The purpose of this study was to assess efficacy and safety of the study drug Odelepran, 125 mg as compared to placebo in the treatment of alcohol dependence in adult outpatients.
Patients for this study were recruited in specialized psychiatric and addictology clinical sites in Russia and Kazakhstan. Eligible patients were randomly allocated in one of the following treatment groups in 1:1 ratio: * The main group was taking the study drug Odelepran, one 125 mg tablet per day; * The comparison group was taking the comparison drug (Placebo) orally, one tablet per day. Duration of the study treatment period was 24 weeks (starting from the Day 1). Patients were keeping a diary to register their drug taking and amount and kind of alcohol beverages consumed. Patients were not allowed to participate in psychotherapy or take any psychotropic drugs except for short-acting benzodiazepines for insomnia. However benzodiazepines were not allowed for taking less than 24 before any study visit. Patients visited clinical sites regularly as per the Schedule for visits and procedures. During the visits to the site the patient's mental state examination with the use of psychometric scales was conducted and the study drug was provided. Starting at randomization and subsequently at all scheduled visits investigators conducted a brief (15 minutes or less) psychotherapeutic intervention (individual counseling) during which patients were asked to provide information on aspects of alcohol consumption and emotional states experienced while abstaining from alcohol. Such individual counseling was aimed to reinforce lifestyle changes, motivate sobriety and enhance protocol adherence. All clinical sites performed such counseling in standardized manner in accordance with protocol-specific Guideline developed at St. Petersburg Psychoneurological Research Institute named after V.M. Bekhterev for the purposes of this study.28 days after the last dose of study drug patients were asked to come for a follow up visit to assess adverse events. Patients were not paid for participation in the study. Assessments of efficacy and safety were performed monthly. Assessments of drinking behavior were based on the Time Line Follow-Back (TLFB) method used to provide information of daily number of standard drinks. At every visit patients reported about dynamics of drinking (frequency and amount of consumed alcohol) since the previous visit. For all assessed variables, the baseline was defined as an assessment at the screening visit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
644
Tablets, 125 mg
Contains the same excipients as Odelepran but it does not contain the active agent. Placebo is identical to Odelepran in terms of drug form and external characteristics (colour, smell, etc). Doses and route of administration are identical to those for Odelepran.
Republican Research center of psychiatry, psychotherapy and addictology
Almaty, Kazakhstan
Change from baseline in the mean daily alcohol consumption
Calculated as total number of drinks in month divided by number of days in month.
Time frame: Baseline and Week 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 of treatment
Change in the number of days of abstinence per month as compared to the baseline
Time frame: Baseline and Week 24 of treatment
Change in the percentage of days of heavy drinking per month as compared to the baseline
Heavy drinking to be considered as 5 or more drinks per day for men and 4 or more drinks per day for women.
Time frame: Baseline and Week 24 of treatment
Time to the first day of drinking
Full abstinence period duration.
Time frame: From baseline till the first day of alcohol consumption
Time to the first day of heavy drinking
Heavy drinking to be considered as 5 or more drinks per day for men and 4 or more drinks per day for women.
Time frame: From baseline till the first day of heavy drinking
Change from baseline in alcohol consumption per drinking day
Calculated as total number of drinks in month divided by number of drinking days in month.
Time frame: Baseline and Week Week 1, 2, 3, 4, 6, 8, 10, 12, 16, 20 and 24 of treatment
Change in alcohol craving from the baseline (based on Obsessive-Compulsive Drinking Scale (OCDS) score)
The OCDS is a validated scale consisted of 14 items for patient self-assessment of alcohol craving. Scoring by simple addition. Higher scores indicate greater level of craving (Anton R.F., Moak D.H., Latham P.K., 1996).
