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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05964335
Registration number
NCT05964335
Ethics application status
Date submitted
7/07/2023
Date registered
27/07/2023
Titles & IDs
Public title
Cough Reduction in IPF With Nalbuphine ER
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Scientific title
A Randomized, Double-Blind, Placebo-Controlled, Parallel, 4-Arm Dose Ranging Study of the Safety and Efficacy of Nalbuphine Extended-Release Tablets (NAL ER) for the Treatment of Cough in Idiopathic Pulmonary Fibrosis (IPF)
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Secondary ID [1]
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NAL03-202
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Universal Trial Number (UTN)
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Trial acronym
CORAL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Idiopathic Pulmonary Fibrosis
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0
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Condition category
Condition code
Respiratory
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0
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Other respiratory disorders / diseases
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Inflammatory and Immune System
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0
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0
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Connective tissue diseases
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Inflammatory and Immune System
0
0
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0
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - nalbuphine ER 27 mg
Treatment: Drugs - Placebo
Treatment: Drugs - nalbuphine ER 54 mg
Treatment: Drugs - nalbuphine ER 108 mg
Experimental: NAL ER 27 mg - BID
Experimental: NAL ER 54 mg - BID
Experimental: NAL ER 108 mg - BID
Placebo comparator: Placebo - Placebo, tablets BID
Treatment: Drugs: nalbuphine ER 27 mg
Oral tablets
Treatment: Drugs: Placebo
Oral tablets
Treatment: Drugs: nalbuphine ER 54 mg
Oral Tablets
Treatment: Drugs: nalbuphine ER 108 mg
Oral tablets
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Effect of NAL ER on 24-hour cough frequency (coughs per hour)
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Assessment method [1]
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Relative change from Baseline in 24-hour cough frequency versus placebo
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Timepoint [1]
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Week 6
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Secondary outcome [1]
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Effect of NAL ER on the EXAcerbation of Chronic pulmonary disease Tool
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Assessment method [1]
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Relative change from Baseline in the EXACT© question 2 at Week 6 versus placebo
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Timepoint [1]
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Week 6
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Secondary outcome [2]
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Safety and tolerability of NAL ER
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Assessment method [2]
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Adverse event, vitals signs, ECGs, clinical laboratory tests, spirometry, physical examinations, Subjective Opiate Withdrawal Scale (SOWS)
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Timepoint [2]
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Screening through 14 day post last dose
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Secondary outcome [3]
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24-hour cough frequency (Coughs per hour)
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Assessment method [3]
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Relative change from Baseline in 24-hour cough frequency (coughs per hour) versus placebo
• Proportion of responders with =30%, =50% and =75% reduction in the 24-hour cough frequency at Week 2, 4, and 6, for NAL ER compared with placebo.
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Timepoint [3]
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Weeks 2, 4, 6
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Secondary outcome [4]
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Awake cough frequency (Coughs per hour)
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Assessment method [4]
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Relative change from Baseline in awake cough frequency (coughs per hour) versus placebo.
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Timepoint [4]
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Weeks 2, 4, 6
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Secondary outcome [5]
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Sleep cough frequency (Coughs per hour)
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Assessment method [5]
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Relative change from Baseline in sleep cough frequency (coughs per hour) at versus placebo.
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Timepoint [5]
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Weeks 2, 4, 6
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Secondary outcome [6]
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EXACT© (EXAcerbation of Chronic pulmonary disease Tool) (EXAcerbation of Chronic pulmonary disease Tool)
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Assessment method [6]
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Change from Baseline in the EXACT© question 2 compared with placebo. Proportion of EXACT© question 2 responders, with response defined as at least a one category improvement versus placebo. Change from Baseline in the EXACT© sub-domains and individual items versus placebo.
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Timepoint [6]
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Weeks 1, 2, 3, 4, 5, 6
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Secondary outcome [7]
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CS-NRS (Cough Severity Numerical Rating Scale)
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Assessment method [7]
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Change from Baseline in the CS-NRS versus placebo.
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Timepoint [7]
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Weeks 1, 2, 3, 4, 5, 6
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Secondary outcome [8]
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LCQ© (Leicester Cough Questionnaire)
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Assessment method [8]
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Change from Baseline in the LCQ© total score versus placebo. Proportion of LCQ© responders, with response defined as 1.3-point increase versus placebo
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Timepoint [8]
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Week 6
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Secondary outcome [9]
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L-IPF© (Living with Pulmonary Fibrosis Impacts Questionnaire)
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Assessment method [9]
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Change from Baseline in the L-IPF© versus placebo.
