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MalnutritionPhase 1CanPanNCT05503147

Sativex® and Gentamicin for Optimized Pharmagological Treatment in Older Patients (CanPan)

A Phase 1 study testing Sativex in people with Malnutrition and Anorexia, run by Ove Andersen at 1 site in Denmark.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Malnutrition and inappropriate prescribing of renally excreted drugs are common among older persons and are associated with severe consequences such as complicated courses of treatment, mortality, and reduced quality of life. Read more about this study

Who is it for?
Ages 65 years and older
Conditions the study is for
Malnutrition, Anorexia, Cannabis
What is being tested?
Sativex
Could I receive a placebo?
No, everyone receives an active treatment
How many people
17 participants
Where
1 siteDenmark
Study dates
24 Mar 2022to 1 Sep 2023
Phase
Phase 1
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 65 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • ≥65 years of age
  • Admitted to the acute medical department, Hvidovre Hospital
  • Can cooperate cognitively and physically (patient reported)
  • Low appetite/anorexia of ageing measures by SNAQ score ≤14
  • BMI ≤30 (screening)
  • Able to read and understand Danish
  • Postmenopausal defined as missed periods for at least 12 months before the start of the trial

Who cannot join

  • Regular use of medical cannabis (patient reported)
  • Use of medical cannabis within 14 days at baseline (patient reported)
  • Recognized or suspected psychotic illness in the subject or the subjects family (medical record and patient report)
  • Severe personality disorders (journal)
  • Significant psychiatric disorder in addition to mild to moderate depression (medical record)
  • Allergy to the ingredients of Sativex®, placebo and Hexamycin® (patient reported)
Show all 26Show fewer
  • Terminal diagnosis (journal)
  • Liver transplant (journal)
  • Chronic eGFR ≤15 mL / min2 or dialysis treatment (medical record)
  • High risk of nephrotoxicity due to existing drug treatment (medical assessment)
  • Pacemaker (journal)
  • Epilepsy (journal)
  • Recurrent seizures (journal)
  • Uncontrolled hypertension (journal)
  • Food intolerance to the ingredients in the test meals (patient-reported)
  • Vegetarian and vegan (patient-reported)
  • Unwilling to avoid driving for up to 72 hours after administration of Sativex® (patient-reported)
  • Unwilling to avoid alcohol 24 hours up to test days (patient-reported)
  • Patients with ascites ( journal)
  • Patients with significant edema on the days of the trial (journal / visual inspection)
  • In active treatment of cancer or have disseminated cancer (journal)
  • Known with brain - or kidney tumor (journal)
  • Known with angina pectoris or intermittent claudication
  • Known with stroke, AMI, or heart failure (NYHA III-IV) within the past 5 years (journal)
  • In isolation
  • Obs. Covid-19

Trial locations and contacts

1 site in 1 country.

Denmark1 site, 1 recruiting
  • Clinical Research Centre

    Hvidovre, 2650

    Ove Andersen, MSc, PhD, 004538623335, ove.andersen@regionh.dk

    Linda Andresen, MBA, 004538623322, linda.camilla.andresen@regionh.dk

    Recruiting

Other trials in Denmark

About this study

Official title: A Pharmacological Trial With Sativex® and Gentamicin for Optimized Phamacological Treatment of Older Patients With Focus on Appetite Stimulation and Renal Risk Drugs

Malnutrition and inappropriate prescribing of renally excreted drugs are common among older persons and are associated with severe consequences such as complicated courses of treatment, mortality, and reduced quality of life. The overall purpose of CanPan is to optimize treatment of older persons with malnutrition with a focus on appetite stimulation and optimized prescribing of renal risk drugs.

The CanPan trial consists of two sub-studies. Substudy 1 will provide knowledge on appetite and appetite stimulation and together, sub study 1 and 2 will offer unique knowledge on how body composition, renal function and biomarkers of organ function influence pharmacokinetics for a highly lipophilic (Sativex®) and hydrophilic (Hexamycin®) drug in older medical patients with malnutrition.

Read the detailed description

The CanPan trial consists of sub study 1 and sub study 2. Subjects who meet all the inclusion criteria and none of the exclusion criteria are invited to participate in both sub studies. Sub study 1 consist of trial days 1 and 2 and sub study 2 consists of trial day 3.

Sub study 1:

Sub study 1 is a double-blinded, randomized, placebo-controlled, multidose, crossover trial that evaluates the appetite stimulating effect as well as the pharmacokinetics of Sativex®. The primary purpose of sub study 1 is to 1) uncover whether Sativex® has appetite stimulating properties defined as increased energy intake compared to placebo, 2) to develop a pharmacokinetic-pharmacodynamic model, and gain knowledge about the effect of Sativex® on other markers of appetite, the intraocular pressure of the eye and safety parameters.

