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ObesityPhase 3NCT00567255

A Safety and Efficacy Study of Naltrexone SR/Bupropion SR in Overweight and Obese Subjects

A Phase 3 study testing Naltrexone SR 32 mg/bupropion SR 360 mg/day and Ancillary therapy in people with Obesity and Overweight, run by Orexigen Therapeutics, Inc at 36 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to determine whether the combination of naltrexone SR and bupropion SR is safe and effective in the treatment of obesity. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Obesity, Overweight
What is being tested?
Naltrexone SR 32 mg/bupropion SR 360 mg/day and Ancillary therapy
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,496 participants
Where
36 sitesUnited States
Study dates
Dec 2007to Jun 2009
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female or male subjects aged 18 to 65 years (inclusive)
  • Body mass index (weight [kg]/height [m²]) ≥30 and ≤45 kg/m² for subjects with uncomplicated obesity, and BMI of ≥27 and ≤45 kg/m² for subjects with obesity with controlled hypertension and/or dyslipidemia
  • Normotensive (systolic ≤140 mm Hg and diastolic ≤90 mm Hg). Anti-hypertensive medications were allowed with the exception of alpha-adrenergic blockers and clonidine. Medical regimen was to be stable for at least 6 weeks prior to randomization.
  • Medications for the treatment of dyslipidemia were allowed as long as the medical regimen had been stable for at least 6 weeks prior to randomization.
  • Free of opioid medication for 7 days prior to randomization
  • No clinically significant abnormality of serum albumin, blood urea nitrogen (BUN), creatinine, bilirubin, sodium, potassium, chloride, calcium or phosphorus
Show all 18Show fewer
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) within 2.5 times upper limit of normal (ULN)
  • No clinically significant abnormality of hematocrit, white blood cell (WBC) count, WBC differential, or platelets
  • Fasting glucose <126 mg/dL and not receiving hypoglycemic agents and fasting triglycerides level <400 mg/dL
  • No clinically significant abnormality on urinalysis
  • Thyroid stimulating hormone (TSH) within normal limits or normal triiodothyronine (T3), if TSH was below normal limits
  • Female subjects of childbearing potential had a negative serum pregnancy test
  • Negative urine drug screen (UDS)
  • An IDS-SR score <2 on individual items: 5 (sadness), 6 (irritability), 7 (anxiety/tension), and 18 (suicidality) and an IDS-SR total score <30
  • Female subjects of childbearing potential were non-lactating and agreed to continue to use effective contraception throughout the study and 30 days after discontinuation of study drug
  • Able to comply with all required study procedures and schedule
  • Able to speak and read English
  • Provided written informed consent

