Computerized Chemosensory-Based Orbitofrontal Cortex (CBOT) for Opioid Use Disorder

NCT ID: NCT04850664

Last Updated: 2021-08-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

190 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-26

Study Completion Date

2022-12-31

Brief Summary

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Opioid Use Disorders (OUD) cause significant burden to individuals, families, and the society. Our product - Computerized Chemosensory-Based Orbitofrontal Cortex Training (CBOT) - offers a cost-saving, home-based, user-friendly brain stimulation system that increased 6-month treatment retention of OUDs in a pilot study; and also, acutely reduced opioid withdrawal severity and negative affect during induction into opioid maintenance therapy. This study will establish its effectiveness in a broad category of OUD subjects at different stages of OUD care continuum.

Detailed Description

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Evon Medics proposes to evaluate the effectiveness of Computerized Chemosensory-Based Orbitofrontal Cortex Training (CBOT), as an alternative strategy for relapse prevention in patients with Opioid Use (OUD) and other substance use disorders (SUD). This treatment leverages the overlap in brain regions that process smell and mediate decision making. The CBOT is portable and can be used at home. This clinical trial is being conducted to demonstrate its utility for home application by nontreatment seeking and treatment-seeking OUD populations, to engage in long-term, successful opioid recovery.

Key objectives of this project are to: (1) establish the effectiveness of CBOT for improved retention and relapse prevention in a large sample of OUD subjects; (2) establish its effectiveness for acute reduction of withdrawal severity and negative affect early in recovery; and (3) evaluate its safety, user-friendliness and acceptability. Accomplishment of these goals would lead to larger clinical trials for OUD and wider applications of CBOT in other addictive disorders.

Conditions

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Opioid Use Disorder, Moderate Opioid Use Disorder, Severe Withdrawal Symptoms Craving Negative Affectivity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Evon Medics will perform randomization of participants stratified by sex at site level. Site staff and participants will be blinded to treatment assignment.
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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CBOT + TAU

CBOT consists of 40 cycles of olfactory stimulation and OFC training tasks, lasting \~45 minutes, once daily over 3 months. Treatment-as-usual (TAU) is standard dosing of buprenorphine (BUP) to a median dose of 24 mg (range 16-32 mg).

Group Type EXPERIMENTAL

CBOT + TAU

Intervention Type DRUG

The CBOT with proprietary odorant molecules is designed to stimulate olfactory neural activity over long periods of time. It is paired with OFC-dependent cognitive tasks.

Sham + TAU

Sham is a CBOT device that uses artificially-scented compressed room air instead of olfactory stimulants and has no OFC cognitive tasks. Similar to the CBOT, sham will be used daily for 45 minutes. TAU is standard dosing of buprenorphine (BUP) to a median dose of 24 mg (range 16-32 mg).

Group Type SHAM_COMPARATOR

Sham + TAU

Intervention Type DRUG

Sham CBOT device uses artificially scented compressed room air instead of olfactory stimulants and has control cognitive tasks.

Interventions

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CBOT + TAU

The CBOT with proprietary odorant molecules is designed to stimulate olfactory neural activity over long periods of time. It is paired with OFC-dependent cognitive tasks.

Intervention Type DRUG

Sham + TAU

Sham CBOT device uses artificially scented compressed room air instead of olfactory stimulants and has control cognitive tasks.

Intervention Type DRUG

Other Intervention Names

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plant based essential oils

Eligibility Criteria

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Inclusion Criteria

* Age 18- 70years
* Diagnosis of current moderate or severe OUD in the past 6 months, including the past one month
* Willing to receive study interventions and buprenorphine during the study
* Do not meet criteria for current moderate or severe use of other substance use disorders (except nicotine use disorder)
* Diagnosis of Major Depressive Disorder, Anxiety disorders, and Post-traumatic Stress disorders will be included as long as the symptoms are stable, no suicidal ideas or plans and there are no recent changes in treatment of these conditions in the last 6 weeks prior to enrollment
* No intranasal disease
* Willing to participate by signing the informed consent form and
* Have a place to stay when receiving the intervention.