In sub study 1, subjects receive both Sativex® and placebo. Both Sativex® and placebo are administered as an oromucosal spray. Sativex consists of 2.7 mg tetrahydrocannabinol (THC) and 2.5 mg cannabidiol (CBD) per dose of spray (Cannabis sativa L. extract, cannabis leaf and flower). Subjects receive three dose of spray two times during a trial day. Trial day 1 is planned <14 days after inclusion and there is a 2-week break between trial days 1 and 2 due to a wash-out period. Follow-up visits/phonecalls are made on days 1, 2 and 7 after trial days 1 and 2.

Sub study 2:

Sub-study 2 is a single-dose pharmacokinetic study using gentamicin (Hexamycin®) as a renally excreted model drug. The purpose of sub study 2 is to compare the prediction accuracy of clearance estimates between eGFRpanel (creatinine-cystatinC-beta-2_microglobulin-beta_trace_protein, eGFRcomb (creatinine-cystatinC), eGFRcreatinine (creatinine), uCrCl (24-hour urine creatinine clearance) and mGFR (measured GFR) as covariates in population based pharmacokinetic modeling of gentamicin.

On trial day 3, gentamicin is used as the model substance for a drug that is excreted > 90% renally. Gentamicin is administered as a single dose of 5 mg/kg as an intravenous injection (bolus). The marketed drug, Hexamycin® (40 mg / mL), is used for this purpose. Trial day 3 is held within 4 weeks after trial day 2. Follow-up visits are made on day 1 and 2 after trial day 3.

Being tested
Sativex
Medical subject headings
Malnutrition, Anorexia, Marijuana Abuse, Emergencies

What participants receive

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

  • SativexDrug

    Also called nabiximols

    Sativex® is administered as an oromucosal spray and consists of 2.7 mg tetrahydrocannabinol (THC) and 2.5 mg cannabidiol (CBD) per dosis spray (Cannabis sativa L. extract, cannabis leaf and flower). The dose (3 sprays) is administered twice, at breakfast and lunch, respectively, with approximately 4 hours between each administration.

Study groups in NCT05503147
Study groupRoleWhat they receive
Sativex first (blinded) (3 dose of spray)ExperimentalTrial day 1: Sativex (3 dose of spray x 2) Trial day 2: Placebo (3 dose of spray x 2) Trial day 3: Voluntary
Receives: Drug: Sativex
Placebo first (blinded) (3 dose of spray)ExperimentalTrial day 1: Placebo (3 dose of spray x 2) Trial day 2: Sativex (3 dose of spray x 2) Trial day 3: Voluntary
Receives: Drug: Sativex

What is being measured

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

  1. Difference in energy intake (kJ) between Sativex® and placebo

    Measured at test meal

    Measured: Trial days 1 and 2.

  2. Differences in the objective function value of the population-based pharmacokinetic model when implementing renal clearance assessed by measured GFR (mL/min), or GFR estimates based on different endogenous markers, as covariates on gentamicin clearance

    The objective function value (minus two times the log-likelihood) describes the prediction accuracy (goodness-of-fit) of a population pharmacokinetic model. A drop in the objective function value of 6.63 in a model with one (1) added covariate implemented on any specific parameter compared to a base model corresponds to a significant improvement in model fit with a p-value of 0.01 in a chi-squared test.

    Population-based pharmacokinetic modelling is an analysis method performed on pharmacokinetic data, i.e., plasma concentrations over time. Relevant pharmacokinetic parameters are estimated simultaneously by fitting the data to the model. The model structure is found through the analysis and determines which pharmacokinetic parameters are estimated. As a minimum, the clearance and distribution volume of the central compartment are estimated

    Measured: Trial day 3.

Secondary outcomes (14)
  1. Differences in the objective function values of the population-based models of CBD and THC when implementing bodyweight, age, and body composition factors as covariates on the pharmacokinetic parameters of the model (e.g., clearance)

    The objective function value (minus two times the log-likelihood) describes the prediction accuracy (goodness-of-fit) of a population pharmacokinetic model. A drop in the objective function value of 6.63 in a model with one (1) added covariate implemented on any specific parameter compared to a base model corresponds to a significant improvement in model fit with a p-value of 0.01 in a chi-squared test.

    Population-based pharmacokinetic-pharmacodynamic modelling is an analysis method performed on pharmacokinetic data, i.e. plasma concentrations over time, coupled to pharmacodynamic data. Relevant pharmacokinetic and -dynamic parameters are estimated simultaneously by fitting the data to the model. The model structure is found through the analysis and determines which pharmacokinetic and -dynamic parameters are estimated. As a minimum, the clearance and distribution volume of the central compartment are estimated

    Measured: Trial days 1 and 2.

