The primary objective of this study was to evaluate the abuse potential of single doses of cebranopadol (GRT6005) relative to hydromorphone (immediate-release formulation \[IR\] and placebo in 48 non-dependent recreational opioid users. Secondary objectives were to evaluate the abuse potential of hydromorphone IR compared to placebo (trial validation), to evaluate the safety and tolerability of single doses of cebranopadol (200, 400, and 800 micrograms), and to evaluate pharmacokinetics (PK) of cebranopadol and optionally some of its metabolites.
The study comprised an Enrollment Visit, a Qualification Phase, a Treatment Phase with 7 double-blind treatment periods for each participant, and a Final Examination. In the Qualification Phase, all participants completed a naloxone challenge test to confirm that they were not opioid-dependent. The Objective Opioid Withdrawal Scale was used to record the signs or symptoms of withdrawal observed during the naloxone challenge test. Following the naloxone challenge test, participants received a single oral dose of hydromorphone immediate-release (IR) 12 milligrams (mg) and placebo in a double-blinded, randomized crossover manner to ensure that they could discriminate between an active drug and placebo and could tolerate hydromorphone IR 12 mg. After a washout phase of at least 3 days, participants could continue with the Treatment Phase. In the Treatment Phase, each participant received single oral doses of the 7 different investigational medicinal products (IMPs) (Treatment A to Treatment G) in 7 sequential treatment periods. The treatment sequences per participant were randomly assigned, except for one administration of placebo (Treatment G) which always followed the highest dose of cebranopadol (Treatment C). Each IMP administration was given under fasted conditions and was separated by a washout period of at least 14 days. Participants were confined to the study site from Day -1 until 48 hours after the first IMP administration in the Qualification Phase and from Day -1 until 56 hours after the IMP administration in the treatment periods. Pharmacodynamic assessments and blood sampling for pharmacokinetics were performed from pre-dose until 56 hours post-dose in each treatment period. The Final Examination was conducted 5 days to 10 days after the discharge from the last treatment period or upon early discontinuation from the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Tablets were taken under fasted conditions with non-carbonated water.
Tablets were taken under fasted conditions with non-carbonated water.
Over-encapsulated immediate-release tablets were taken under fasted conditions with non-carbonated water.
INC Research
Toronto, Ontario, Canada
Drug Liking (at this moment)
Visual analog scale (VAS) rating; Question text: At this moment, my liking for this drug is ...; Bipolar response anchors: 0 (Strong disliking), 50 (Neither like nor dislike), 100 (strong liking).
Time frame: At 16 distinct time points between 30 minutes and 56 hours after drug intake
Any Drug Effects
Visual analog scale (VAS) rating; Question text: I can feel any drug effect. Unipolar response anchors: 0 (Definitely not) to 100 (Definitely so).
Time frame: At 16 distinct time points between 30 minutes and 56 hours after drug intake
Good Drug Effects
Visual analog scale (VAS) rating; Question text: I can feel good drug effects; Unipolar response anchors: 0 (Definitely not) to 100 (Definitely so).
Time frame: At 16 distinct time points between 30 minutes and 56 hours after drug intake
Bad Drug Effects
Visual analog scale (VAS) rating; Question text: I can feel bad drug effects; Unipolar response anchors: 0 (Definitely not) to 100 (Definitely so).
Time frame: At 16 distinct time points between 30 minutes and 56 hours after drug intake
High
Visual analog scale (VAS) rating; Question text: I am feeling high; Unipolar response anchors: 0 (Definitely not) to 100 (Definitely so).
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Take Drug Again
Visual analog scale (VAS) rating; Question text: I would take this drug again; Unipolar response anchors: 0 (Definitely not) to 100 (Definitely so).
Time frame: At 12, 24, and 56 hours aft drug intake
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Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
226
Placebo matching over-encapsulated hydromorphone tablets were taken under fasted conditions with non-carbonated water.
Placebo matching cebranopadol tablets were taken under fasted conditions with non-carbonated water.
Feeling Sick
Visual analog scale (VAS) rating: Question text: I am feeling sick; Unipolar response anchors: 0 (Definitely not) to 100 (Definitely so).
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Alertness/Drowsiness
Visual analog scale (VAS) rating; Question text: My mental state is...; Bipolar response anchors: 0 (Very drowsy), 50 (Neither drowsy nor alert), 100 (Very alert).
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Floating
Visual analog scale (VAS) rating; Question text: I feel as if I am floating; Unipolar response anchors: 0 (Not at all) to 100 (Very much).
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Detached
Visual analog scale (VAS) rating; Question text: I feel detached from my body; Unipolar response anchors: 0 (Not at all) to 100 (Very much).
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Overall Drug Liking
Visual analog scale (VAS) rating; Question text: Overall, my liking for this drug is ...; Bipolar response anchors: 0 (Strong disliking), 50 (Neither like nor dislike), 100 (Strong liking)
Time frame: At 12, 24, and 56 hours aft drug intake
Drug Similarity
Visual analog scale (VAS) rating; Questions 1-15: How similar is the drug you most recently received to...? with 15 drugs to be assessed and response anchors 0 (Not at all similar) to 100 (Very similar); Question 16: How familiar was the effect of the drug you most recently received? for an overall familiarity assessment with response anchors 0 (Very unfamiliar) to 100 (Very familiar).
Time frame: At 12, 24, and 56 hours aft drug intake
Morphine-Benzedrine Group (MBG) scale
The Addiction Research Center Inventory (ARCI) scale to assess euphoria (MBG scale) was presented to the participant on a computer screen as multiple choices. Participants were asked to select their responses by pointing to one of them with the mouse; the two responses are "False" or "True".
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Benzedrine Group (BG) scale
The Addiction Research Center Inventory (ARCI) scale to assess stimulant-like effects: amphetamine, A-scale and Benzedrine Group (BG scale) was presented to the participant on a computer screen as multiple choices. Participants were asked to select their responses by pointing to one of them with the mouse; the two responses are "False" or "True".
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) scale
The Addiction Research Center Inventory (ARCI) scale to assess sedation was presented to the participant on a computer screen as multiple choices. Participants were asked to select their responses by pointing to one of them with the mouse; the two responses are "False" or "True".
Time frame: Pre-dose and at 16 distinct time points between 30 minutes and 56 hours after drug intake
Pupillometry
Pupil diameter was measured under mesopic lighting conditions. Data from a series of frames were used in the calculation, and the weighted average and standard deviation of the pupil size was calculated.
Time frame: Pre-dose and at 9 distinct time points between 1 and 56 hours after drug intake
Divided Attention Test
Manual-tracking test with a simultaneous visual target detection component. Participant is provided with joystick and presented with the image of an airplane and a randomly curving road; participant has to position the airplane over the center of the road while being distracted repeatedly by visual targets they have to respond to. Time over the road (percentage), response latency of correct responses (milliseconds) and target hits (percentage) are recorded.
Time frame: Pre-dose and at 8 distinct time points between 1 and 56 hours after drug intake