Who cannot join

  • Obesity of known endocrine origin (e.g., untreated hypothyroidism, Cushing's syndrome)
  • Serious medical condition (including but not limited to renal or hepatic insufficiency; Class III or IV congestive heart failure, history of angina pectoris, myocardial infarction, claudication, or acute limb ischemia within the previous 6 months; lifetime history of stroke)
  • History of malignancy within the previous 5 years, with exception of non-melanoma skin cancer or surgically cured cervical cancer
  • Lifetime history of serious psychiatric illness, including lifetime history of bipolar disorder, schizophrenia or other psychosis, bulimia, or anorexia nervosa
  • Current serious psychiatric illness including severe personality disorder (e.g., borderline or antisocial), current severe major depressive disorder, recent (previous 6 months) suicide attempt, current active suicidal ideation or recent hospitalization due to psychiatric illness
  • Response to the bipolar disorder questions that indicated the presence of bipolar disorder
Show all 24Show fewer
  • Required medications for the treatment of a psychiatric disorder (with the exception of short-term insomnia) within the previous 6 months prior to randomization
  • History of drug or alcohol abuse or dependence (with the exception of nicotine dependence) within 1 year prior to study initiation
  • Type I or Type II diabetes mellitus
  • Screening ECG with a corrected QT (QTc) interval (using Bazett's formula >450 millisecond (msec) [males] and >470 msec [females]) or the presence of any clinically significant cardiac abnormalities, including but not limited to patterns consistent with myocardial ischemia, electrolyte abnormalities, or atrial or ventricular dysrhythmia or significant conduction abnormalities
  • Received excluded concomitant medications: any psychotropic agents (including antipsychotic, antidepressant, anxiolytic, mood stabilizer or anticonvulsant agents or agents for the treatment of attention deficit disorder) with the exception of low-dose benzodiazepine or hypnotic agents for the treatment of insomnia (up to 2 mg lorazepam/day or equivalent dose of a benzodiazepine or hypnotic agent); any anorectic or weight loss agents; any over the-counter dietary supplements or herbs with psychoactive, appetite or weight effects; alpha-adrenergic blockers; dopamine agonists; clonidine; coumadin; theophylline; cimetidine; oral corticosteroids; cholestyramine; cholestypol; Depo-Provera®; smoking cessation agents; use of opioid or opioid-like analgesics, including analgesics and antitussives
  • History of surgical or device (e.g., gastric banding) intervention for obesity
  • History of seizures of any etiology, or of predisposition to seizures (e.g., history of cerebrovascular accident, head trauma with ≥5 minutes loss of consciousness, concussion symptoms lasting ≥15 minutes, brain surgery, skull fracture, subdural hematoma, or febrile seizures)
  • History of treatment with bupropion or naltrexone within the preceding 12 months
  • History of hypersensitivity or intolerance to bupropion or naltrexone
  • Initiation or discontinuation of tobacco products including inhaled tobacco (e.g., cigarettes, cigars, pipes, etc), chewing tobacco or snuff within 3 months prior to randomization or planned during study participation. Use of nicotine replacement products (e.g., nicotine gum, patch, etc) during study participation was not allowed
  • Used drugs, herbs, or dietary supplements believed to significantly affect body weight or participated in a weight loss management program within one month prior to randomization
  • Loss or gained >4.0 kilograms within the previous 3 months prior to randomization
  • Females who were pregnant or breast-feeding or planning to become pregnant during the study period or within 30 days of discontinuing study drug
  • Planned surgical procedure that could impact the conduct of the study
  • Received any investigational drug or used an experimental device or procedure within the previous 30 days
  • Participated in any previous clinical trial conducted by Orexigen
  • Had any condition that in the opinion of the investigator made the subject unsuitable for inclusion into the study
  • Investigators, study personnel, sponsor representatives and their immediate families

Trial locations and contacts

36 sites in 1 country.

36 sites in 1 country

United States36 sites
  • Lovelace Scientific Resources

    Albuquerque, New Mexico, 87108

  • Comprehensive NeuroScience, Inc

    Atlanta, Georgia, 30328

  • Nutrition and Weight Mangement Center Boston Medical Center

    Boston, Massachusetts, 02118

  • Twin Cities Clinical Research

    Brooklyn Center, Minnesota, 55430

  • Northern California Research

    Carmichael, California, 98608

  • Metrolina Medical Research

    Charlotte, North Carolina, 28209

  • Patient Priority

    Cincinnati, Ohio, 45242

  • The Cooper Institute

    Dallas, Texas, 75230

  • Geisinger Medical Center

    Danville, Pennsylvania, 17822

  • Center for Human Nutrition University of Colorado Health Sciences Center

    Denver, Colorado, 80220

  • Endocrinology & Diabetes Consultants

    Dover, New Hampshire, 03820

  • Sierra Medical Research

    Fresno, California, 93710

  • Mountain View Clinical Research

    Greer, South Carolina, 29349

  • HealthStar Research

    Hot Springs, Arkansas, 71913

  • Wells Institute For Health Awareness

    Kettering, Ohio, 45429

  • Clinical Research Center of Nevada

    Las Vegas, Nevada, 89104

  • Trover Center for Clinical Studies

    Madisonville, Kentucky, 42431

  • Central New York Clinical Research

    Manlius, New York, 13104

  • Milford Emergency Associates, Inc

    Milford, Massachusetts, 01757

  • Palmetto Medical Research

    Mt. Pleasant, South Carolina, 29464

  • Clinical Research Associates, Inc.

    Nashville, Tennessee, 37203

  • Comprehensive Weight Control Program

    New York, New York, 10021

  • Pharmacology Research Institute

    Newport Beach, California, 92660

  • Summit Research Network, Inc.

    Okemos, Michigan, 48864

  • Suncoast Clinical Research

    Palm Harbor, Florida, 34684

  • Lovelace Scientific Resources

    Phoenix, Arizona, 85016

  • HOPE Research Institute

    Phoenix, Arizona, 85050

  • The Portland Clinic

    Portland, Oregon, 97205

  • Summit Research Network, Inc.

    Seattle, Washington, 98104

  • Mercy Health Research

    St Louis, Missouri, 63141

  • Radiant Research, Inc.

