AzTrials
AzTrials

Tobacco Use DisorderPhase 1NCT04055467

Brain Imaging in Tobacco Smokers During a Quit Attempt

A Phase 1 study testing [F18]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6-[18F]fluorodibenzo[b,d]thiophene 5,5-dioxide) and Contingency Management in people with Tobacco Use Disorder and Tobacco Smoking, run by Johns Hopkins University at 1 site 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 proposed study will help fill gaps in existing research by determining if nicotine-dependent cigarette smokers show changes in α7 nicotinic acetylcholine receptor (nAChR) availability when compared to matched historical controls using positron emission tomography (PET) imaging and the radioactive ligand [18F]-ASEM… Read more about this study

Who is it for?
Ages 21 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Tobacco Use Disorder, Tobacco Smoking
What is being tested?
[F18]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6-[18F]fluorodibenzo[b,d]thiophene 5,5-dioxide) and Contingency Management
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
1 siteUnited States
Study dates
16 Dec 2019to 30 Nov 2022
Phase
Phase 1
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 21 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Subjects must be healthy volunteers
  • Regular tobacco smokers for a period of 2 or more years
  • Positive breath carbon monoxide (CO)
  • Cotinine positive urine test
  • Meet DSM-V criteria for tobacco use disorder.

Who cannot join

  • Meets DSM-5 criteria for alcohol use disorder or substance use disorder (excluding tobacco use disorder)
  • Meets DSM-5 Psychiatric Disorder; in or in need of treatment
  • History of seizures, seizure disorder or closed head trauma
  • HIV positive
  • Weight > 350 lbs
  • < 5th grade reading level
Show all 10Show fewer
  • Recent use of smoking cessation products
  • If female: pregnant, lactating, planning pregnancy; positive urine pregnancy screen
  • Any condition which would preclude MRI
  • Radiation exposure in the last year that when combined with the study protocol would exceed the annual limits.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Elise Weerts

    Baltimore, Maryland, 21224

Other trials in United States

About this study

Official title: Brain Imaging of Nicotinic Acetylcholine Receptors in Tobacco Users and Nonusers

The proposed study will help fill gaps in existing research by determining if nicotine-dependent cigarette smokers show changes in α7 nicotinic acetylcholine receptor (nAChR) availability when compared to matched historical controls using positron emission tomography (PET) imaging and the radioactive ligand [18F]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6 [18F]fluorodibenzo[b,d]thiophene 5,5-dioxide), an α7 nAChR antagonist. The study will also explore whether α7 nAChR availability influences clinically relevant measures of tobacco abstinence (e.g., withdrawal and craving, cognitive impairment), self-reported cigarettes per day, and time to relapse during an 8-day quit attempt during which smokers can receive escalating payments contingent upon providing objective evidence (breath CO and urinary cotinine) of smoking abstinence.

Read the detailed description

The primary objective of this basic clinical research study is to examine the role of the alpha7-nicotinic acetylcholine receptors (nAChRs) in tobacco use disorder. nAChRs are the primary site of action for nicotine (the main psychoactive component of tobacco). The most common types of nAChRs are heteromeric nAChRs containing beta2 subunits and homomeric nAChRs, which contain only alpha7 subunits. It is currently unknown if or how chronic tobacco use affects alpha7 nAChR in humans. The investigators' working hypothesis is brain alpha7 nAChR density associated with chronic nicotine exposure and the development of tobacco use disorder may be influence severity of tobacco craving and withdrawal during early smoking abstinence.

Proposed group sample sizes are 18 tobacco smokers (accrual) and 18 nonsmokers (drawn from historical and contemporary controls in ongoing studies). Media-recruited male and female heavy smokers will be assessed for study inclusion/exclusion criteria using a structured diagnostic interview and a standard battery of instruments, as well as a medical exam to determine general health. Study candidates also provide breath and urine samples to determine biomarkers of tobacco use (breath carbon oxide and urinary cotinine levels), other drug use (breath alcohol and urine toxicology) and for females a pregnancy test. To ensure there are a sufficient number of subjects, 60 subjects will be screened for study eligibility and assessed for matching criteria (age, race and sex). Groups (smokers vs. non-smokers) will include equal numbers of males and females. In addition, male and female smokers will be matched for tobacco use disorder severity using symptom counts (DSM 5).