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Republican clinical mental hospital n.a. V.M. Bekhterev
Kazan', Russia
First Moscow State Medical University named after I.M.Sechenov
Moscow, Russia
Institute of mental health and addictology, LCC
Moscow, Russia
Murmansk regional narcological dispensary
Murmansk, Russia
Clinical mental hospital #1, Dispensery department
Nizhny Novgorod, Russia
Clinical mental hospital #1,Medico-rehabilitational department
Nizhny Novgorod, Russia
Research center Feniks, LLC
Rostov-on-Don, Russia
Baltic Medicine LLC
Saint Petersburg, Russia
City addiction clinic, 2nd department
Saint Petersburg, Russia
...and 12 more locations
Time frame: Baseline and Week 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 of treatment
Change in alcohol craving (based on completed VIsual Analogue Scale)
VIsual Analogue Scale (VAS) ranged from 0 to 100, where 0 corresponds to "no craving at all" and 100 corresponds to "maximal craving"
Time frame: Baseline and Week 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 of treatment
Change in patient's self-assessed quality of life (by the SF-36 Questionnaire) as compared to the baseline
The Short Form Health Survey (SF-36) is a validated 36 item self-report Quality of Life Questionnaire that measures eight multi-item dimensions of health: physical functioning, social functioning, role limitations due to physical problems, role limitations due to emotional problems, mental health, energy/vitality, pain, and general health perception. Version 2 was used. (Ware J.E., 2000)
Time frame: Baseline and Week 8, 24 of treatment
Proportion of patient with clinical improvement as assessed by Clinical Global Impression-improvement (CGI-I) scale
CGI-I scale is a 7 point scale that requires the investigator to assess how much the patient's illness has improved or worsened relative to a baseline. Rated as: 1 - very much improved, 2 - much improved, 3 - minimally improved, 4 - no change, 5 - minimally worse, 6 - much worse, 7 - very much worse. (Guy W, 1970; 1976)
Time frame: Week 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 of treatment
Efficacy index of CGI
Efficacy index is a 4×4 rating scale that assesses the therapeutic effect of treatment with psychiatric medication (with possible considerations: 1 - unchanged or worse; 2 - minimal - slight improvement which doesn't alter status of care of patient; 3 - moderate marked - decided improvement, partial remission of symptoms; 4 - marked - vast improvement, complete or nearly complete remission of all symptoms) and associated side effects (with possible considerations: 1 - none; 2 - do not significantly interfere with patient's functioning; 3 - significantly interfere with patient's functioning; 4 - outweigh therapeutic effect). Derived by dividing therapeutic effect score by side effects score. The lower efficacy index corresponds to the better result (Guy W, 1970; 1976)
Time frame: Week 12 and 24 of treatment
Change from baseline in the Drinker Inventory of Consequences questionnaire (DrInC-2R) total score
DrInC-2R is a validated self-report questionnaire consisted of 50 questions to measure adverse consequences of alcohol abuse in five areas: Interpersonal, Physical, Social, Impulsive, and Intrapersonal as well as frequency of these consequences (answers given on frequency scale grade from 0-3: 0 - never, 1 - once or a few times, 2 - once or twice a week 3 - daily or almost daily). Higher scores indicate greater levels of alcohol-related problems. (Miller W.R., 1995)
Time frame: 3 previous months, baseline and Week 4, 8, 12, 16, 20 and 24 of treatment
Change in impulsivity (Barratt impulsivity scale by the subscales and by the total score) from the baseline
Barratt impulsivity scale (BIS-11) is a validated self-report questionnaire composed of 30 items describing common impulsive or non-impulsive (for reverse scored items) behaviors and preferences. Items are scored on a 4-point scale: Rarely/Never = 1, Occasionally = 2, Often = 3, Almost Always/Always = 4. Total score is assessed. The higher total score corresponds to the more impulsive behavior (Patton et al., 1995)
Time frame: Baseline and Week 8, 16 and 24 of treatment
Proportion of patients completed the trial
Time frame: Week 24 of treatment
Time to untimely withdrawal from the study
Time frame: From baseline to Week 24 of treatment
Number of the early dropouts from the study
Per reasons
Time frame: Week 24 of treatment