. History of severe allergies or multiple adverse drug reactions 14. Known hypersensitivity to CERC-501 15. Current use of a proton pump inhibitor or histamine 2 blocker 16. Use of any investigational medication within 2 months prior to the start of this study or scheduled to receive an investigational drug other than the study drug during the course of this study 17. Current use of any psychoactive medications including: antipsychotics, benzodiazepines, mood stabilizers, selective serotonin reuptake inhibitor/serotonin norepinephrine reuptake inhibitor (SSRI/SNRI) or other antidepressants mood stabilizers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Latency | 50 min | Latency (in minutes and seconds) to time of first cigarette smoking during the delay period |
| Number of Cigarettes Smoked | 60 min | Number of cigarettes smoked during the self administration period |
Countries
United States
Participant flow
Pre-assignment details
This is a cross-over design. Medication arms are within-subject.
Participants by arm
| Arm | Count |
|---|---|
| All Study Participants Administered orally once daily, 10mg daily, 8 days
CERC-501: CERC-501
7 day wash-out
Administered orally once daily, placebo
Order of placebo/CERC-501 counterbalanced | 17 |
| Total | 17 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Protocol Violation | 1 | 1 |
| Overall Study | Withdrawal by Subject | 1 | 1 |
Baseline characteristics
| Characteristic | All Study Participants |
|---|---|
| Age, Continuous | 35.18 years STANDARD_DEVIATION 8.13 |
| Cigarettes per day | 16.24 cigarettes per day STANDARD_DEVIATION 3.9 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 10 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 7 Participants |
| Region of Enrollment United States | 17 participants |
| Sex: Female, Male Female | 7 Participants |
| Sex: Female, Male Male | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 16 | 0 / 15 |
| other Total, other adverse events | 3 / 16 | 3 / 15 |
| serious Total, serious adverse events | 0 / 16 | 0 / 15 |
Outcome results
Latency
Latency (in minutes and seconds) to time of first cigarette smoking during the delay period
Time frame: 50 min
Population: 13 subjects completed study (i.e., completed both CERC-501 and Placebo periods in this cross over design).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| CERC-501 | Latency | 24.56 minutes | Standard Error 6.4 |
| Placebo | Latency | 26.64 minutes | Standard Error 6.62 |
Number of Cigarettes Smoked
Number of cigarettes smoked during the self administration period
Time frame: 60 min
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| CERC-501 | Number of Cigarettes Smoked | 1.67 number of cigarettes | Standard Error 0.28 |
| Placebo | Number of Cigarettes Smoked | 1.92 number of cigarettes | Standard Error 0.25 |