  2. Difference in subjective appetite between Sativex® and placebo

    Using combined subjective appetite scores measured using 100-mm Visual Analogue Scales (VAS), with 0.0 as the minimum value and 10.0 as the maximum value. The following will be used to calculate a combined appetite score: [desire to eat + hunger + prospective food consumption + (10.0 - fullness) + (10.0 - satiety)], with higher scores indicating better appetite.

    Measured: Trial days 1 and 2.

  3. Differences in the appetite hormones, total ghrelin and glucagon like peptide 1 (GLP-1) between Sativex® and placebo

    The appetite hormones (total ghrelin, GLP-1) is measured from blood samples

    Measured: Trial days 1 and 2.

  4. Change in the intraocular pressure of the eye between Sativex® and placebo

    Measured by Icare ic100 tanometer

    Measured: Trial days 1 and 2.

  5. Safety parameter (CNS effects) for Sativex®

    Measured using 100-mm Visual Analogue Scales (VAS), with 0.0 as the minimum value and 10.0 as the maximum value. Higher scores indicate a larger effect.

    Measured: Trial days 1 and 2.

  6. Safety parameter (cognition) for Sativex®

    Measured using Hopkins Verbal Learning Test-Revised for a total score of the following sub-tests: 'Total recall', 'Delayed recall', 'Retention' and 'Recognition'. Higher scores indicate better performance.

    Measured: Trial days 1 and 2.

  7. Safety parameter (balance disorders) for Sativex®

    Bergs Balance Test is used to measure balance disorders. Balance disorders are defined as a summerated score of ≤45.

    Measured: Trial days 1 and 2.

  8. Safety parameter (blood pressure) for Sativex®

    Blood pressure is measured in millimeter of mercury (mmHg) using automatic standardized equipment.

    Measured: Trial days 1 and 2.

  9. Safety parameter (heart rate) for Sativex®

    Heart rate is measured in beats per minute (bpm) using automatic standardized equipment.

    Measured: Trial days 1 and 2.

  10. Correlation coefficient between clearance of gentamicin and clearance determined as mGFR or eGFR

    Pharmacokinetic modeling

    Measured: Trial day 3.

  11. Change in plasma creatinine µmol/L between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkeres before and after administration of gentamicin

    Measured: Trial day 3

  12. Change in plasma cystatin C mg/L between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkers before and after administration of gentamicin

    Measured: Trial day 3

  13. Change in plasma NGAL ng/mL between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkers before and after administration of gentamicin

    Measured: Trial day 3

  14. Change in plasma KIM-1 pg/mL between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkers before and after administration of gentamicin

    Measured: Trial day 3

Timeline

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

  1. First posted16 Aug 2022
  2. Study start24 Mar 2022
  3. Primary completion1 Aug 2023 (estimated)
  4. Study completion1 Sep 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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
17 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05503147
Sponsor's protocol ID
H-21044231
Acronym
CanPan
Status last verified
Sep 2022
First submitted
13 Apr 2022
Last updated
21 Sep 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Bornaes O, Nielsen RL, Christensen LWS, Storgaard IK, Kallemose T, Juul-Larsen HG, Tavenier J, Jawad B, Andersen O, Holst JJ, Hartmann B, Andersen AL, Poulsen I, Sonne DP, Houlind MB, Pedersen MM. Effects of Sativex(R) Versus Placebo on Glucagon-like Peptide-1, Total Ghrelin, and Subjective Appetite in Older Adults with Poor Appetite: A Protocolized Secondary Analysis of a Double-Blind, Randomized, Placebo-Controlled Crossover Trial. Nutrients. 2026 Jul 11;18(14):2274. doi: 10.3390/nu18142274.

    PubMed 42514343
  • Nielsen RL, Bornaes O, Christensen LWS, Juul-Larsen HG, Storgaard IK, Kallemose T, Jorgensen LM, Jawad BN, Altintas I, Lund TM, Rasmussen HH, Munk T, Andersen O, Houlind MB, Andersen AL. The appetite stimulating effect and safety of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in older patients with poor appetite: A triple-blinded, randomized, placebo-controlled, cross-over trial. Clin Nutr. 2025 Apr;47:248-257. doi: 10.1016/j.clnu.2025.02.024. Epub 2025 Feb 24.

    PubMed 40069983

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Sativex in people with Malnutrition and Anorexia, run by Ove Andersen at 1 site in Denmark.

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 7 inclusion and 26 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 21 Sep 2022. 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 Denmark. 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?

Results are not available in the source record.

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

Contact Olivia Bornæs (+4538623184, olivia.bornaes@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference in energy intake (kJ) between Sativex® and placebo (time frame: Trial days 1 and 2.). 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 NCT05503147, which also lists 2 linked publications.

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 Sep 2022.

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