The primary objectives of this study are: * To evaluate the pharmacokinetic (PK) parameters during repeat dosing of 1.5 mg or 3.0 mg cytisine when administered as the commercial 25-day schedule. * To evaluate the pharmacodynamic (PD) effects (e.g., reduction in smoking) with repeat dosing of 1.5 mg or 3.0 mg cytisine when administered as the commercial 25-day schedule.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
26
film-coated tablets; depending on arm assignment, 1 or 2 tablets to be taken with 240 mL water for each dose
Simbec Research Ltd
Cardiff, United Kingdom
Maximum Observed Plasma Concentration (Cmax)
Time frame: after the first dose and the last dose on Day 1; after the last dose on Days 2, 3, 12, 16, 20, 24; and after the morning dose on Day 25
Time of Occurrence of Cmax (Tmax)
Time frame: after the first dose and the last dose on Day 1; after the last dose on Days 2, 3, 12, 16, 20, 24; and after the morning dose on Day 25
Minimum Observed Plasma Concentration (Cmin)
Time frame: after the first dose on Days 4, 13, 17, 21 and 25
Area Under the Plasma Concentration Versus Time Curve (AUC) From Time Zero to the Last Sampling Time (AUC0-t)
Time frame: after the administration of the final dose of cytisine on Day 25
Total AUC From Time Zero to Infinity (AUC0-∞)
Time frame: after the administration of the final dose of cytisine on Day 25
Residual Area or Percentage of Extrapolated Part for the Calculation of AUC0-∞ (%AUC)
Time frame: after the administration of the final dose of cytisine on Day 25
Apparent Terminal Elimination Rate Constant (λz)
Time frame: after the administration of the final dose of cytisine on Day 25
Apparent Terminal Elimination Half-Life (t1/2)
Time frame: after the administration of the final dose of cytisine on Day 25
Number of Cigarettes Smoked Daily During Treatment and at Day 26
Time frame: Day 1 through Day 26
Change From Baseline in Number of Cigarettes Smoked Daily up to Day 26
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Time frame: Baseline, Day 1 through Day 26
Change From Baseline in Expired Air CO up to Day 26
Time frame: Baseline, Days 4, 13, 17, 21, 26
Number of Participants Who Ceased or Continued Smoking on Day 26
A status of "ceased smoking" is defined as not having smoked any cigarettes for the past 24 hours on Day 26 and having an expired CO level \<10 ppm on Day 26.
Time frame: Day 26
Change From Baseline Over Time in Urine Cotinine
Time frame: Baseline, Days 4, 13, 17, 21, 26
Change From Baseline Over Time in TCQ-SF Score: Emotionality
The TCQ-SF is a 12-item questionnaire that assesses 4 components of tobacco craving: emotionality (3 items), expectancy (3 items), compulsivity (3 items) and purposefulness (3 items). Responses to each item are scored from 1 (strongly disagree) through 7 (strongly disagree). Component scores are defined as the sum of the scores within each component. The total score is defined as the sum of the 4 component scores. Emotionality scores may range from 3 to 21, with lower scores indicating weaker emotional signs of tobacco craving.
Time frame: Baseline (Day -1), Days 4, 13, 17, 21, 26
Change From Baseline Over Time in TCQ-SF Score: Expectancy
The TCQ-SF is a 12-item questionnaire that assesses 4 components of tobacco craving: emotionality (3 items), expectancy (3 items), compulsivity (3 items) and purposefulness (3 items). Responses to each item are scored from 1 (strongly disagree) through 7 (strongly disagree). Component scores are defined as the sum of the scores within each component. The total score is defined as the sum of the 4 component scores. Expectancy scores may range from 3 to 21, with lower scores indicating less positive expectations about smoking.
Time frame: Baseline (Day -1), Days 4, 13, 17, 21, 26
Change From Baseline Over Time in TCQ-SF Score: Compulsivity
The TCQ-SF is a 12-item questionnaire that assesses 4 components of tobacco craving: emotionality (3 items), expectancy (3 items), compulsivity (3 items) and purposefulness (3 items). Responses to each item are scored from 1 (strongly disagree) through 7 (strongly agree). Component scores are defined as the sum of the scores within each component. The total score is defined as the sum of the 4 component scores. Compulsivity scores may range from 3 to 21, with lower scores indicating compulsion to smoke was a lesser component of tobacco craving.
Time frame: Baseline (Day -1), Days 4, 13, 17, 21, 26
Change From Baseline Over Time in TCQ-SF Score: Purposefulness
The TCQ-SF is a 12-item questionnaire that assesses 4 components of tobacco craving: emotionality (3 items), expectancy (3 items), compulsivity (3 items) and purposefulness (3 items). Responses to each item are scored from 1 (strongly disagree) through 7 (strongly disagree). Component scores are defined as the sum of the scores within each component. The total score is defined as the sum of the 4 component scores. Purposefulness scores may range from 3 to 21, with lower scores indicating stronger ability to not smoke.
Time frame: Baseline (Day -1), Days 4, 13, 17, 21, 26
Change From Baseline Over Time in TCQ-SF Score: Total Score
The TCQ-SF is a 12-item questionnaire that assesses 4 components of tobacco craving: emotionality (3 items), expectancy (3 items), compulsivity (3 items) and purposefulness (3 items). Responses to each item are scored from 1 (strongly disagree) through 7 (strongly disagree). Component scores are defined as the sum of the scores within each component. The total score is defined as the sum of the 4 component scores. Total scores may range from 12 to 84, with lower scores indicating lower tobacco craving.
Time frame: Baseline (Day -1), Days 4, 13, 17, 21, 26
Cytisine Amount Excreted in Urine Over Time (Ae0-24h)
Time frame: Day 1 (6 times daily at 2-hour intervals); after the administration of the single dose of cytisine on Day 25
Percent of Drug Excreted in Urine (Ae%)
Time frame: Day 1 (6 times daily at 2-hour intervals); after the administration of the single dose of cytisine on Day 25
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, and Discontinuation of Study Drug Due to TEAEs
An adverse event (AE) is defined as any untoward medical occurrence in a clinical trial subject administered a medicinal product and which does not necessarily have a causal relationship with the treatment. A serious adverse event (SAE) is defined as an AE that results in any of the following: results in death; is life-threatening; requires hospitalisation or prolongs existing inpatient's hospitalisation; results in persistent or significant disability or incapacity; results in a congenital abnormality or birth defect; is an important medical event which requires medical intervention to prevent any of the above outcomes.TEAEs are defined as AEs not present prior to first administration of investigational product, or AEs present before first administration of investigational product that worsen after the participant receives the first dose of investigational product.
Time frame: From first dose of study drug through Day 26 plus 6-8 days
Number of Participants With Clinically Significant Values in Biochemistry, Hematology, and Urinalysis
Time frame: up to Day 26
Number of Participants With Clinically Significant Values in Vital Signs and Physical Examinations
Time frame: up to Day 26
Number of Participants With Clinically Significant Changes in 12-lead Electrocardiogram (ECG) Parameters
Time frame: up to Day 26
Number of Participants With Holter ECG Outlier Values
Based on the mean of the triplicate recordings at each time point. Increase (↑)/decrease (↓) calculated from Baseline (BL), defined as the mean of all recordings taken prior to dosing on Day 1 (i.e. -30 minutes and -15 minutes). A participant with multiple occurrences of an event is counted only once per event.
Time frame: on Day 1 and Day 25 at 30 and 15 minutes prior to the first dose and 0.5 hour, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours and 24 hours post dose