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Behavioural AddictionPhase 3NABAbNCT05540288

NAlmefene Versus Placebo in Addition to Treatment as Usual on Craving in Behavioural Addictions

A Phase 3 study testing Nalmefene in people with Behavioural Addiction, run by Nantes University Hospital at 13 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Behavioural addictions (BAs) [gambling disorder (GD), food addiction (FA), sexual addiction (SA)] may lead to disastrous consequences. They are often associated with other addictive or psychiatric disorders, and high rates of suicide attempts. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Behavioural Addiction
What is being tested?
Nalmefene
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
266 participants
Where
13 sitesFrance
Study dates
31 Mar 2023to Jul 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Having presented at least one episode of craving with an intensity ≥ 4/10 at the NRS during the week prior to inclusion
  • Women must meet one of the following criteria at the time of inclusion:
  • use adequate contraceptive measures as recommended by the CTFG (Recommendations related to contraception and pregnancy testing in clinical trials v1.1), and have a negative pregnancy test (urine test) prior to receiving the first dose of study drug;
  • or be post-menopausal (over 50 years of age with amenorrhea for at least 12 months after discontinuation of all exogenous hormonal therapy)
  • or (if under 50 years of age) have been amenorrheic for at least 12 months after discontinuation of exogenous hormonal therapy and with luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels corresponding to post-menopausal levels
  • or have undergone irreversible surgical sterilization by hysterectomy, bilateral oophorectomy or bilateral salpingectomy (this operation must be documented).

Who cannot join

  • Being currently treated by another anti-craving drug that have been already tested for craving reduction in BAs (naltrexone, acamprosate, baclofène, topiramate, bupropion, N-acetyl-cystéine, disulfiram, etc.);
  • Presenting a contraindication for the use of nalmefene (listed in the SmPC):
  • Known hypersensitivity to the active substance or to any of the excipients. In particular, intolerance to galactose or deficiency in Lapp lactase or glucose-galactose malabsorption (rare hereditary diseases);
  • Treatment by opioid agonists (full or partial) (opioid pain relievers, opioid substitution drugs);
  • Recent history of opioid dependence or current opioid dependence;
  • Current symptoms of the acute opioid withdrawal syndrome;
Show all 22Show fewer
  • Suspected recent consumption of opioid (necessity to consider the half-life);
  • Severe hepatic impairment (Child-Pugh stage B or C);
  • Severe renal impairment (estimated glomerular filtration rate [TFGe] <30 mL/min/1.73 m2);
  • History of recent acute alcohol withdrawal syndrome (including hallucinations, convulsions and delirium tremens).
  • Predictable opioid treatment during the study period;
  • Unstable psychiatric disorders (meaning disorders for which the treatment was modified since less than a month (corresponding to the instauration of a new treatment, or the increase in dosage of a treatment already being taken)), including severe risk of suicide (i.e. necessity to engage specific medication or hospitalization; psychotropic medication engaged since less than 1 month; absence of improvement after one month of medication) (because nalmefene has not been studied in patients with unstable psychiatric disorders). Patients with a food addiction diagnosed with eating disorders marked by the presence of binge eating can be included;
  • Anorexia nervosa-restricting type (because food addiction concept is poorly established among patients with AN-R, who do not have binge eating episodes induced by craving);
  • Extreme leanness (body mass index < 16.5) (because loss of appetite and/or weight loss are frequent adverse effects of nalmefene);
  • Current treatment with potent inhibitor drugs of the UGT2B7 (UDP-Glucuronosyltransferase-2B7); for example: diclofenac, fluconazole, medroxyprogesterone acetate, meclofenamic acid;
  • Current treatment with UGT inducing drugs; for example: dexamethasone, phenobarbital, rifampicin, omeprazole;
  • Inability to indicate the time of day of the most intense craving episode (because this information will determine the time of day the treatment should be taken);
  • Pregnancy (attested by a pregnancy urinary test for women of childbearing age) or breastfeeding woman;
  • Trusteeship;
  • Major cognitive impairment;
  • Not fluent in French;
  • Participation to another interventional study during the last month or expected participation to another interventional study during participation to the NABAB study.