Eligible subjects will be enrolled in an outpatient protocol completed at the Behavioral Pharmacology Research Unit (BPRU) at the Johns Hopkins Bayview Medical Center, and at the Johns Hopkins Hospital (JHH) PET imaging Center. Abstinent smokers (as verified by CO and cotinine, see below) will complete an magnetic resonance imaging (MRI) scan and a PET scan with the alpha-7 nAChR radiotracer [18F]-ASEM. Matched historical controls will have completed the MRI and PET scans previously.

Tobacco users will receive contingency management incentive payments for verified smoking abstinence (Intervention 2, behavioral counseling). Smokers will continue in the study after the PET scan and complete an 8-day practice quit attempt. To evaluate smoking abstinence and lapse behavior, smokers will be asked to complete study six visits with a practice quit attempt. Smoker will receive the incentive intervention for smoking abstinence. At each visit, smokers will provide carbon monoxide (CO) and urine samples, and complete assessment instruments to self-report on daily symptoms of nicotine withdrawal and craving, and number of cigarettes smoked. The incentive intervention is a validated, established intervention for smoking cessation. At each visit, smokers will receive escalating incentive payments contingent upon provision of samples that meet study defined abstinence criteria. The incentive earning schedule starts at $9 on day 1 of abstinence and increases by $1.50 for each day of verified abstinence to $19.50 on day 8. To boost the incentive for abstinence, provision of samples that meet bonus abstinence (cotinine <100 ng/ml day 8) results additional $10 or $20 bonus payments. The incentive earnings schedule includes allowance for a slip, and a reset contingency to allow smokers to retry the quit attempt and complete the study. This incentive earnings schedule with resets is of high magnitude to reinforce abstinence, and increase participant retainment. The number of days in the quit attempt (8) yields a sufficient sample to examine both withdrawal and biomarkers (CO and cotinine) to quantify number of days in which use of any nicotine occurred vs. days participants were compliant in maintaining abstinence. These data will be utilized to explore the relationship of alpha7-nAChR availability to these clinically meaningful measures of tobacco use and abstinence.

Being tested
[F18]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6-[18F]fluorodibenzo[b,d]thiophene 5,5-dioxide), Contingency Management
Keywords
smoking cessation, neuroimaging, nicotinic acetylcholine receptors, abstinence
Medical subject headings
Tobacco Use Disorder, Tobacco Smoking, Smoking Cessation

What participants receive

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

  • [F18]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6-[18F]fluorodibenzo[b,d]thiophene 5,5-dioxide)Drug

    Also called [F18]-ASEM

    Brain imaging of alpha-7 nicotinic acetylcholine receptors

  • Contingency ManagementBehavioural

    Also called Incentive payments

    Incentive payments contingent upon provision of samples that meet criterion levels of exhaled carbon oxide and urinary cotinine at study visits

Study groups in NCT04055467
Study groupRoleWhat they receive
[F18]-ASEM + Contingency ManagementOtherPET radiopharmaceutical 3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6 [18F]fluorodibenzo[b,d]thiophene 5,5-dioxide with incentive payments.
Receives: Drug: [F18]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6-[18F]fluorodibenzo[b,d]thiophene 5,5-dioxide); Behavioral: Contingency Management

What is being measured

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

  1. Distribution Volume (VT) as Determined by [18F]-ASEM PET Scan

    Distribution volume (VT) in volumes of interest (VOI) in tobacco smokers. VOI are cingulate, hippocampus, frontal cortex, amygdala, and ventral striatum. VOI are defined via each individual subject's Magnetic Resonance Imaging for anatomical identification of the VOI for alignment with PET images.

    Measured: 1 day

  2. Total Withdrawal Score on the Minnesota Nicotine Withdrawal Scale (MNWS) on Day of PET Scan

    Self-report form has a 15-item list of symptoms where subjects self-rate symptom severity on a scale of 0-4. Validated symptoms for tobacco withdrawal in smokers will be used for the study to quantify total withdrawal symptoms at baseline (smoking as usual), when compared to symptoms on the day of the PET scan. Scores for each item range from 0-4, with 0 representing no symptoms and 4 representing severe withdrawal symptoms. The score range for validated symptoms is 0-36. Higher scores indicate greater nicotine withdrawal severity. Results reported are scores from day of PET scan.