    St Louis, Missouri, 63141

  • Behavioral Medical Research

    Staten Island, New York, 10305

  • Clinical Research Atlanta

    Stockbridge, Georgia, 30281

  • Northwest Indiana Center for Clinical Research

    Valparaiso, Indiana, 46383

  • George Washington University

    Washington D.C., District of Columbia, 20037

  • Chase Medical Research, LLC

    Waterbury, Connecticut, 06708

Other trials in United States

About this study

Official title: A Multicenter, Randomized, Double Blind, Placebo Controlled Study Comparing the Safety and Efficacy of Naltrexone Sustained Release (SR)/Bupropion Sustained Release (SR) and Placebo in Obese Subjects

The purpose of this study is to determine whether the combination of naltrexone SR and bupropion SR is safe and effective in the treatment of obesity.

Read the detailed description

Two Phase II clinical trials demonstrated that a combination of bupropion SR and naltrexone is associated with greater weight loss than naltrexone alone, bupropion SR alone or placebo in subjects with uncomplicated obesity. The current study investigated the safety and efficacy of the combination of naltrexone SR and bupropion SR compared to placebo in obese subjects with uncomplicated obesity and in those with overweight/obesity and hypertension and/or dyslipidemia.

Conditions
Obesity, Overweight
Being tested
Naltrexone SR 32 mg/bupropion SR 360 mg/day, Placebo, Ancillary therapy
Keywords
Obesity
Medical subject headings
Obesity, Overweight

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Naltrexone SR 32 mg/bupropion SR 360 mg/dayDrug

    Also called NB32

  • PlaceboDrug

  • Ancillary therapyBehavioural

    Ancillary therapy consisting of diet instruction, advice on behavior modification, and exercise counseling

Study groups in NCT00567255
Study groupRoleWhat they receive
NB32ExperimentalNaltrexone SR 32 mg/bupropion SR 360 mg/day with ancillary therapy
Receives: Drug: Naltrexone SR 32 mg/bupropion SR 360 mg/day; Behavioral: Ancillary therapy
PlaceboPlacebo comparatorPlacebo with ancillary therapy
Receives: Drug: Placebo; Behavioral: Ancillary therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Co-primary: Body Weight- Mean Percent Change From Baseline to Week 28

    Measured: Baseline, 28 weeks

  2. Co-primary: Body Weight- Proportion of Subjects With ≥5% Decrease From Baseline to Week 28

    Measured: Baseline, 28 weeks

Secondary outcomes (18)
  1. Body Weight- Mean Percent Change From Baseline to Week 56

    Beginning at Week 28 through Week 44, NB32-treated subjects who failed to achieve or maintain at least 5% body weight loss from baseline were re-randomized (1:1 ratio) to continue NB32 or begin treatment with a higher dose of naltrexone SR - naltrexone SR 48 mg/bupropion SR 360 mg (referred to as NB48) (daily dose of bupropion SR was 360 mg for NB32 and NB48).The analysis of NB32 vs. placebo at Week 56 was completed using a weighted analysis. This analysis was referred to as the weighted LOCF analysis.

    Subjects treated with NB32 who were re-randomized to NB48 were not included. Subjects re-randomized to NB32 were double-weighted and subjects who were not re-randomized were single-weighted. Subjects in the placebo group were single-weighted. The double weighting analysis restored the influence of poor performers at Weeks 28 to 44 in the NB32 group without including any data from the higher dose group (NB48).

    Measured: Baseline, 56 weeks

  2. Body Weight- Proportion of Subjects With ≥5% Decrease From Baseline to Week 56

    Beginning at Week 28 through Week 44, NB32-treated subjects who failed to achieve or maintain at least 5% body weight loss from baseline were re-randomized (1:1 ratio) to continue NB32 or begin treatment with a higher dose of naltrexone SR - naltrexone SR 48 mg/bupropion SR 360 mg (referred to as NB48) (daily dose of bupropion SR was 360 mg for NB32 and NB48).The analysis of NB32 vs. placebo at Week 56 was completed using a weighted analysis. This analysis was referred to as the weighted LOCF analysis.

    Subjects treated with NB32 who were re-randomized to NB48 were not included. Subjects re-randomized to NB32 were double-weighted and subjects who were not re-randomized were single-weighted. Subjects in the placebo group were single-weighted. The double weighting analysis restored the influence of poor performers at Weeks 28 to 44 in the NB32 group without including any data from the higher dose group (NB48).

