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Methadone ToxicityNCT05981573

Assessment of Methadone Dose Taken

An observational study of Methadone Toxicity and Methadone Overdose, run by Cari Health Inc. at 1 site in United States.

Recruiting

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

Sites and contacts
Official record
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Trial summary

Proof of concept: Pilot Study A Pilot, proof of concept, observational study with a long-term goal to develop a minimally invasive wearable Remote Medication Monitor (RMM) that provides continuous, real-time data on methadone levels in interstitial fluid (ISF). Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo, Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo and ISF Extraction Device 2
Type of treatment
Medical device
How many people
30 participants
Where
1 siteUnited States
Study dates
26 Aug 2024to Apr 2026
Phase
Observational
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 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Chronic pain patients that have been prescribed at least 10mg of methadone per day.

Who may be able to join

  • Age 18-70
  • A prescription for methadone for chronic pain at a dose of 10mg or more for at least one week.
  • Taking methadone as prescribed during the last 4 days before consent to participate in the study.

Who cannot join

  • Age <18 or >70
  • A condition preventing or complicating ISF collection
  • dermatological (skin) condition
  • immunodeficiency
  • recent blood donation
  • anemia
Show all 19Show fewer
  • end stage renal disease
  • liver cirrhosis
  • cancer
  • congestive heart failure
  • bleeding diathesis
  • tuberculosis (TB)
  • Any active severe depression
  • suicidal ideation
  • mania symptoms
  • Pregnancy
  • Intending to become pregnant during the course of the study
  • Enrolled in a substance use disorder treatment program
  • Under a conservatorship.

Trial locations and contacts

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

Foster P Carr, MD contact

6192343725

drcarr@carihealth.com

Torsten Feibig, PhD contact

torsten@carihealth.com

United States1 site, 1 recruiting
  • Synergy

    Lemon Grove, California, 91945

    Woody Woodman

    Ryan Woodman

    Recruiting

Other trials in United States

About this study

Proof of concept: Pilot Study

A Pilot, proof of concept, observational study with a long-term goal to develop a minimally invasive wearable Remote Medication Monitor (RMM) that provides continuous, real-time data on methadone levels in interstitial fluid (ISF). An RMM could be used as a medication adherence monitor and would allow for the physician, counselor, patient, or family member to remotely verify that a physician-prescribed dose has been taken.

Read the detailed description

The investigator will conduct a non-randomized, non-blinded, feasibility study at a single center in the United States. The study will include up to 20 subjects of an equal number of male and female adults (ages 18-70) who have a prescription for methadone for chronic pain. In Aim 1, the investigator will determine if an RMM can assess the status of taking a prescribed dose of methadone, using biosamples (i.e., ISF, blood) collected from subjects and tested in a laboratory setup. Biosample collections and pharmacokinetic monitoring will take up to 6 consecutive hours. By completing this aim, the investigator will determine if a physician is able to recognize the peak and trough of a methadone dose using ex vivo Continuous Monitor.

In Aim 2, the investigator will determine if an RMM can continuously assess the status of taking a prescribed dose of methadone over time, by inserting the intradermal microneedle sensing elements into the subjects' skin. Biosample collections (i.e., ISF, blood) and pharmacokinetic monitoring will occur over a 6-hour period. By completing this aim, the investigator will determine if a physician is able to recognize the pharmacokinetic profile of a taken dose of methadone. The physician will see a dosing curve display generated from intradermal microneedle sensing elements that are worn continuously on the skin. Completion of Aims 1-2 will require two separate visits.

Being tested
Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo, Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo, ISF Extraction Device 2
Keywords
Pharmacokinetics
Medical subject headings
Chronic Pain, Drug Metabolism, Poor, CYP2D6-Related

What participants receive

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

  • Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivoDiagnostic test

    Also called dose taken peak-trough test

    Measurement of Methadone and its metabolites in interstitial fluid with Liquid Chromatography - Mass Spectroscopy (LC-MS) and Aptamer based Assay

  • Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivoDrug

    Also called In vivo Continuous molecular monitoring

    Measurement of Methadone and its metabolites in ISF with LC-MS and RMM

  • ISF Extraction Device 2Device

    Also called Ascilion

    Up to 15 minute periods of continuous ISF collection for analysis

Study groups in NCT05981573
Study groupRoleWhat they receive
Visit 2AIM 2 : Determine if an RMM can assess the status of taking a prescribed dose of methadone. To complete this aim, the peak and trough concentrations of a witnessed methadone dose will be assessed in ISF collected through the surface of the skin using existing ISF extraction methods and assessed outside the body via Lateral Flow Immunoassay for up to 6 hours. Methadone metabolites and protein binding factors may be assessed in the collected ISF samples using (LC-MS). We hypothesize that the methadone peak and trough levels as well as the metabolites in the blood samples will correlate with the levels of methadone in ISF. The Investigators hypothesize that the methadone peak and trough levels as well as the metabolites in the blood samples will correlate with the levels of methadone in ISF.
Receives: Diagnostic Test: Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo; Drug: Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo; Device: ISF Extraction Device 2
Visit 3AIM 3: Determine if an RMM can continuously assess the status of taking a prescribed dose of methadone over time. To complete this aim, the pharmacokinetic profile of a witnessed methadone dose will be assessed in ISF continuously from the surface of the skin using the RMM for up to 12 hours (Aim 3a) and over 3 days (Aim 3b). Methadone metabolites will also be assessed over these three time points in the continuously collected ISF samples using LC-MS. The Investigators hypothesize that a clinician can recognize a dose taken and the methadone metabolites from the RMM generated measurements in the ISF.
Receives: Diagnostic Test: Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo; Drug: Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo; Device: ISF Extraction Device 2
Visit 1Aim 1: Characterize dermal interstitial fluid (ISF) in healthy adults with Liquid Chromatography-Mass Spectroscopy (LC-MS) based proteomics. To complete this aim, the dermal interstitial fluid will be extracted from the surface of the skin of healthy adults over a period up to 3 hours. The participants may also have continuous monitoring of their interstitial fluid using the RMM. We hypothesize that the protein content of ISF will be 50% the level of normal human serum levels and contain potential protein biomarkers of disease status.
Receives: Device: ISF Extraction Device 2