    Measured: 1 day

  3. Craving/Urge to Smoke as Determined Via the Questionnaire of Subjective Urges (QSU) on Day of PET Scan

    The QSU is a 10-item questionnaire to measure craving/urges to smoke. For each item, subjects rate how strongly the subject feel "right now" on a Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). Items are summed to yield two factor scores, Factor 1 Intention/desire to smoke (minimum score=5, maximum score=35), and Factor 2: Relief of negative affect and Urgent desire to smoke (minimum score=5, maximum score=35). Factor 1 and Factor 2 scores are combined, with a score range of 10-70, higher score indicating maximum cravings/urges to smoke (worse). Results reported reflect QSU scores on day of PET scan vs baseline.

    Measured: 1 day

Secondary outcomes (5)
  1. Cigarettes Smoked Per Day

    Self-reported number of cigarettes smoked daily using a calendar-based time line method for past 90-days (i.e., time line follow back method) when smoking as usual. Average number of daily cigarettes smoked calculated using past 90 days (3 months).

    Measured: 3 months

  2. Number of Days of Smoking Abstinence on Day of PET Scan

    Number of days abstinent (collected on day of PET scan) will be determined from counting number of CO-and cotinine-verified abstinence days. Abstinence will be defined as negative breath carbon oxide (CO)6ppm or lower AND urinary cotinine decreased by 25 percent from prior sample or <100 ng/ml.

    Measured: 1 day

  3. Negative Mood as Determined by the Positive and Negative Affect Scale (PANAS)

    Consists of two 10-item mood scales to provide independent measures of positive and negative affect. Scores for negative affect subscale when smoking as usual, will be compared to days of CO and/or cotinine verified abstinence. Negative Affect Score: Add the scores on items 2, 4, 6, 7, 8, 11, 13, 15, 18, and 20. Scores can range from 0 - 40, with lower scores representing lower levels of negative affect.

    Measured: Baseline, Day of PET

  4. Attention as Assessed by Connors Continuous Performance Task

    In this computerized task, a stimuli are presented, and subjects are instructed to respond as fast as possible to a specific target stimuli (X) and refrain from responding to more rarely occurring non-target stimuli (non-X). Inattention is indicated by high numbers of omissions and long reaction times. Omissions result from the failure to respond to target letters (i.e., non-Xs); omissions and reaction times when smoking as usual will be compared to those on visits 1-6 during the quit attempt abstinence days. Higher score for detectability represents worse sustained attention. Score range 0 to 100 with higher score being worse.

    Measured: Baseline, Day of PET

  5. Performance on the Paced Serial Addition Task (PASAT)

    The number of correct responses for each trial of the Paced Serial Addition Task (PASAT); Involves presenting a series of single digit numbers where the two most recent digits must be summed. The participant must respond prior to the presentation of the next digit for a response to be scored as correct. Minimum score is 0 and maximum score is 120, with a lower number representing lower levels of sustained attention.The number of correct responses for each trial (maximum = 60). Data reported are the total (sum) correct responses for 2 trials.

    Measured: Baseline, Day of PET

Timeline

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

  1. First posted13 Aug 2019
  2. Study start16 Dec 2019
  3. Primary completion30 Oct 2022
  4. Study completion30 Nov 2022

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 1
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
15 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04055467
Sponsor's protocol ID
IRB00173536
Other IDs
1R21DA047795-01A1
Status last verified
Jul 2024
First submitted
12 Aug 2019
Last updated
6 Aug 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing [F18]-ASEM (3-(1,4-diazabicyclo[3.2.2]nonan-4-yl)-6-[18F]fluorodibenzo[b,d]thiophene 5,5-dioxide) and Contingency Management in people with Tobacco Use Disorder and Tobacco Smoking, run by Johns Hopkins University at 1 site 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 5 inclusion and 10 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 6 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 6 Aug 2024). 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?

Distribution Volume (VT) as Determined by [18F]-ASEM PET Scan (time frame: 1 day). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 6 Aug 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in