Repurposing Cholinesterase Inhibitors for Smoking Cessation.
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 98
- 试验地点
- 1
- 主要终点
- Total Number of Smoke-free Days (Biochemically Verified) During a 7-day Quit Attempt.
研究概览
简要总结
This is a randomized, double-blind, placebo-controlled study to test whether a medication called galantamine (Brand Name: Razadyne) will help smokers quit and whether it reduces cognitive problems that smokers experience during a quit attempt.
详细描述
Galantamine, an FDA-approved treatment for Alzheimer's disease, is used to treat cognitive impairment by enhancing acetylcholine through inhibition of the enzyme, acetylcholinesterase. We propose randomized double-blind placebo-controlled study of short-term (23 days) treatment with galantamine.
Eighty chronic smokers will complete a validated procedure for screening new medications. An equal number of subjects will be assigned to one of two groups: galantamine-ER or placebo. Participants in both groups will take one capsule each day and follow the same procedures. This is not a cross-over trial.
For participants in the galantamine group, following an initial 1-week drug run-up phase (8mg daily of galantamine-ER), the medication dose will be increased to 16mg daily of galantamine-ER for the remainder of the study (up to Day 23).
On Day 15, smokers will begin a mandatory 24-hour abstinence period, which will be followed by a programmed smoking lapse on Day 16. Smokers will then be instructed to abstain for the following 7 days (observed abstinence). Following completion of the study, participants will be offered standard smoking cessation treatment.
On Days 0 (Baseline), 14, and 16, subjects will perform the following computer tasks: a working memory task (Visual/Spatial N-Back), sustained attention tasks (Penn Continuous Performance Task [PCPT-nl] and XO Reaction Time Task), a recall memory task (Word Recognition), an interference control task (Stroop test), and a response inhibition task (Stop Signal Task).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Care Provider, Investigator)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Smokers who are between 18 and 60 years of age who self-report smoking at least 10 cigarettes (menthol and non-menthol) per day for at least the last 6 months.
- •Interest in quitting smoking in the next 2 to 6 months.
- •Healthy as determined by the Study Physician, based on a medical evaluation including medical history and physical examination, and psychiatric evaluation.
- •Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the combined consent and HIPAA form.
- •Women of childbearing potential must consent to use a medically accepted method of birth control while participating in the study (e.g., condoms and spermicide, oral contraceptive, Depo-provera injection, contraceptive patch, tubal ligation).
排除标准
- •Smoking behavior
- •Use of chewing tobacco, snuff, and/or snus.
- •Current enrollment in a smoking cessation program, or use of other smoking cessation medications in the last month or plans to do either in the next 2 months.
- •Provide a carbon monoxide (CO) breath sample reading less than 10 parts per million (ppm) at either the Intake or Baseline visits.
- •Alcohol/Drugs
- •Lifetime history of substance abuse (other than nicotine) and/or currently receiving treatment for substance abuse (e.g., alcohol, opioids, cocaine, stimulants, PCP, benzodiazepines, or study-prohibited medications/recreational drugs) as determined by self-report during the phone screen and/or through the MINI during the Intake visit.
- •Current alcohol consumption that exceeds 25 standard drinks/week over the past 6 months.
- •Providing a breath alcohol concentration (BrAC) reading of greater than or equal to 0.01 at the Intake, Baseline, or Testing Days.
- •A positive urine drug screen for cocaine, amphetamines, methamphetamines, benzodiazepines, PCP, methadone, barbiturates, and opiates at the Intake visit, Baseline visit, or the Testing days.
- •Women who are pregnant, planning a pregnancy in the next 3 months, or lactating; all female subjects shall undergo a urine pregnancy test at the Intake visit and must agree in writing to use an approved method of contraception. Following enrollment, pregnancy tests will be conducted at the Baseline visit and Testing days for all female subjects of child-bearing potential.
- •Diagnosis of Alzheimer's Disease or dementia.
- •Current treatment of cancer or diagnosed with cancer (except basal cell carcinoma) in the past 6 months.
- •Liver/kidney failure, peptic ulcer disease, benign prostate hypertrophy.
- •Asthma or chronic obstructive pulmonary disease (COPD).
- •History (last 6 months) of abnormal heart rhythms, tachycardia and/or cardiovascular disease (stroke, angina, heart attack). These conditions will be evaluated on a case by case basis by the Study Physician/Health Care Provider.
- •Serious or unstable disease within the past 6 months, as determined by the Study Physician/Health Care Provider.
- •Clinically significant abnormalities within physical examination and vital signs at Medical Screen. Abnormalities will be assessed by the Study Physician/Health Care Provider and eligibility will be determined on a case-by-case basis.
- •Any impairment (physical and/or neurological) including visual or other impairment preventing cognitive task performance.