What is being measured

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

  1. LC-MS based Proteome analysis of dermal interstitial fluid in non opioid use disordered patients

    Measure the dermal interstitial fluid proteome using LC-MS in subjects without opioid use disorder

    Measured: 1 day

  2. Methadone Concentration in ISF before and after a dose

    measure dermal interstitial fluid with LC-MS for methadone before and after a daily dose

    Measured: 1 day

  3. Methadone Concentration in blood before and after a dose

    measure blood for methadone with LC-MS before and after a daily dose

    Measured: 1 day

  4. Concentration of Methadone in ISF with LC-MS versus Electrochemical Assay

    measure ISF with two procedures (Liquid Chromatography - Mass Spectroscopy and Differential Pulse Voltammetry.

    Measured: 2 days

  5. Concentration of Methadone in blood with LC-MS versus Electrochemical Assay

    measure blood with two procedures (Liquid Chromatography - Mass Spectroscopy and Differential Pulse Voltammetry.

    Measured: 2 days

  6. Pearson Correlation of Methadone between ISF and Blood

    measure blood and ISF methadone with LC-MS and determine pearson correlation

    Measured: 2 days

  7. Pearson Correlation between DPV and LC-MS ISF Methadone

    measure ISF for methadone by LC-MS and DPV and determine Pearson correlation

    Measured: 2 days

  8. Pearson Correlation between DPV and LC-MS ISF EDDP

    measure ISF for EDDP by LC-MS and DPV and determine Pearson correlation

    Measured: 2 days

  9. Pearson Correlation between DPV and LC-MS blood EDDP

    measure blood for EDDP by LC-MS and DPV and determine Pearson correlation

    Measured: 2 days

  10. EDDP concentration in ISF before and after daily dose of methadone

    measure ISF for EDDP by LC-MS before and after daily dose of methadone

    Measured: 1 day

  11. EDDP concentration in blood before and after daily dose of methadone

    measure blood for EDDP by LC-MS before and after daily dose of methadone

    Measured: 1 day

  12. EMDP concentration in ISF before and after daily dose of methadone

    measure EMDP in ISF before and after daily dose of methadone

    Measured: 1 day

  13. EMDP concentration in blood before and after daily dose of methadone

    measure EMDP in blood by LC-MS before and after daily dose of methadone

    Measured: 1 day

  14. Pearson Correlation of Methadone to Metabolite Ratio ( MMR ) between ISF and Blood using LC-MS

    Calculate methadone to EDDP ratio of ISF and Blood and determine Pearson Correlation using LC-MS

    Measured: 2 days

  15. Pearson Correlation of Methadone to Metabolite Ratio ( MMR ) between ISF and Blood using DPV

    Calculate methadone to EDDP ratio of ISF and Blood and determine Pearson Correlation using DPV

    Measured: 2 days

Timeline

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

  1. First posted8 Aug 2023
  2. Study start26 Aug 2024
  3. Primary completionMar 2026 (estimated)
  4. Study completionApr 2026 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05981573
Sponsor's protocol ID
1358643
Status last verified
Feb 2025
First submitted
28 Jul 2023
Last updated
13 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Friedel M, Werbovetz B, Drexelius A, Watkins Z, Bali A, Plaxco KW, Heikenfeld J. Continuous molecular monitoring of human dermal interstitial fluid with microneedle-enabled electrochemical aptamer sensors. Lab Chip. 2023 Jul 12;23(14):3289-3299. doi: 10.1039/d3lc00210a.

    PubMed 37395135
  • Gomes NO, Raymundo-Pereira PA. On-Site Therapeutic Drug Monitoring of Paracetamol Analgesic in Non-Invasively Collected Saliva for Personalized Medicine. Small. 2023 Mar;19(12):e2206753. doi: 10.1002/smll.202206753. Epub 2023 Jan 15.

    PubMed 36642790
  • Ribet F, Bendes A, Fredolini C, Dobielewski M, Bottcher M, Beck O, Schwenk JM, Stemme G, Roxhed N. Microneedle Patch for Painless Intradermal Collection of Interstitial Fluid Enabling Multianalyte Measurement of Small Molecules, SARS-CoV-2 Antibodies, and Protein Profiling. Adv Healthc Mater. 2023 May;12(13):e2202564. doi: 10.1002/adhm.202202564. Epub 2023 Feb 21.

    PubMed 36748807

Questions about this trial

What is this clinical trial studying?

An observational study of Methadone Toxicity and Methadone Overdose, run by Cari Health Inc. 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 3 inclusion and 19 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 13 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 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.

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 Foster P Carr, MD (6192343725, drcarr@carihealth.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

LC-MS based Proteome analysis of dermal interstitial fluid in non opioid use disordered patients (time frame: 1 day). The study lists 15 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 NCT05981573, which also lists 3 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 13 Feb 2025.

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