Pan African Clinical Trials Registry

South African Medical Research Council, South African Cochrane Centre
PO Box 19070, Tygerberg, 7505, South Africa
Telephone: +27 21 938 0506 / +27 21 938 0834 Fax: +27 21 938 0836
Email: pactradmin@mrc.ac.za Website: pactr.samrc.ac.za
Trial no.: PACTR202012739471223 Date of Approval: 18/12/2020
Trial Status: Registered in accordance with WHO and ICMJE standards
TRIAL DESCRIPTION
Public title TONIX PHASE II CLINICAL STUDY IN KENYA
Official scientific title A Phase 2, Double-Blind, Randomized, Multicenter, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Daily Bedtime TNX-102 SL in Participants with PTSD. (Protocol No. TNX-CY-P308)
Brief summary describing the background and objectives of the trial Post-traumatic stress disorder (PTSD) is a mental health illness that is triggered by exposure to potentially traumatic events, such as warfare, sexual assault, terrorist attack, being taken hostage or kidnapped, severe car accident, unexpected death of a loved one, or any other threat on a person's life [3, 4]. There are few medications used for treatment of PTSD. Most of these include selective serotonin reactive inhibitors among other drugs mainly used for depression and anxiety. It is important to continuously explore other potential medications in order to optimize the outcomes. Primary: To evaluate the efficacy of TNX-102 SL (cyclobenzaprine HCl sublingual tablets) in the treatment of posttraumatic stress disorder (PTSD) Secondary: To evaluate the safety of TNX-102 SL (cyclobenzaprine HCl sublingual tablets) in the treatment of PTSD
Type of trial RCT
Acronym (If the trial has an acronym then please provide)
Disease(s) or condition(s) being studied Mental and Behavioural Disorders
Sub-Disease(s) or condition(s) being studied
Purpose of the trial Treatment: Drugs
Anticipated trial start date 01/07/2022
Actual trial start date 01/07/2022
Anticipated date of last follow up 30/06/2023
Actual Last follow-up date 30/06/2023
Anticipated target sample size (number of participants) 220
Actual target sample size (number of participants) 220
Recruitment status Not yet recruiting
Publication URL
Secondary Ids Issuing authority/Trial register
STUDY DESIGN
Intervention assignment Allocation to intervention If randomised, describe how the allocation sequence was generated Describe how the allocation sequence/code was concealed from the person allocating the participants to the intervention arms Masking If masking / blinding was used
Parallel: different groups receive different interventions at same time during study Randomised Stratified allocation where factors such as age, gender, center, or previous treatment are used in the stratification Central randomisation by phone/fax Masking/blinding used Participants
INTERVENTIONS
Intervention type Intervention name Dose Duration Intervention description Group size Nature of control
Experimental Group Cyclobenzaprine HCl Taken Daily at Bedtime 12-weeks TNX-102 SL 5.6 mg (2 x 2.8 mg tablets) – a sublingual formulation of cyclobenzaprine 2 tablets of TNX-102 SL 2.8 mg taken simultaneously and sublingually (under the tongue) each day at bedtime starting on Day 1 for 12 weeks. 110
Control Group Placebo 12 weeks 2 placebo tablets will be taken simultaneously and sublingually (under the tongue) each day at bedtime starting on Day 1 for 12 weeks. 110 Placebo
ELIGIBILITY CRITERIA
List inclusion criteria List exclusion criteria Age Category Minimum age Maximum age Gender