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Timepoint [9]
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Week 6
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Secondary outcome [10]
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L-IPF© (Living with Pulmonary Fibrosis Symptoms Questionnaire)
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Assessment method [10]
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Change from Baseline in the L-IPF© versus placebo.
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Timepoint [10]
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Week 6
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Secondary outcome [11]
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EQ-5D-5Lâ„¢
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Assessment method [11]
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Change from Baseline in the EQ-5D-5Lâ„¢ versus placebo.
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Timepoint [11]
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Week 6
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Secondary outcome [12]
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PGI-S Cough (Patient Global Impression of Severity for Cough)
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Assessment method [12]
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1 item measure rating the severity of cough past 7 days from No cough, Mild, Moderate or Severe
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Timepoint [12]
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Weeks 2, 4, 6
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Secondary outcome [13]
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PGI-S IPF (Patient Global Impression of Severity and Change for IPF)
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Assessment method [13]
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1 item measure rating the symptoms of IPF past 7 days from No symptoms, Mild, Moderate or Severe
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Timepoint [13]
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Weeks 2, 4, 6
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Secondary outcome [14]
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CGI-S, (Clinicians Global Impression of Severity)
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Assessment method [14]
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A one-item measure evaluating severity of the condition. No Symptoms Mild Moderate Severe
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Timepoint [14]
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Baseline and Week 6
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Secondary outcome [15]
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PGI-C Cough; (Patient Global Impression of Change for Cough)
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Assessment method [15]
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1 item measure rating the symptoms of IPF. (past 7 days)
* Much better
* Moderately better
* A little better
* No change
* A little worse
* Moderately worse
* Much worse
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Timepoint [15]
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Weeks 2, 4, 6
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Secondary outcome [16]
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PGI-C IPF (Patient Global Impression of Change in IPF symptoms)
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Assessment method [16]
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1 item measure rating the symptoms of IPF. (Past 7 days)
* Much better
* Moderately better
* A little better
* No change
* A little worse
* Moderately worse
* Much worse
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Timepoint [16]
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Weeks 2, 4, 6
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Secondary outcome [17]
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CGI-C
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Assessment method [17]
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A one-item measure evaluating change from the initiation of treatment on a seven point scale.
1. = Very much improved
2. = Much improved
3. = Minimally improved
4. = No change
5. = Minimally worse
6. = Much worse
7. = Very much worse
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Timepoint [17]
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Week 6
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Eligibility
Key inclusion criteria
* Diagnosis of IPF as determined by the Principal Investigator based on ATS/ERS/JRS/ALAT guidelines.
* Cough Severity Score = 4 on CS-NRS (Cough Severity Numerical Rating Scale) during the Screening period and Baseline.
* History of chronic cough for at least 8 weeks before screening.
* SpO2 = 92%, taken after at least 5 minutes in a sitting position, undisturbed and non-stimulated (Saturation of Hemoglobin with Oxygen as Measured by Pulse Oximetry).
* FVC = 40% predicted of normal - Forced Vital Capacity, as determined by spirometry adhering to ATS/ERS guidelines.
* DLCO = 25% predicted of normal - Diffusing capacity of the lung for carbon monoxide corrected for hemoglobin, assessed within the last 12 weeks, or at the time of screening.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Currently on continuous oxygen therapy for longer than 16 hours at any level or delivered by any modality. Intermittent oxygen use of any duration over any given 24-hour period is allowed.
* Inadequate swallow reflex as assessed by the ability to sip 3 fluid oz (or 89 mL) of water without coughing or choking.
* Upper or lower respiratory tract infection in the last 8 weeks prior to the baseline visit.
* Clinical history of aspiration pneumonitis.
* Diagnosis of sleep apnea.
* Abnormal kidney or liver functions based on Screening lab results.
* Known hypersensitivity to nalbuphine or to NAL ER excipients
* History of major psychiatric disorder.
* History of substance abuse.
* Significant medical condition or other factors that may interfere with the subject's ability to successfully complete the study.
* Pregnant or lactating female subject.
* Known intolerance (gastrointestinal, central nervous system symptoms), hypersensitivity, drug allergy following the use of an opioid drug.
* Use of opiates is prohibited within 14 days prior to the baseline visit.
* Use of benzodiazepines are prohibited within 14 days prior to the baseline visit and for the duration of the study.
* Monoamine oxidase inhibitors (MAOIs) including methylene blue (methylthioninium chloride) and the antibiotic linezolid are prohibited within 14 days prior to the baseline visit and for the duration of the study.
* Use of oral corticosteroid cough treatment is prohibited within 4 weeks prior to the baseline visit and for the duration of the study.