- •Uncontrolled high blood pressure (Systolic BP greater than 160 and/or Diastolic BP greater than 100).
- •Hearing impairment, significant hearing loss (more than 20% in either ear), cochlear implants, or bi-lateral hearing aids.
- •History of brain injury.
- •History of epilepsy or a seizure disorder.
- •Color Blindness.
- •Low or borderline intellectual functioning - determined by receiving a score of less than 90 on the Shipley Institute of Living Scale (SILS) which correlates with the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Estimated IQ Test (administered at the Intake visit).
- •Psychiatric Exclusions (determined by self-report on phone screen and/or through the MINI during the Intake visit)
- •Current diagnosis of major depression. Persons with a history of major depression, in remission for 6 months or longer, are eligible, provided they are not excluded based on medications (below).
- •Suicide risk score on MINI greater than
- •History or current diagnosis of schizophrenia, psychosis, and/or bipolar disorder.
- •Current or past hypomanic/manic episode.
- •Current or history of a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD).
- •Current use, recent discontinuation (within the last month) of any form of smoking cessation medications (i.e., Zyban, Wellbutrin, Wellbutrin SR, Chantix, nicotine replacement therapy).
- •Current use or recent discontinuation (within the last 60 days) of any of the following:
- •Anti-anxiety or panic disorder medications.
- •Anti-psychotic medications.
- •Mood-stabilizers (e.g., Lithium, Lamictal/lamotrigine, Neurontin/gabapentin, Topamax/topiramate, valproic acid, Tegretol/carbamazepine).
- •Anti-depressants (e.g., Wellbutrin, MAOIs, SSRIs, tricyclic antidepressants).
- •Prescription stimulants (e.g., Provigil, Ritalin, Adderall).
- •Systemic Steroids (e.g., Prednisone).
- •Alzheimer's disease medications (e.g., Acetylcholinesterase inhibitors (ACIs), Aricept/donepezil, Exelon/rivastigmine, Tacrine, or memantine).
- •Parkinson's disease medications(e.g., Cogentin/benztropine).
- •Irritable bowel syndrome medication (e.g., Dicylomine/Bentyl).
- •Heart medications (e.g., quinidine or Procardia/nifedipine).
- •Peptic ulcer disease medication (e.g, Zantac/ranitidine).
- •Muscle relaxants (e.g., Soma/carisoprodol, Anectine/succinylcholine).
- •Anti-fungal medication (e.g., Nizoral/ketoconazole).
- •Anti-seizure medications (e.g., Ativan, Banzel, Carbatrol, Dilantin, Lamictal, Gabitril, Lyrica, Neurontin, Tegretol, Topamax).
- •COPD medication (e.g., Atrovent/Ipratropium Bromide).
- •Urinary retention medications (e.g., Duvoid/bethanechol, Proscar/finasteride, Avodart/dutasteride, Dibenzyline/phenoxybenzamine, Regitine/phentolamine).
- •Eye medication (e.g., Atropine).
- •Daily use of any of the following:
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研究组 & 干预措施
Galantamine
Galantamine hydrobromide-ER (extended release) is currently marketed for the treatment of Alzheimer's disease. The dosing regimen follows the FDA-approved guidelines. For the first week of study treatment, participants will take 8mg daily of galantamine-ER, preferably with food. 8mg is the lowest dose and this period is designed to introduce the medication into their system. After the initial week, participants will increase their daily dose to 16mg. They will remain on 16mg daily until the end of the treatment period for a total of 23 days on active study medication.
Galantamine will be purchased, encapsulated, and packaged into blister packs by the Investigational Drug Service at the University of Pennsylvania. Both active medication and placebo will look identical.
干预措施: Galantamine (Drug)
Placebo
Participants assigned to the placebo (sugar pill) arm will take one capsule daily, preferably with food, for a total of 23 days. They will follow the same instructions and complete the same procedures as those in the active treatment.
Placebo ingredients (sucrose filler and gel capsules) will be purchased, encapsulated, and packaged into blister packs by the Investigational Drug Service at the University of Pennsylvania. Both active medication and placebo will look identical.
干预措施: Placebo (Drug)
结局指标
主要结局
Total Number of Smoke-free Days (Biochemically Verified) During a 7-day Quit Attempt.
时间窗: Days 17-23
Day 17 will be the beginning of a 7-day quit attempt, during which the total number of days of abstinence will be assessed.
次要结局
- Subjective Symptoms(Baseline (day 0), Days 7, 14, 16, 17, 19, 21, and 23)
- Common Side Effects of Galantamine Check List(Baseline (day 0), Days 7, 14, 16, 17, 19, 21, and 23)
- Cognitive Performance(Baseline (Day 0), Day 14 (day before start of 24-hour abstinence period), Day 16 (after 24-hour abstinence period ends))