Trial locations and contacts

13 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Marie GRALL-BRONNEC contact

+33240847620

marie.bronnec@chu-nantes.fr

13 sites in 1 country

France13 sites, 13 recruiting
  • CHU de Besançon

    Besançon

    Julie GIUSTINIANI, jgiustiniani@chu-besancon.fr

    Julie GIUSTINIANI, Dr

    Not yet recruiting
  • CHU de Bordeaux

    Bordeaux, 33000

    Mélina FATSEAS-LOPEZ, melina.fatseas@chu-bordeaux.fr

    Mélina FATSEAS-LOPEZ

    Recruiting
  • CHRU de Brest

    Brest, 29200

    Morgane GUILLOU-LANDREAT, morgane.guillou@chu-brest.fr

    Morgane GUILLOU-LANDREAT

    Recruiting
  • CHU de Clermont Ferrand

    Clermont-Ferrand, 63000

    Georges BROUSSE, gbrousse@chu-clermontferrand.fr

    Georges BROUSSE

    Recruiting
  • CHU de Dijon

    Dijon, 21000

    Benoit TROJAK, Pr, +333.80.29.37.69, benoit.trojak@chu-dijon.fr

    Benoit TROJAK, Pr

    Not yet recruiting
  • CH de La Rochelle

    La Rochelle, 17000

    Patrick BENDIMERAD, patrick.bendimerad@ght-atlantique17.fr

    Patrick BENDIMERAD

    Recruiting
  • Hospices Civils de Lyon

    Lyon, 69000

    Véronique FONTEILLE, veronique.fonteille@chu-lyon.fr

    Véronique FONTEILLE

    Recruiting
  • CHU de Montpellier

    Montpellier, 34295

    Hélène DONNADIEU, Pr, +334.67.33.70.20, h-donnadieu@chu-montpellier.fr

    Hélène DONNADIEU, Pr

    Not yet recruiting
  • CHU de Nantes

    Nantes

    Marie GRALL-BRONNEC, marie.bronnec@chu-nantes.fr

    Marie GRALL-BRONNEC

    Recruiting
  • CHU de Nîmes

    Nîmes, 30000

    Amandine LUQUIENS, amandineluquiens@gmail.com

    Amandine LUQUIENS

    Recruiting
  • Hôpitaux Universitaires de Strasbourg

    Strasbourg, 67000

    Louis-Marie D'USSEL, louis-marie.dussel@chru-strasbourg.fr

    Louis-Marie D'USSEL

    Recruiting
  • CHRU de Tours

    Tours, 37000

    Paul BRUNAULT, paul.brunault@univ-tours.fr

    Paul BRUNAULT

    Recruiting
  • Hôpital Paul Brousse

    Villejuif, 94800

    Amine BENYAMINA, amine.benyamina@aphp.fr

    Amine BENYAMINA

    Recruiting

Other trials in France

About this study

Behavioural addictions (BAs) [gambling disorder (GD), food addiction (FA), sexual addiction (SA)] may lead to disastrous consequences. They are often associated with other addictive or psychiatric disorders, and high rates of suicide attempts. Epidemiological studies report prevalence reaching 2.7% for GD, 5% for SA, and up to 7.9% for FA.

Many similarities have been highlighted between BAs, as well as with substance use disorders. One core clinical similarity between those disorders is craving (uncontrollable urge to engage in rewarding behaviours), which has been consistently associated with diminished control over the behaviour and relapse.

Read more

At present, no pharmacological treatment has been approved for BAs, but several medications have been tested. Among them, two opioid receptor antagonists - naltrexone and nalmefene - appear the most promising. By decreasing dopamine neurotransmission in the reward circuitry, they reduce both excitement for rewarding behaviours and craving.

Compared to naltrexone, nalmefene seems to have a better safety. To date, no study investigated the efficacy of nalmefene as a pan-addiction treatment for BAs. Two clinical trials have demonstrated its efficacy for the treatment of GD, but no clinical trial was conducted for FA and SA.

The investigators hypothesise that nalmefene (36 mg/d), compared to a placebo, can have a therapeutic effect as an add-on to usual treatment for decreasing craving in several BAs.

Being tested
Nalmefene, Placebo
Keywords
Nalmefene, Craving, Behavioural addiction, Gambling disorder, Food addiction, Sexual addiction
Medical subject headings
Gambling, Food Addiction, Compulsive Sexual Behavior Disorder

What participants receive

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

  • NalmefeneDrug

    Week 1: 18 mg/d

    Week 2:

    1. In the absence of ARs or in the presence of grade 1 or 2 ARs, 36 mg/d
    2. In the presence of grade 3 ARs, 18 mg/d
    3. In the presence of grade 4 ARs, treatment will be stopped immediately.