    Measured: Baseline, 56 weeks

  3. Body Weight- Proportion of Subjects With ≥10% Decrease From Baseline to Week 28

    Measured: Baseline, 28 weeks

  4. Change in Waist Circumference

    Measured: Baseline, 28 weeks

  5. Change in Fasting HDL Cholesterol Levels

    Measured: Baseline, 28 weeks

  6. Change in Fasting Triglycerides Levels, Using Log-transformed Data

    Measured: Baseline, 28 weeks

  7. Change in IWQOL-Lite Total Scores

    IWQOL-Lite= Impact of Weight on Quality of Life-Lite Questionnaire Total score is based on a scale from 0 to 100, with 0 representing the poorest and 100 the best quality of life and where a score of 71-79 indicates moderate impairment

    Measured: Baseline, 28 weeks

  8. Change in High-sensitivity C Reactive Protein (Hs-CRP) Levels, Using Log-transformed Data

    Measured: Baseline, 28 weeks

  9. Change in Fasting Insulin Levels, Using Log-transformed Data

    Measured: Baseline, 28 weeks

  10. Change in Fasting Blood Glucose Levels

    Measured: Baseline, 28 weeks

  11. Change in HOMA-IR Levels, Using Log-transformed Data

    HOMA-IR= Homeostasis Model Assessment-Insulin Resistance

    Measured: Baseline, 28 weeks

  12. Change in Question 19 From 21-Item COE (Control of Eating) Questionnaire

    Question 19: Generally, how difficult has it been to control your eating? Scoring: 0=not at all difficult; 100=extremely difficult

    Measured: Baseline, 28 weeks

  13. Change in Fasting LDL Cholesterol Levels

    Measured: Baseline, 28 weeks

  14. Change in Systolic Blood Pressure

    Measured: Baseline, 28 weeks

  15. Change in Diastolic Blood Pressure

    Measured: Baseline, 28 weeks

  16. Change in IDS-SR Total Score

    IDS-SR= Inventory of Depressive Symptoms-Subject Rated IDS-SR total score is based on 30 items. The total score can range from 0-84, with 0 being no depressive symptoms and 84 being very severe depressive symptoms. A total score ≤ 13 indicates no depression.

    Measured: Baseline, 28 weeks

  17. Change in Food Craving Inventory Sweets Subscale Score

    The Food Craving Inventory is a 33-item self-report measure designed to assess specific food cravings and is organized into 4 subscales (high fats, sweets, carbohydrates/starches, and fast-food fats). A craving was defined as an intense desire to consume a particular food (or food type) that was difficult to resist over the past month. Subjects rated their frequency of cravings for each of the 33 items using a 5-point scale, where 1=never, 2=rarely, 3=sometimes, 4=often, and 5=always. The sweets subscale consisted of 8 items and the score ranges from 8 (better outcome) to 40 (worse outcome).

    Measured: Baseline, 28 weeks

  18. Change in Food Craving Inventory Carbohydrates Subscale Score

    The Food Craving Inventory is a 33-item self-report measure designed to assess specific food cravings and is organized into 4 subscales (high fats, sweets, carbohydrates/starches, and fast-food fats). A craving was defined as an intense desire to consume a particular food (or food type) that was difficult to resist over the past month. Subjects rated their frequency of cravings for each of the 33 items using a 5-point scale, where 1=never, 2=rarely, 3=sometimes, 4=often, and 5=always. The carbohydrates subscale consisted of 8 items and the score ranges from 8 (better outcome) to 40 (worse outcome).

    Measured: Baseline, 28 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Dec 2007 (estimated)
  2. Study startDec 2007
  3. Primary completionJun 2009
  4. Study completionJun 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
1,496 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00567255
Sponsor's protocol ID
NB-303
Other IDs
COR-II
Status last verified
Nov 2014
First submitted
30 Nov 2007
Last updated
21 Nov 2014
Data monitoring committee
Yes

Publications

  • Apovian CM, Aronne L, Rubino D, Still C, Wyatt H, Burns C, Kim D, Dunayevich E; COR-II Study Group. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity (Silver Spring). 2013 May;21(5):935-43. doi: 10.1002/oby.20309.

    PubMed 23408728

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Naltrexone SR 32 mg/bupropion SR 360 mg/day and Ancillary therapy in people with Obesity and Overweight, run by Orexigen Therapeutics, Inc at 36 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 18 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Nov 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 36 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Nov 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Co-primary: Body Weight- Mean Percent Change From Baseline to Week 28 (time frame: Baseline, 28 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00567255, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Nov 2014.

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