1. Male or female between 18 and 75 years of age at the time signing informed consent from (ICF), inclusive. 2. Diagnosed with current PTSD as determined by the Clinician-Administered PTSD Scale (CAPS-5) for Diagnostic and Statistical Manual of Mental Disorders-Version 5 (DSM-5) and of sufficient symptom severity, defined as all of the following at Screening Visit 1 using the Diagnostic version (1-month recall): a. The A criterion is 1=YES, and b. At least ONE item of the B criterion items must have a score of ≥2, and c. At least ONE item of the C criterion items must have a score of ≥2, and d. At least TWO items of the D criterion items must have a score of ≥2, and e. At least TWO items of the E criterion items must have a score of ≥2, and f. The F item 22 criterion is 1=YES (≥1-month duration of symptoms) g. At least ONE item of the G items must have a score of ≥2, and h. The total CAPS-5 score (of items 1 through 20 is) ≥29 3. Index trauma(s) resulting in PTSD must meet the following: a. DSM-5 criterion A for PTSD as described in the CAPS-5 and Criterion A – Assessment Form (CA-AF), and b. Must have occurred within 9 years of Screening Visit 1, and c. Must have occurred when the patient was ≥18 years of age. 4. Willing and able to withdraw and refrain from opioids for the course of the study. 5. Willing to refrain from use of all other formulations of cyclobenzaprine for the course of the study. 6. Willing and able to refrain from antidepressants, antipsychotics, mood stabilizers, anticonvulsants, benzodiazepines, non-benzodiazepine hypnotics, buspirone, stimulants (e.g. amphetamines, methylphenidate, modafinil, armodafinil), prazosin and trazodone for the course of the study. 7.Capable of reading and understanding English and able to provide written informed consent to participate. Separate written, signed informed consent will be required if the patient is to participate in the optional pharmacogenomic assessment. 1. Current or ongoing exposure to the trauma that resulted in the PTSD. 2. Increased risk of suicide on the basis of the Investigator’s judgment and/or the results of the Mini International Neuropsychiatric Interview, Version 7.0.2 (MINI 7.0.2) conducted at Screening and the Columbia Suicide Severity Rating Scale (C-SSRS) conducted at Screening and/or Baseline and Item 10 of the Montgomery-Åsberg Depression Rating Scale (MADRS) at Screening and/or Baseline. Any of the following will be exclusionary: a. High suicidality based on a MINI Module B score ≥ 17 (Screening); or, b. Patient answers YES to either MINI question B10 or B11 (Screening); or, c. Patient meets criteria for CURRENT Suicidal Behaviour Disorder on the MINI (Screening); or, d. C-SSRS Type 4 or Type 5 ideation within 6 months of Screening or at the Baseline visit; or, e. Any suicidal behaviour in the past 12 months as identified by the C-SSRS at Screening or Baseline. f. A score of > 4 on Item 10 of the MADRS at Screening or Baseline. 3. Increased risk of suicide, based on the Investigator’s judgment that is of a severity that is not appropriate for outpatient management, or that warrants additional therapy excluded by the protocol. 4. Significant (e.g., moderate or severe) comorbid traumatic brain injury (TBI) by history. Based on past history and Investigator’s judgment, patients with mild TBI are eligible. 5. Severe depression suggested by a Screening (Visit 1) MADRS score > 26. Patients with a Screening MADRS score of > 26 may be randomized upon Medical Monitor approval, based on a review of all Screening rating scales and the patient’s psychiatric/medical history. 6. Clinically significant laboratory abnormalities based on screening laboratory tests and/or medical history in the Investigator’s opinion, including a Thyroid Stimulating Hormone (TSH) level > 1.5 times the upper limit of normal and aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) > 3 times the upper li Adolescent: 13 Year-18 Year,Adult: 19 Year-44 Year,Aged: 65+ Year(s),Middle Aged: 45 Year(s)-64 Year(s) 18 Year(s) 75 Year(s) Both
ETHICS APPROVAL
Has the study received appropriate ethics committee approval Date the study will be submitted for approval Date of approval Name of the ethics committee
Yes 22/04/2022 Moi University Moi Teaching and Referral Hospital Institutional Research and Ethics Committee.