    Week 3 to week 5:

    1. In case of acceptable safety profile at the 18mg/d dosage during week 2, the treatment will be maintained at the same dosage
    2. In the presence of sustained grade 3 ARs at the 18mg/d dosage during week 2, the treatment will be stopped.
    3. In case of acceptable safety profile at the 36mg/d dosage during week 2, the treatment will be maintained at the same dosage
    4. In the presence of grade 3 ARs at the 36mg/d dosage during week 2, the treatment dosage will be decreased at 18mg/d
    5. Whatever the dosage during week 2, in the presence of grade 4 ARs, the treatment will be stopped immediately.
  • PlaceboDrug

    Week 1: 1 tablet/d

    Week 2:

    1. In the absence of ARs or in the presence of grade 1 or 2 ARs, 2 tablets/d
    2. In the presence of grade 3 ARs, 1 tablet/d
    3. In the presence of grade 4 ARs, the treatment will be stopped immediately.

    Week 3 to week 5:

    1. In case of acceptable safety profile at the dosage of 1 tablet/d during week 2, the treatment will be maintained at the same dosage
    2. In the presence of sustained grade 3 ARs at the dosage of 1 tablet/d during week 2, the treatment will be stopped.
    3. In case of acceptable safety profile at the dosage of 2 tablets/d during week 2, the treatment will be maintained at the same dosage
    4. In the presence of grade 3 ARs at the dosage of 2 tablets/d during week 2, the treatment dosage will be decreased at 1 tablet/d
    5. Whatever the dosage during week 2, in the presence of grade 4 ARs, the treatment will be stopped immediately.
Study groups in NCT05540288
Study groupRoleWhat they receive
NalmefeneExperimentalNot described
Receives: Drug: Nalmefene
PlaceboPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

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

  1. Variation of averaged intensity of craving episodes between start and end of treatment.

    Variation of averaged intensity of craving episodes between start (during the week preceding initiation of treatment) and end (during the week preceding end of treatment) of treatment. Each craving episode will be reported by the patient on a weekly diary, with intensity assessed through a Numerical Rating Scale (NRS) form 0 to 10 (0=lowest intensity and 10= highest intensity).

    Measured: 5 weeks

Secondary outcomes (12)
  1. Variation of averaged weekly frequency (number of episodes) of craving episodes between start and end of treatment.

    Measured: 5 weeks

  2. Variation of averaged weekly duration (cumulative duration of all episodes) of craving episodes between start and end of treatment.

    Measured: 5 weeks

  3. Variation of averaged weekly intensity, frequency and duration of craving episodes between start of treatment and 4 weeks after the end of treatment.

    Measured: 9 weeks (5 weeks of treatment +4 weeks of follow up after treatment)

  4. Variation of averaged weekly frequency of the BA episodes: (i) between start and end of treatment and (ii) between start of treatment and 4 weeks after the end of treatment.

    Measured: 9 weeks

  5. Variation of averaged weekly duration of the BA episodes: (i) between start and end of treatment and (ii) between start of treatment and 4 weeks after the end of treatment.

    Measured: 9 weeks

  6. Variation of averaged weekly intensity of the BA episodes: (i) between start and end of treatment and (ii) between start of treatment and 4 weeks after the end of treatment.

    Assessed through a Numerical Rating Scale (NRS) form 0 (lowest intensity) to 10 (highest intensity)

    Measured: 9 weeks

  7. Overall clinical improvement, assessed though the Clinical Global Impression - Improvement (CGI-I) scale.

    Measured: 9 weeks

  8. Overall clinical improvement, assessed though the GGI - Efficacy Index (CGI-EI).

    Measured: 9 weeks

  9. Variation of averaged weekly use of psychoactive substances (including nicotine) and daily life behaviors of interest (gambling, sex, food) between start of treatment and 4 weeks after the end of treatment

    Measured: 9 weeks

  10. Number, type and severity of self-reported adverse side effects, during either weeks of treatment at a dosage of 18 mg/d or 36 mg/d.

    Measured: 9 weeks

  11. Mutation(s) associated with non-response to nalmefene treatment

    Measured: 9 weeks

  12. Sociodemographic, medical and clinical data, especially psychiatric and addictive co-morbidities assessed with the Mini International Neuropsychiatric Interview - Simplified (MINI-S) and the age of the BA

    Measured: 1 week

Timeline

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

  1. First posted14 Sep 2022
  2. Study start31 Mar 2023
  3. Primary completionJul 2027 (estimated)
  4. Study completionJul 2027 (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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
266 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05540288
Sponsor's protocol ID
RC21_0336
Acronym
NABAb
Status last verified
Feb 2025
First submitted
6 Sep 2022
Last updated
12 Feb 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Nalmefene in people with Behavioural Addiction, run by Nantes University Hospital at 13 sites in France.

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 6 inclusion and 22 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: looking for participants now, as of the sponsor's last update on 12 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in France. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Marie GRALL-BRONNEC (+33240847620, marie.bronnec@chu-nantes.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Variation of averaged intensity of craving episodes between start and end of treatment. (time frame: 5 weeks). 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 12 Feb 2025.

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