Drug Metabolism, Poor, CYP2D6-Related, Metabolism Medication Toxicity, Methadone Overdose, Methadone Toxicity, Pain, Chronic
Conditions
Keywords
Pharmacokinetics
Brief summary
Proof of concept: Pilot Study A Pilot, proof of concept, observational study with a long-term goal to develop a minimally invasive wearable Remote Medication Monitor (RMM) that provides continuous, real-time data on methadone levels in interstitial fluid (ISF). An RMM could be used as a medication adherence monitor and would allow for the physician, counselor, patient, or family member to remotely verify that a physician-prescribed dose has been taken.
Detailed description
The investigator will conduct a non-randomized, non-blinded, feasibility study at a single center in the United States. The study will include up to 20 subjects of an equal number of male and female adults (ages 18-70) who have a prescription for methadone. In Aim 1, the investigators will determine if an RMM can continuously assess the status of taking a prescribed dose of methadone over time, by inserting the dermal ISF sensing elements into the subjects' abdominal skin. Biosample collections (i.e., ISF, blood) and pharmacokinetic monitoring will occur over a 6-hour period. By completing this aim, the investigator will determine if a physician is able to recognize the pharmacokinetic profile of a taken dose of methadone. The physician will see a dosing curve display generated from dermal ISF dialysis fluid sampling using an external fiberoptic sensor system that is worn continuously on the abdomen similar to continuous glucose monitors.
Interventions
Measurement of Methadone and its metabolites in interstitial fluid with Liquid Chromatography - Mass Spectroscopy (LC-MS) and Aptamer based Assay
Measurement of Methadone and its metabolites in ISF with LC-MS and RMM
Up to 15 minute periods of continuous ISF collection for analysis
Sponsors
Study design
Eligibility
Inclusion criteria
* Age 18-70 * A prescription for methadone at a dose of 10mg or more for at least one week. * Taking methadone as prescribed during the last 4 days before consent to participate in the study.
Exclusion criteria
* Age \<18 or \>70 * A condition preventing or complicating ISF collection * dermatological (skin) condition * immunodeficiency * recent blood donation * anemia * end stage renal disease * liver cirrhosis * cancer * congestive heart failure * bleeding diathesis * tuberculosis (TB) * Any active severe depression * suicidal ideation * mania symptoms * Pregnancy * Intending to become pregnant during the course of the study * Enrolled in a substance use disorder treatment program * Under a conservatorship.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Methadone Concentration in ISF before and after a dose | 1 day | measure dermal interstitial fluid with LC-MS for methadone before and after a daily dose |
| Methadone Concentration in blood before and after a dose | 1 day | measure blood for methadone with LC-MS before and after a daily dose |
| Concentration of Methadone in ISF with LC-MS versus Fluorescent Aptamer Switch | 2 days | measure ISF with two procedures (Liquid Chromatography - Mass Spectroscopy and Fluoroscopy |
| Concentration of Methadone in blood with LC-MS versus Fluorescent Aptamer Switch | 2 days | measure blood with two procedures (Liquid Chromatography - Mass Spectroscopy and Fluoroscopy |
| Pearson Correlation of Methadone between ISF and Blood | 2 days | measure blood and ISF methadone with LC-MS and determine pearson correlation |
| Pearson Correlation between Fluoroscopy and LC-MS ISF Methadone | 2 days | measure ISF for methadone by LC-MS and Fluoroscopy and determine Pearson correlation |
Countries
United States