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Alcohol Use DisorderPhase 2NCT06471686

Safety of Acamprosate in Treating Alcohol Use Disorder in the Post Liver Transplant Populations

A Phase 2 study testing Acamprosate in people with Alcohol Use Disorder and Liver Transplant; Complications, run by University of Southern California 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
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Trial summary

Acamprosate for alcohol use disorder may benefit liver transplant (LT) recipients with alcohol-associated liver disease (ALD), yet data on feasibility and safety in LT recipients are lacking. Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
Acamprosate
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited States
Study dates
1 Dec 2021to 30 Oct 2023
Phase
Phase 2
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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • >18 years of age
  • must have received a transplant for liver disease secondary to alcohol-associated hepatitis or alcohol-associated cirrhosis
  • greater than 24 hours of abstinence.

Who cannot join

  • patients with hypersensitivity to acamprosate calcium or any of its components
  • severe renal impairment (creatinine clearance ≤30 mL/min)
  • substance dependence other than THC, alcohol, or nicotine
  • need for inpatient detoxification or inpatient treatment of alcohol use
  • participation in a clinical trial within the past 60 days
  • women of childbearing potential without a medically acceptable form of contraception

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Southern California

    Los Angeles, California, 90033

Other trials in United States

About this study

Acamprosate for alcohol use disorder may benefit liver transplant (LT) recipients with alcohol-associated liver disease (ALD), yet data on feasibility and safety in LT recipients are lacking. This was a single-center unblinded randomized controlled trial of adults (≥18 years) with LT for ALD enrolled between 2021-2023 who were randomized 2:1 to the intervention of acamprosate (666mg dose three time daily) or standard of care (SOC) for 14 weeks. The primary outcome was safety [prevalence of adverse events (AE)]. Secondary outcomes included feasibility (weekly survey response rate >60%), adherence (self reported acamprosate use>60%), and efficacy (reduction in Penn Alcohol Craving Scale [PACS]) and relapse). Relapse was defined as blood phosphatidylethanol≥20ng/mL or reported alcohol use. All analyses were done in the intention to treat (ITT) population and per-protocol population (PPP) (excluding withdrawals/acamprosate non-adherent).

Read the detailed description

Acamprosate for alcohol use disorder may benefit liver transplant (LT) recipients with alcohol-associated liver disease (ALD), yet data on feasibility and safety in LT recipients are lacking.

This was a single-center unblinded randomized controlled trial of adults (≥18 years) with LT for ALD enrolled between 2021-2023 who were randomized 2:1 to the intervention of acamprosate (666mg dose three time daily) or standard of care (SOC) for 14 weeks. The primary outcome was safety [prevalence of adverse events (AE)]. Secondary outcomes included feasibility (weekly survey response rate >60%), adherence (self reported acamprosate use>60%), and efficacy (reduction in Penn Alcohol Craving Scale [PACS]) and relapse). Relapse was defined as blood phosphatidylethanol≥20ng/mL or reported alcohol use. All analyses were done in the intention to treat (ITT) population and per-protocol population (PPP) (excluding withdrawals/acamprosate non-adherent).

Being tested
Acamprosate
Medical subject headings
Alcoholism

What participants receive

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

  • AcamprosateDrug

    Also called acamprosate pills

    2 pills three times a day

Study groups in NCT06471686
Study groupRoleWhat they receive
AcamprosateExperimentalThe intervention group was assigned to acamprosate 666 mg oral tablets three times daily in addition to routine medical care for 14 weeks. Once assigned to this group, participants underwent a medication reconciliation with a transplant pharmacist to ensure there were no drug-drug interactions and answer questions regarding the medication. The medication prescription was then sent by the principal investigator (HH) to the patient preferred pharmacy. The research assistants (KL and JA) would confirm that the medication was obtained. They then underwent weekly telemedicine visits with a research member for 14 weeks and filled out self-report surveys to evaluate cravings, alcohol use, and side effects
Receives: Drug: Acamprosate
Standard of CareNo interventionThe control group continued with what was considered routine medical care as indicated by their medical condition including frequency of clinic visits (ranging from 1-6 months dependent on time from transplant), frequency of laboratory draws (ranging from twice monthly to biannually dependent on time from transplant), and adjustment of LT related medications (i.e. immunosuppression and prophylaxis against communicable disease). They also underwent weekly telemedicine visits with a research member for 14 weeks and filled out self-report surveys to evaluate cravings, alcohol use, and side effects