Ethics Committee Address
Street address City Postal code Country
Moi Teaching and Referral Hospital Nandi Road ELDORET 3-30100 Kenya
OUTCOMES
Type of outcome Outcome Timepoint(s) at which outcome measured
Primary Outcome The mean change from baseline (Visit 2) in the Total CAPS-5 score evaluated at the landmark visit. Visit 2
Secondary Outcome The efficacy endpoints listed below are considered key secondary endpoints and will be tested in the following order: • Change from baseline in the CAPS-5 total score evaluated at non-landmark visit(s). • Change from baseline in CGI-S score. • Change from baseline in the SDS total score. A fixed sequence procedure will be applied to the above key secondary efficacy endpoints to adjust for multiplicity and to control for overall type I error. Change from baseline in patients’ quality of sleep using the PROMIS Sleep Disturbance instrument score. • Change from baseline in the disruption of work/school activities assessed using the SDS. • Change from baseline in disruption of social life/ leisure activities assessed using the SDS. • Change from Baseline in the disruption of family life/home responsibilities assessed using the SDS. • Change from baseline in CAPS-5 Arousal and Reactivity (Criterion E) score. • Change from baseline in CAPS-5 Intrusion symptoms (Criterion B) score. • Change from baseline in CAPS-5 Negative Cognition and Mood (Criterion D) score. • Change from baseline in CAPS-5 Persistent Avoidance (Criterion C) score. • Change from baseline in CAPS-5 Sleep Disturbance (item E6) score. • Mean PGIC score. • Proportion of patients with a PGIC score of “much improved” or “very much improved”. • Mean CGI-I score. • Proportion of patients with a treatment response on the CGI-I defined as a CGI-I score of “much improved” or “very much improved”. • Proportion of patients with a Total CAPS-5 score of 0 –10 (asymptomatic/few symptoms). • Proportion of patients with a Total CAPS-5 score of 0-22 (asymptomatic or mild PTSD/subthreshold). • Proportion of patients with Response, defined as a ≥ 10-point improvement from baseline in Total CAPS-5 score. • Proportion of patients with Loss of Diagnosis, defined as Response AND no longer meeting DSM-5 symptom criteria in any one or more of the four clusters (B, C, D, E) after 8 weeks AND 12 weeks
RECRUITMENT CENTRES
Name of recruitment centre Street address City Postal code Country
MOI UNIVERSITY Nandi Road ELDORET 30100 Kenya
Kenya Medical Research Institute. KEMRI Off Mbagathi Road Nairobi 00100 Kenya
Chiromo Lane Medical Centre P.O Box 1501-00606 Nairobi 00100 Kenya
FUNDING SOURCES
Name of source Street address City Postal code Country
Tonix Pharmaceuticals 509 Madison Avenue Suite 1608 New York United States of America
SPONSORS
Sponsor level Name Street address City Postal code Country Nature of sponsor
Primary Sponsor Tonix Pharmaceuticals Company 509 Madison Avenue Suite 1608 New York, NY 10022 New York United States of America Commercial Sector/Industry
COLLABORATORS
Name Street address City Postal code Country
Dr. Linet Ongeri off mbagathi road Nairobi Kenya
Dr. Frank Njenga Chiromo Lane off Muthithi Road Westlands Nairobi Kenya
Dr. Silvia Ongeri Chiromo Lane off Muthithi Road Westlands Nairobi Kenya
Dr. Edith Kwobah Nandi Street Nairobi Kenya
Prof. Gabriel Kigen Nandi Road Eldoret Kenya
Dr. Bernhards Ogutu off Mbagathi road Nairobi Kenya
CONTACT PEOPLE
Role Name Email Phone Street address
Principal Investigator Lukoye Atwoli lukoye@gmail.com 0722943397 3rd Parklands Avenue, Limuru Road,Nairobi, Kenya
City Postal code Country Position/Affiliation
Nairobi Kenya Dean
Role Name Email Phone Street address
Public Enquiries Stella Gichuru stellakenina@gmail.com 0721466103 Nandi Road
City Postal code Country Position/Affiliation
Eldoret Kenya Project Manager
Role Name Email Phone Street address
Scientific Enquiries Gabriel Kigen kigengfk@gmail.com 0732845896 Nandi Road
City Postal code Country Position/Affiliation
Eldoret Kenya Moi University
REPORTING
Share IPD Description Additional Document Types Sharing Time Frame Key Access Criteria
Yes All participants personal information will be kept confidential. Each participant will be assigned a personal identification number. Information maybe disclosed if required by law. Informed Consent Form,Statistical Analysis Plan,Study Protocol The study protocol, statistical analysis plan and informed consent forms will be available at the beginning of the study and will be availed to any relevant authorities. The final study report will be available once the study close out has taken place and all data analysis has been done. Records maybe reviewed by; 1. Tonix Pharmaceutical company 2. National Commission for Science, Technology and Innovation 3. Pharmacy and Poisons Board, Kenya 4. Moi University/Moi Teaching and Referral hospital Institutional Research and Ethics Committee (IREC) 5. Study Monitors
URL Results Available Results Summary Result Posting Date First Journal Publication Date
No
Result Upload 1: Result Upload 2: Result Upload 3: Result Upload 4: Result Upload 5:
Result URL Hyperlinks Link To Protocol
Result URL Hyperlinks
Changes to trial information