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ObesityPhase 4COR-WRNCT04587843

A Trial Evaluating the Effectiveness of Contrave in Patients Who Have Weight Recidivism Following Bariatric Surgery

A Phase 4 study testing Contrave 8Mg-90Mg Extended-Release Tablet in people with Obesity, run by St. Joseph's Healthcare Hamilton at 4 sites in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Contrave (naltrexone HCl and bupropion HCl) extended-release tablet is an approved drug and indicated to be used with a low calorie diet and increased physical activity for chronic weight management in obese adults (BMI 30 Kg/m2 or greater) or overweight adults (BMI 27 Kg/m2 or greater) with at least one weight… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Obesity
What is being tested?
Contrave 8Mg-90Mg Extended-Release Tablet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
18 participants
Where
4 sitesCanada
Study dates
1 Apr 2021to 31 Dec 2023
Phase
Phase 4
Are there results?
None posted in the registry

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

  • >=18 years of age
  • prior primary roux en-y gastric bypass (RYGB) or sleeve gastrectomy (SG) at a surgical Center of Excellence within the Ontario Bariatric Network (OBN)
  • inadequate weight loss or significant weight regain based on the OBN criteria13, defined as one of the following:
  • < 10% total body weight (TBW) loss at 6 months or;
  • < 20% TBW loss at 12 months or;
  • Weight regain of > 25% of weight loss.
  • body Mass Index (BMI) of ≥ 30 Kg/m2 or ≥ 27 Kg/m2 and the presence of at least one weight related co-morbidity
  • able and willing to provide signed informed consent

Who cannot join

  • pregnancy, planned pregnancy in the next 18 months and or breastfeeding
  • does not agree to use highly effective method of birth control if a woman of child bearing potential, for the duration of the study
  • revisional bariatric procedure or duodenal switch
  • simultaneous or planned use of other weight loss medication (e.g. Saxenda / Orlistat) or meal replacement products (e.g. Optifast)
  • uncontrolled hypertension, severe hepatic impairment, end-stage renal disease, end stage cardiac disease
  • myocardial infarction or stroke within 6 months prior to consent
Show all 20Show fewer
  • renal impairment defined as eGFR < 60
  • seizure disorder or a history of seizures or following conditions that may predispose subjects to risk of seizure: history of head trauma, arteriovenous malformation, central nervous system tumor or infection, or a metabolic disorder that in opinion of the investigator may contraindicate treatment with Contrave and increase risk of seizure (e.g. hypoglycemia, hyponatremia)
  • lifetime history of a suicide attempt or history of any suicidal behavior within the past month before entry into the trial
  • history of major depressive disorder or a PHQ-9 (Patient Health Questionnaire-9) score of more than 15 within the last 2 years or history of other severe psychiatric disorders
  • use of other bupropion-containing products (including, but not limited to, Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban), because the incidence of seizure is dose dependent
  • current or prior diagnosis of bulimia or anorexia nervosa, because of a higher incidence of seizures
  • chronic opioid or opiate agonist (eg, methadone) or partial agonists (eg, buprenorphine) use, or acute opiate withdrawal
  • excessive use of alcohol or sedatives, addiction to cocaine or stimulants (street drugs), or withdrawal from sedatives
  • patients undergoing an abrupt discontinuation of alcohol, benzodiazepines or other sedatives and antiepileptic drugs
  • concomitant administration of monoamine oxidase inhibitors (MAOI). At least 14 days should elapse between discontinuation of a MAOI and initiation of treatment with Contrave
  • concomitant administration of the antipsychotic thioridazine, since bupropion may inhibit thioridazine metabolism, thus causing an increase in thioridazine levels and a potential increased risk of thioridazine-related serious ventricular arrythmias and sudden death
  • known hypersensitivity (or known allergic reaction) to the investigational product(s) or any of its ingredients including lactose
  • current participation in another interventional clinical trial
  • not able to complete subject reported, self administered questionnaires or cannot fully understand all instructions in English

Trial locations and contacts

4 sites in 1 country.

Canada4 sites
  • Guelph General Hospital

    Guelph, Ontario, N1E 4J4

  • St Joseph's Healthcare Hamilton

    Hamilton, Ontario, L8N 3K7

  • Kingston Health Sciences Centre

    Kingston, Ontario, K7L 2V7

  • Humber River Hospital

    North York, Ontario, M3M 0B2

Other trials in Canada

About this study

Official title: A Randomized Controlled Trial Evaluating the Effectiveness of Contrave (Naltrexone HCl and Bupropion HCl) in Patients Who Have Weight Recidivism Following Bariatric Surgery: Contrave Obesity Trials (COR) Weight Regain Study

Contrave (naltrexone HCl and bupropion HCl) extended-release tablet is an approved drug and indicated to be used with a low calorie diet and increased physical activity for chronic weight management in obese adults (BMI 30 Kg/m2 or greater) or overweight adults (BMI 27 Kg/m2 or greater) with at least one weight related condition such as hypertension or diabetes. It is unknown how many or which medical treatments for weight loss, such as Contrave work in the subjects who have had bariatric surgery.