* Exposure to any investigational medication, including placebo, is prohibited within 4 weeks prior to the baseline visit and for the duration of the study.
* Medications prescribed as cough suppressants are prohibited unless on a stable dose 14-days prior to the baseline visit and are expected to remain on that dose for the duration of the study.
* Use of medications that affect serotonergic neurotransmission and that when used concomitantly with opioids can increase the risk of serotonin syndrome are prohibited unless on a stable dose 14-days prior to the baseline visit and are expected to remain on that dose for the duration of the study.
* Anti-fibrotic medications are prohibited unless on a stable dose for 8 weeks prior to the baseline visit and are expected to remain on that dose for the duration of the study.
* Strong inhibitors/inducers of the P450 Isozymes are prohibited unless on a stable dose for 14-days prior to baseline visit and are expected to remain on that dose for the duration of the study.
* Use of a medication having a "known risk" of Torsade de Pointes (categorized as "KR" on the Credible Meds® website.) 4 weeks prior to Baseline.
* Use of unstable doses of medications associated with a potential risk of QT prolongation but not clearly associated with Torsade de Pointes within 4 weeks of screening.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
6/02/2024
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
14/10/2024
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Actual
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Sample size
Target
160
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Eastern Health-Box Hill Hospital - Box Hill
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Recruitment hospital [2]
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Concord Repatriation General Hospital - Concord
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Recruitment hospital [3]
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Austin Hospital - Heidelberg
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Recruitment hospital [4]
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Respiratory Clinical Trials Pty Ltd - Kent Town
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Recruitment hospital [5]
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TrialsWest Pty Ltd - Spearwood
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Recruitment hospital [6]
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Westmead Hospital - Westmead
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Recruitment postcode(s) [1]
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3128 - Box Hill
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Recruitment postcode(s) [2]
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2139 - Concord
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Recruitment postcode(s) [3]
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3084 - Heidelberg
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Recruitment postcode(s) [4]
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5067 - Kent Town
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Recruitment postcode(s) [5]
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6163 - Spearwood
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Recruitment postcode(s) [6]
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2145 - Westmead
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Recruitment outside Australia
Country [1]
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Canada
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State/province [1]
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Ajax
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Canada
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Vancouver
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Chile
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State/province [3]
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Concepcion
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Chile
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Quillota
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Chile
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Santiago
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Chile
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Talca
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Chile
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Valparaiso
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Chile
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Vina del Mar
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Germany
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Essen
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Germany
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Frankfurt am Main
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Germany
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Hannover
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Germany
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Leipzig
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Germany
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Mainz
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Germany
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Solingen
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Italy
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Catania
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Italy
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Foggia
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Italy
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Monza
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Italy
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Padua
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Italy
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Rome
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's-Hertogenbosch
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Den Haag
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Groningen
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Rotterdam
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Poland
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Gdansk
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Poland
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Krakow
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Poland
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Lodz
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Poland
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Olsztyn
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Poland
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Sosnowiec
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Poland
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Szczecin
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Santander
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Turkey
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Ankara
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Turkey
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Antalya
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Turkey
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Canakkale
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Turkey
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Istanbul
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Turkey
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Izmir
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Turkey
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Selcuklu
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United Kingdom
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Cambridge
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United Kingdom
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Cottingham
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United Kingdom
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Edinburgh
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Londonderry
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London
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Manchester
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Norwich
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United Kingdom
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Nottingham
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United Kingdom
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Oxford
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United Kingdom
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Southampton
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Trevi Therapeutics
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a multi-center randomized, double-blind, placebo-controlled, parallel, 4-arm study of nalbuphine ER (NAL ER). After meeting eligibility during the Screening Period, subjects will be randomized (1:1:1:1) to one of four treatment arms with placebo and increasing doses of nalbuphine ER. Each arm will be titrated to their fixed dose during the blinded 2-week Titration period followed by the 4-week Fixed Dose Period for a total of 6 weeks on drug. For more information see the country specific approved websites: Germany, Netherlands, Poland, Spain, Italy, Chile: TheCoralTrial.com United Kingdom, Australia, Canada: CoralCoughTrial.com Turkey: please refer to the list of locations and reach out to the site directly
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Trial website
https://clinicaltrials.gov/study/NCT05964335
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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David Clark, MD
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Address
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Trevi Therapeutics
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Country
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Phone
0
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Fax
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Email
0
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Contact person for public queries
Name
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Beata Dworakowska
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Address
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Country
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Phone
0
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203-654-3284
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Fax
0
0
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Email
0
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05964335