Randomized, multi-center, double-blind, parallel-group, placebo-controlled study. Eligible subjects will be randomized to receive either 0.33 mg AD04 or placebo orally twice-daily for 24 weeks in conjunction with brief psychological counseling. Randomization will be stratified by: 1. Level of alcohol consumption prior to enrollment in the study (heavy drinkers averaging \<10 drinks per day of drinking or very heavy drinkers averaging ≥10 drinks per day of drinking), and 2. Gender (male or female).
Target enrollment of subjects with AUD who regularly engage in risk alcohol consumption (i.e. \>6/day or more heavy alcohol consumption in the 4 weeks preceding the screening visit), and have selected genotypes (LL/TT genotype and/or 1, 2 or 3 of the SNPs on the genes for the 5-HT3 receptor subunits: rs1150226-AG or rs1176713-GG in the gene that encodes the 5-HT3A receptor subunit, and rs17614942-AC in the gene that encodes the 5-HT3B receptor subunit), and who are eligible to participate in the study based on meeting the remaining study inclusion/exclusion criteria. Eligible subjects will be randomized to receive either 0.33 mg AD04 or placebo BID for 24 weeks. The trial will have a 16-week grace period to enable medication effects to be optimal for comparison with placebo. The grace period starts immediately after beginning of study drug treatment, in which consumption of alcohol is not counted as a failure. All primary and secondary efficacy endpoints will be assessed during the last 8 weeks of treatment (i.e. weeks 17-24). The primary measure of efficacy, incidence risk alcohol consumption, will be assessed over the last 8 weeks of treatment. The secondary measure of efficacy evaluating the incidence of risk alcohol consumption over the last 4 weeks of treatment, important because it has been used commonly to validate efficacy for regulatory agencies such as the European Medicines Agency, was also calculated. To enhance study feasibility, subjects will be evaluated every week during the first 8 weeks of treatment and every other week for the remaining 16 weeks of the treatment period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
AD04 (ondansetron) 0.33 mg, orally (p.o.) twice a day (BID)
Matching placebo to AD04 (ondansetron), orally (p.o.) twice a day (BID)
Companion Diagnostic for Genetic Testing
Mental Health Centre Prof. Dr. Ivan Temkov Burgas EOOD Department for treatment of Emergency Psychiatric conditions
Burgas, Bulgaria
Change from baseline in the percentage of monthly heavy drinking days (PHDD)
Change from baseline in the percentage of monthly HDDs, where (heavy) drinking is defined as the consumption of ≥ 60 g alcohol/day (if male) or ≥ 40 g alcohol/day (if female).
Time frame: Weeks 16 to 24
Change from baseline in the primary efficacy endpoint at each study month
Change from baseline in PHDD at each study month.
Time frame: Weeks 4, 8, 12, 16, 20, and 24
Change from baseline in AUD symptoms and clinical status
AUD symptoms and clinical status (\<2 symptoms, Mild, Moderate, or Severe) based on DSM-5 criteria at Baseline, weeks 12 and 24 visits
Time frame: Weeks 12 and 24
Change from baseline in Drinking Risk Levels (DRL), 1-level shift
Proportion of subjects with a 1-level categorical shift from baseline in modified DRL
Time frame: Week 24
Change from baseline in Drinking Risk Levels (DRL), 2-level shift
Proportion of subjects with a 2-level categorical shift from baseline in modified DRL
Time frame: Week 24
Change from baseline in total alcohol consumption (TAC)
Change from baseline in total alcohol consumption (TAC), defined as the mean daily alcohol consumption expressed in g/day
Time frame: Weeks 16 to 24
Change from baseline in the Patient Health Questionnaire-9 (PHQ-9)
Change from baseline in the PHQ-9 calculated as the difference from baseline to Week 24.
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QUADRUPLE
Enrollment
302
Brief Psychological Counseling
State Psychiatric Hospital
Kardzhali, Bulgaria
UMHAT Dr. Georgi Stranski Second Psychiatric Clinic
Pleven, Bulgaria
Ambulatory for Group Practice for Specialized Psychiatric Help - Philipopolis OOD
Plovdiv, Bulgaria
Medical Center Intermedica OOD
Sofia, Bulgaria
State Psychiatric Hospital for Treatment of drug addiction and alcoholism
Sofia, Bulgaria
Diagnostic-Consultative Center Mladost-М Varna
Varna, Bulgaria
Clinical Hospital Center Split
Split, Croatia
Polyclinic Neuron
Zagreb, Croatia
University Psychiatric Hospital Vrapče Klinika za psihijatriju Vrapče
Zagreb, Croatia
...and 15 more locations
Time frame: Week 24
Change from baseline in risk alcohol consumption responders
The number of subjects with no risk alcohol consumption will be calculated
Time frame: Weeks 16 to 24
Change from baseline in percent reduction in monthly total alcohol consumption (TAC)
Proportion of subjects with ≥10%, ≥20%, ≥30%, ≥40%, ≥50%, ≥60%, ≥70%, ≥80%, and ≥90% reduction from baseline in monthly TAC
Time frame: Weeks 20 to 24
Change from baseline in the percent of non-drinking days (PNDD)
Change from baseline in the percent of non-drinking days (PNDD)
Time frame: Weeks 16 to 24
Change from baseline in drinks per drinking day (DDD)
Change from baseline in the monthly drinks per drinking day (DDD)
Time frame: Weeks 16 to 24