The purpose of this study is to explore the effectiveness of Contrave combined with usual care (dietary and behaviour counselling) compared to placebo with usual care, in patients who have inadequate weight loss or significant weight regain following bariatric surgery.

Read the detailed description

Obesity is associated with increased mortality and morbidity and represents a worldwide epidemic that is increasing in prevalence and remains a significant problem in Canada and a burden on our healthcare system. Maintaining long-term weight loss is the "Achilles' heel" of obesity therapy. Treatment for obesity with surgery is increasing because it has been shown to produce the best results for long-term weight loss and improving obesity related risk factors and diseases. But, these benefits are often reduced by inadequate weight loss or by weight regain in many patients after surgery.

Contrave (naltrexone HCl and bupropion HCl) extended-release tablet is an approved drug and indicated to be used with a low calorie diet and increased physical activity for chronic weight management in obese adults (BMI 30 Kg/m2 or greater) or overweight adults (BMI 27 Kg/m2 or greater) with at least one weight related condition such as hypertension or diabetes. It is unknown how many or which medical treatments for weight loss, such as Contrave work in the subjects who have had bariatric surgery.

This is a 1 year, phase 4, prospective, randomized, double-blind, placebo controlled study that will be conducted across multiple Bariatric Centres of Excellence (BCoE) in Ontario. Consenting participants will be randomly assigned to receive Contrave with usual care (dietary and behaviour counselling) or placebo with usual care. All subjects will also continue to receive usual care. The study includes several follow up visits to assess safety and treatment effects, some in person and others by telephone or video conferencing. Body weight, blood pressure, heart rate, waist circumference, lab tests, and subject completed questionnaires will be collected as part of usual care or for the study. Changes in medications and any possible side effects will also be monitored during the study.

To qualify, men and women must have had prior bariatric surgery (roux en-y gastric bypass or sleeve gastrectomy) at a surgical Center of Excellence within the Ontario Bariatric Network, and have inadequate weight loss or significant weight regain, based on the following OBN criteria:

  1. < 10% total body weight (TBW) loss at 6 months or;
  2. < 20% TBW loss at 12 months or;
  3. Weight regain of > 25% of weight loss.

The aim of this study is to explore the effectiveness of Contrave combined with usual care (dietary and behaviour counselling) compared to placebo with usual care, in patients who have inadequate weight loss or significant weight regain following bariatric surgery.

Conditions
Obesity
Being tested
Contrave 8Mg-90Mg Extended-Release Tablet, Placebo
Keywords
weight recidivism, weight regain, inadequate weight loss
Medical subject headings
Obesity

What participants receive

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

  • Contrave 8Mg-90Mg Extended-Release TabletDrug

    Also called naltrexone HCl/bupropion HCl

    Each Contrave Extended Release Tablet contains 8Mg of naltrexone HCl and 90Mg of bupropion HCl and will be administered orally. Total daily dose is 32Mg / 360Mg.

    Participants randomized to the treatment arm will be administered 4 Contrave tablets a day for 1 year (2 tablets taken twice a day).

  • PlaceboDrug

    Also called Inactive

    Placebo tablets will be administered orally. Participants randomized to the control arm will be administered 4 placebo tablets a day for 1 year (2 tablets, taken twice a day).

Study groups in NCT04587843
Study groupRoleWhat they receive
Contrave 8mg/90mg Extended Release TabletExperimentalGroup treated with Contrave Extended Release Tablets
Receives: Drug: Contrave 8Mg-90Mg Extended-Release Tablet
PlaceboPlacebo comparatorGroup given placebo
Receives: Drug: Placebo

What is being measured

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

  1. Change in absolute weight (Kg)

    To determine the weight loss effect of Contrave with usual care compared to placebo with usual care, in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  2. Proportion of participants achieving 5 percent total weight loss

    To determine the weight loss effect of Contrave with usual care compared to placebo with usual care, in a post-bariatric surgery population with weight loss failure compared to a placebo with usual care.