Exclusion Criteria

* Any significant neurologic disease such as stroke, dementia, meningitis, neurosyphilis, cerebral palsy, encephalitis, epilepsy or seizures
* Mental retardation
* Schizophrenia or bipolar disorders
* Experiencing current suicide ideas or plans
* Any unstable medical condition such as uncontrolled hypertension, uncontrolled diabetes, and liver cirrhosis, as determined by site PI
* History of severe traumatic nose injury that affects ability to smell, as determined by site PI
* Allergies or intolerance to aromas from plant essential oils (e.g. orange and lemon)
* Breastfeeding or Pregnancy test positive.
* On parole or probation mandated to receive treatment for OUD.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Howard University

OTHER

Sponsor Role collaborator

Family and Medical Counseling Service, Inc

UNKNOWN

Sponsor Role collaborator

Maryland Treatment Centers @ ARTC

UNKNOWN

Sponsor Role collaborator

Clinics of Dr. Edwin Chapman, MD, PC @ MHDG

UNKNOWN

Sponsor Role collaborator

Evon Medics LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Evaristus Awele Nwulia

Chief Scientific Officer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Evaristus A Nwulia, MD

Role: PRINCIPAL_INVESTIGATOR

Evon Medics LLC

Tanya Alim, MD

Role: PRINCIPAL_INVESTIGATOR

Howard University

Mark Johnson, MD

Role: PRINCIPAL_INVESTIGATOR

Howard University

Marc Fishman, MD

Role: PRINCIPAL_INVESTIGATOR

Maryland Treatment Centers

Michael Serlin, MD

Role: PRINCIPAL_INVESTIGATOR

Family and Medical Counseling Service, Inc

Edwin Chapman, MD

Role: PRINCIPAL_INVESTIGATOR

Clinics of Dr. Edwin C. Chapman, MD, PC @ MHDG

Locations

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Clinics of Dr. Edwin Chapman @ MHDG

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Family and Medical Counseling Service, Inc

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Howard University

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Maryland Treatment Centers @ Avery Road Treatment Center

Rockville, Maryland, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Evaristus A Nwulia, MD, MHS

Role: CONTACT

410-227-2005

Maria M Hipolito, MD

Role: CONTACT

571-241-2766

Facility Contacts

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Settles-Reaves

Role: primary

Adenuga

Role: backup

Serlin

Role: primary

Jackson

Role: backup

Rai

Role: primary

Hipolito

Role: backup

Wenzel

Role: primary

Machineni

Role: backup

References

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Jackson C, Rai N, McLean CK, Hipolito MMS, Hamilton FT, Kapetanovic S, Nwulia EA. Overlapping Risky Decision-Making and Olfactory Processing Ability in HIV-Infected Individuals. Clin Exp Psychol. 2017 Sep;3(3):160. doi: 10.4172/2471-2701.1000160. Epub 2017 Aug 15.

Reference Type BACKGROUND
PMID: 29057388 (View on PubMed)

Volkow ND, Fowler JS. Addiction, a disease of compulsion and drive: involvement of the orbitofrontal cortex. Cereb Cortex. 2000 Mar;10(3):318-25. doi: 10.1093/cercor/10.3.318.

Reference Type BACKGROUND
PMID: 10731226 (View on PubMed)

Lucantonio F, Takahashi YK, Hoffman AF, Chang CY, Bali-Chaudhary S, Shaham Y, Lupica CR, Schoenbaum G. Orbitofrontal activation restores insight lost after cocaine use. Nat Neurosci. 2014 Aug;17(8):1092-9. doi: 10.1038/nn.3763. Epub 2014 Jul 20.

Reference Type BACKGROUND
PMID: 25042581 (View on PubMed)

Temple DM. Isolation techniques for pharmacologically active substances (animal). Annu Rev Pharmacol. 1969;9:407-18. doi: 10.1146/annurev.pa.09.040169.002203. No abstract available.

Reference Type BACKGROUND
PMID: 4894805 (View on PubMed)

Hummel T, Rissom K, Reden J, Hahner A, Weidenbecher M, Huttenbrink KB. Effects of olfactory training in patients with olfactory loss. Laryngoscope. 2009 Mar;119(3):496-9. doi: 10.1002/lary.20101.

Reference Type BACKGROUND
PMID: 19235739 (View on PubMed)

Other Identifiers

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2R44DA049616-02

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CBOTDA049616

Identifier Type: -

Identifier Source: org_study_id

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