What is being measured

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

  1. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]

    prevalence of adverse events (AE) by common toxicity criteria

    Measured: 14 weeks

  2. Incidence of Treatment-Emergent Liver Test Changes

    prevalence of liver test abnormalities [aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin

    Measured: 14 weeks

Secondary outcomes (4)
  1. Proportion of participants with weekly survey response rate >60%

    Feasibility was defined as a response rate >60% to weekly surveys in both treatment groups

    Measured: 14 weeks

  2. Rate of acamprosate usage> 60%

    Adherence to acamprosate was measured via self-reported total milligrams of acamprosate taken weekly. Participants were deemed adherent to acamprosate to if they utilized it as prescribed for ≥60% of weeks (9 of 14 weeks).

    Measured: 14 weeks

  3. Change in alcohol cravings

    Cravings were assessed using the validated survey Penn Alcohol Craving Scale . This is a 5 item Likert scale to measure cravings to drink alcohol within the past week with total scores ranging from 0-30. PACS scores were summarized in 4-week increments with the highest PACS score within +/- 2 weeks reported when missing at the specific time point. The median change in baseline PACS score was utilized in the analysis.

    Measured: 14 weeks

  4. change in alcohol use

    Alcohol use was assessed using a modified Timeline Followback (TFLB) which is a calendar-based method to examine variability, pattern, and extent of drinking using dates to enhance recall within the past 90 days prior to enrollment at baseline and then weekly thereafter until completion of the study. number of standard alcohol drinks per day were calculated based upon the above data.

    Measured: 14 weeks

Timeline

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

  1. First posted24 Jun 2024
  2. Study start1 Dec 2021
  3. Primary completion30 Jul 2023
  4. Study completion30 Oct 2023

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06471686
Sponsor's protocol ID
HS-19-00991
Status last verified
Jun 2024
First submitted
10 Jun 2024
Last updated
27 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Cholankeril G, Ahmed A. Alcoholic Liver Disease Replaces Hepatitis C Virus Infection as the Leading Indication for Liver Transplantation in the United States. Clin Gastroenterol Hepatol. 2018 Aug;16(8):1356-1358. doi: 10.1016/j.cgh.2017.11.045. Epub 2017 Dec 1. No abstract available.

    PubMed 29199144
  • Ilyas F, Ali H, Patel P, Basuli D, Giammarino A, Satapathy SK. Rising alcohol-associated liver disease-related mortality rates in the United States from 1999 to 2022. Hepatol Commun. 2023 Jun 14;7(7):e00180. doi: 10.1097/HC9.0000000000000180. eCollection 2023 Jul 1.

    PubMed 37314743
  • Cotter TG, Sandikci B, Paul S, Gampa A, Wang J, Te H, Pillai A, Reddy KG, di Sabato D, Little EC, Sundaram V, Fung J, Lucey MR, Charlton M. Liver transplantation for alcoholic hepatitis in the United States: Excellent outcomes with profound temporal and geographic variation in frequency. Am J Transplant. 2021 Mar;21(3):1039-1055. doi: 10.1111/ajt.16143. Epub 2020 Aug 13.

    PubMed 32531107
  • Heyes CM, Schofield T, Gribble R, Day CA, Haber PS. Reluctance to Accept Alcohol Treatment by Alcoholic Liver Disease Transplant Patients: A Qualitative Study. Transplant Direct. 2016 Sep 7;2(10):e104. doi: 10.1097/TXD.0000000000000617. eCollection 2016 Oct.

    PubMed 27795986
  • DiMartini A, Dew MA, Day N, Fitzgerald MG, Jones BL, deVera ME, Fontes P. Trajectories of alcohol consumption following liver transplantation. Am J Transplant. 2010 Oct;10(10):2305-12. doi: 10.1111/j.1600-6143.2010.03232.x. Epub 2010 Aug 19.