    Measured: Baseline to 12 months

Secondary outcomes (18)
  1. Change in Body Mass Index (BMI) (Kg/m2)

    To further determine effect of Contrave compared to placebo on BMI in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  2. Percentage total body weight loss (percentage TBWL)

    To determine effect of Contrave compared to placebo on weight loss in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  3. Proportion of participants losing at least 10 percent baseline weight at 12 months

    To further determine effect of Contrave compared to placebo on body weight in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  4. Percent change in HbA1c level

    To determine the effect of Contrave compared to placebo on HbA1c levels (laboratory blood test) as a measure of diabetic control in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  5. Change in blood pressure

    To determine the effect of Contrave compared to placebo on blood pressure and hypertension in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  6. Change in lipid profile

    To determine the effect of Contrave compared to placebo on lipid profile (total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL)) in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  7. Changes in impulsivity behaviours from baseline as assessed by UPPS-P Impulsive Behaviour Scale (self administered questionnaire)

    To determine the effect of Contrave compared to placebo on impulsivity behaviours, in a post-bariatric surgery population with weight loss failure. Urgency, Premeditation (lack of), Perserverance (lack of), Sensation Seeking, Positive Urgency (UPPS-P Impulsive Behaviour Scale)

    Measured: Baseline to 12 months

  8. Changes in quality of life and health economic outcomes as measured with the EQ-5D-5L self administered questionnaire

    To determine the effect of Contrave compared to placebo on quality of life and health economic outcomes in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  9. Percentage of participants who are adherent to pharmacotherapy

    To determine the tolerability of Contrave compared to placebo, in a post behaviour modification program setting.

    Measured: Week 0 to Week 52

  10. Average number of days participants took investigational product (Contrave or placebo)

    To determine the tolerability of Contrave compared to placebo, in a post behaviour modification program setting.

    Measured: Week 0 to Week 52

  11. Change in diabetes medication requirements

    To determine the effect of Contrave compared to placebo on diabetic control in a post-bariatric surgery population with weight loss failure. If the patient is consuming diabetes medications, the diabetes medications will be documented during the study including any changes in medications, and any changes to dosing and frequency.

    Measured: Baseline to 12 months

  12. Change in hypertension (high blood pressure) medication requirements

    To determine the effect of Contrave compared to placebo on blood pressure and hypertension control in a post-bariatric surgery population with weight loss failure. If the patient is consuming medications for high blood pressure (hypertension), these medications will be documented during the study including any changes in medications, and any changes to dosing and frequency.

    Measured: Baseline to 12 months

  13. Change in lipid (cholesterol) medication requirements

    To determine the effect of Contrave compared to placebo on control of elevated total cholesterol, triglycerides and LDL with medication in a post-bariatric surgery population with weight loss failure. If the patient is consuming medications for elevated lipids (cholesterol, triglycerides LDL), these medications will be documented during the study including any changes in medications, and any changes to dosing and frequency.

    Measured: Baseline to 12 months

  14. Changes in eating behaviours from baseline as assessed by Eating Disorder Examination Questionnaire (EDE-Q 6.0) (self administered questionnaire)

    To determine the effect of Contrave compared to placebo on eating behaviours, in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  15. Changes in eating behaviours from baseline as assessed by Yale Food Addiction Scale (YFAS) (self administered questionnaire)

    To determine the effect of Contrave compared to placebo on eating behaviours, in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  16. Changes in food cravings from baseline as assessed by Favourite Food Craving Scale (FFCS) (self administered questionnaire)

    To determine the effect of Contrave compared to placebo on food cravings, in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  17. Changes in depression from baseline as assessed by Patient Health Questionnaire 9 (PHQ-9) (self administered questionnaire)

    To determine the effect of Contrave compared to placebo on depression and depressive problems, in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

  18. Changes in risk of suicidality from baseline as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS)

    To determine the effect of Contrave compared to placebo on risk of suicidality, in a post-bariatric surgery population with weight loss failure.

    Measured: Baseline to 12 months

Timeline

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

  1. First posted14 Oct 2020
  2. Study start1 Apr 2021
  3. Primary completion30 Dec 2023 (estimated)
  4. Study completion31 Dec 2023 (estimated)

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel, randomized, double blind, placebo controlled
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04587843
Sponsor's protocol ID
COR Weight Regain Study
Acronym
COR-WR
Status last verified
Aug 2023
First submitted
5 Oct 2020
Last updated
3 Aug 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Contrave 8Mg-90Mg Extended-Release Tablet in people with Obesity, run by St. Joseph's Healthcare Hamilton at 4 sites in Canada.

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 8 inclusion and 20 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: status not confirmed, as of the sponsor's last update on 3 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Canada. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Results are not available in the source record.

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?

Change in absolute weight (Kg) (time frame: Baseline to 12 months). 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?
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 3 Aug 2023.

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