This is a multicenter, randomized, double-blind, placebo-controlled Phase II clinical trial. The study plans to enroll 210 adult patients with alcohol use disorder. After signing the informed consent form and undergoing screening based on inclusion/exclusion criteria, eligible participants will be randomly assigned to the low-dose group (naltrexone implant 0.9 g + general supportive psychological counseling), high-dose group (naltrexone implant 1.5 g + general supportive psychological counseling), and control group (placebo + general supportive psychological counseling) in a 1:1:1 ratio. On Day 0, participants will receive a single subcutaneous abdominal incision implantation with either 0.9 g or 1.5 g of naltrexone implant or placebo. Efficacy assessment will follow up to 24 weeks after randomization/dosing, while safety assessment will follow up to 48 weeks. There will be a total of 13 follow-up visits. Except for Day 3 (Visit 3) and Week 36 (Visit 12), which are telephone follow-ups, all other visits will be outpatient follow-ups. The first 24 weeks of the study will be double-blind. After completing the Week 24 follow-up, all participants will undergo efficacy assessment. Then they will enter the open-label observation period, followed up until Week 48.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
210
low-dose group (naltrexone implant 0.9 g + general supportive psychological counseling)
high-dose group (naltrexone implant 1.5 g + general supportive psychological counseling)
control group (placebo + general supportive psychological counseling)
The Second Xiangya Hospital of Central South University Address: No. 139, Renmin Road Central, Changsha City
Changsha, Hunan, China
Proportion of heavy drinking days during the 24-week observation period post-randomization/treatment
The "Heavy Drinking Days" are divided by the "Days at Risk of Heavy Drinking", with both calculations ending at the cessation of efficacy observation. "Days at Risk of Heavy Drinking" refers to the number of days participants receive efficacy observation during the study. Drinking rates are assessed based on daily alcohol consumption records completed by participants and their families, using the Timeline Follow-Back (TLFB) method. Heavy drinking is defined as "≥5 standard drinks per day for males and ≥4 standard drinks per day for females (In this trial, 1 standard drink = 10 g of pure alcohol).
Time frame: 24-week
Change in number of heavy drinking days per month relative to baseline
Specifically, the comparison of total monthly heavy drinking days from randomization/drug administration to the end of follow-up/trial completion with baseline monthly heavy drinking days \[calculate monthly corresponding data for weeks 1-24 after randomization/drug administration\]; alcohol consumption rate is assessed using the Timeline Follow-Back (TLFB) method based on daily alcohol consumption records completed by subjects and their families . Heavy drinking is defined as "≥5 standard drinks per day for males and ≥4 standard drinks per day for females (in this trial, 1 standard drink = 10 g of pure alcohol).
Time frame: 24-week
Alcohol-free days percentage
The "number of alcohol-free days" is divided by the "number of days at risk of alcohol consumption", with both calculations ending at the cessation of efficacy observation. The "number of days at risk of alcohol consumption" is defined as the number of days during which participants receive efficacy observation in the study. According to the Time-Line Follow-Back (TLFB) method, this is calculated based on alcohol consumption records; alcohol consumption is defined as any recorded alcohol consumption behavior, regardless of the quantity or frequency of consumption.
Time frame: 24-week
Maximum Consecutive Days of Abstinence
The longest period of continuous alcohol abstinence from randomization/dosing to loss of follow-up/study completion; calculated based on daily alcohol consumption records completed by subjects and their families using the Timeline Follow-Back (TLFB) method.
Time frame: 24-week
Daily and Weekly Alcohol Consumption (Daily Drinking Amount and Weekly Total Drinking Amount)
Daily drinking amount and weekly total drinking amount for the corresponding period; calculated based on weekly data from 1 to 24 weeks after randomization/dosing; calculated using the TLFB method based on daily drinking records completed by subjects and their families.
Time frame: 24-week
Alcohol Breath Concentration
Random/Post-dosing at 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, 16 weeks, 20 weeks, and 24 weeks; measured by digital alcohol breath tester.
Time frame: 24-week
Alcohol Craving Assessment
Randomized/Post-treatment scores at 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, 16 weeks, 20 weeks, and 24 weeks; assessed using Visual Analogue Scale (VAS). VAS assessment: One end of the horizontal line is "0", indicating no craving at all; the other end is "10", indicating extreme craving; the middle section represents varying degrees of craving. Participants are asked to select a number from 0-10 that represents their level of craving based on self-perception. The higher the number, the greater the degree of craving.
Time frame: 24-week
Alcohol Consequences Score
Randomized/Post-treatment at weeks 4, 8, 12, 16, 20, and 24; assessed using the Alcohol Consequences Checklist
Time frame: 24-week
Individual and Social Functioning Status
Assessment of individual and social functioning status at random/4, 8, 12, 16, 20, and 24 weeks post-treatment; Evaluated based on the Personal and Social Performance (PSP) scale: A total score of 71-100 indicates no difficulty or only mild difficulty in social functioning and interpersonal relationships A total score of 31-70 indicates varying degrees of impairment in social functioning and interpersonal relationships A total score below 30 indicates poor functioning, requiring active support or close supervision
Time frame: 24-week
Follow-up duration (from randomization/dosing to last follow-up)
defined as the time from randomization/dosing to the last follow-up visit.
Time frame: 24-week
The proportion of subjects with poor treatment response
defined as the proportion of subjects who were hospitalized for alcohol withdrawal, picked up medication, or lost to follow-up due to poor treatment response;"lost to follow-up due to poor treatment response" is defined as having ≥2 heavy drinking days per week in the 4 weeks prior to loss to follow-up.
Time frame: 24-week
Safety assessment indicators
including adverse events (AE) and serious adverse events (SAE) (including local AE and SAE at the implant site), abnormal occurrences of vital signs, physical examination, 12-lead or more ECG, and laboratory safety data (blood routine, urine routine, clinical biochemistry, and coagulation routine) before and after treatment.
Time frame: 48-week
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