    PubMed 20726963
  • Yoo ER, Cholankeril G, Ahmed A. Treating Alcohol Use Disorder in Chronic Liver Disease. Clin Liver Dis (Hoboken). 2020 Mar 26;15(2):77-80. doi: 10.1002/cld.881. eCollection 2020 Feb.

    PubMed 32226621
  • Rabiee A, Mahmud N, Falker C, Garcia-Tsao G, Taddei T, Kaplan DE. Medications for alcohol use disorder improve survival in patients with hazardous drinking and alcohol-associated cirrhosis. Hepatol Commun. 2023 Mar 24;7(4):e0093. doi: 10.1097/HC9.0000000000000093. eCollection 2023 Apr 1.

    PubMed 36972386
  • Ayyala D, Bottyan T, Tien C, Pimienta M, Yoo J, Stager K, Gonzalez JL, Stolz A, Dodge JL, Terrault NA, Han H. Naltrexone for alcohol use disorder: Hepatic safety in patients with and without liver disease. Hepatol Commun. 2022 Dec;6(12):3433-3442. doi: 10.1002/hep4.2080. Epub 2022 Oct 25.

    PubMed 36281979
  • Weinrieb RM, Van Horn DH, McLellan AT, Alterman AI, Calarco JS, O'Brien CP, Lucey MR. Alcoholism treatment after liver transplantation: lessons learned from a clinical trial that failed. Psychosomatics. 2001 Mar-Apr;42(2):110-6. doi: 10.1176/appi.psy.42.2.110.

    PubMed 11239123
  • Rogal S, Youk A, Zhang H, Gellad WF, Fine MJ, Good CB, Chartier M, DiMartini A, Morgan T, Bataller R, Kraemer KL. Impact of Alcohol Use Disorder Treatment on Clinical Outcomes Among Patients With Cirrhosis. Hepatology. 2020 Jun;71(6):2080-2092. doi: 10.1002/hep.31042. Epub 2020 May 22.

    PubMed 31758811
  • Im GY, Mellinger JL, Winters A, Aby ES, Lominadze Z, Rice J, Lucey MR, Arab JP, Goel A, Jophlin LL, Sherman CB, Parker R, Chen PH, Devuni D, Sidhu S, Dunn W, Szabo G, Singal AK, Shah VH. Provider Attitudes and Practices for Alcohol Screening, Treatment, and Education in Patients With Liver Disease: A Survey From the American Association for the Study of Liver Diseases Alcohol-Associated Liver Disease Special Interest Group. Clin Gastroenterol Hepatol. 2021 Nov;19(11):2407-2416.e8. doi: 10.1016/j.cgh.2020.10.026. Epub 2020 Oct 16.

    PubMed 33069880
  • Flannery BA, Volpicelli JR, Pettinati HM. Psychometric properties of the Penn Alcohol Craving Scale. Alcohol Clin Exp Res. 1999 Aug;23(8):1289-95.

    PubMed 10470970
  • Rief W, Barsky AJ, Glombiewski JA, Nestoriuc Y, Glaesmer H, Braehler E. Assessing general side effects in clinical trials: reference data from the general population. Pharmacoepidemiol Drug Saf. 2011 Apr;20(4):405-15. doi: 10.1002/pds.2067. Epub 2010 Nov 8.

    PubMed 21442687
  • Robinson SM, Sobell LC, Sobell MB, Leo GI. Reliability of the Timeline Followback for cocaine, cannabis, and cigarette use. Psychol Addict Behav. 2014 Mar;28(1):154-62. doi: 10.1037/a0030992. Epub 2012 Dec 31.

    PubMed 23276315
  • Ayyala-Somayajula D, Bottyan T, Shaikh S, Lee BP, Cho SH, Dodge JL, Terrault NA, Han H. Safety of acamprosate for alcohol use disorder after liver transplant: A pilot randomized controlled trial. Liver Transpl. 2025 Apr 1;31(4):498-507. doi: 10.1097/LVT.0000000000000475. Epub 2024 Sep 3.

    PubMed 39225670

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Acamprosate in people with Alcohol Use Disorder and Liver Transplant; Complications, run by University of Southern California 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 6 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 27 Jun 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] (time frame: 14 weeks). 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 NCT06471686, which also lists 15 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 27 Jun 2024.

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