Effect of Naltrexone Hydrochloride ER and Bupropion Hydrochloride ER Combination (Contrave®/Mysimba®) on Major Adverse Cardiovascular Events (MACE)
Purpose
A randomized, double-blinded, placebo controlled study intended to capture cardiovascular outcomes during real-world use of naltrexone/bupropion (NB).
Condition
- Obesity
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Patient age ≥18 years at screening 2. Able to understand the key components of the study, as described in the written informed consent document, and willing and able to provide written informed consent 3. BMI ≥30 kg/m2 (obese) or ≥27 kg/m2 (overweight) in the presence of at least 1 weight-related comorbidity (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia) 4. At increased risk of adverse cardiovascular outcomes: In the opinion of the investigator, has a high likelihood of cardiovascular disease with at least 1 of the following: - History of documented MI >90 days prior to screening - History of coronary revascularization (ie, coronary artery bypass graft surgery, stent placement, percutaneous transluminal coronary angioplasty, or laser atherectomy) >90 days prior to screening - History of carotid or peripheral revascularization (ie, carotid endarterectomy, lower extremity atherosclerotic disease atherectomy, repair of abdominal aorta aneurysm, femoral or popliteal bypass) >90 days prior to screening - Angina with ischemic changes (resting echocardiogram (ECHO), ECG changes on a graded exercise test (GXT), or positive cardiac imaging study) - Ankle brachial index <0.9 (by simple palpation) within prior 2 years or Type 2 diabetes mellitus with at least 2 of the following: - Hypertension (controlled with or without pharmacotherapy at <145/95 mmHg) - Dyslipidemia requiring pharmacotherapy - Documented low HDL cholesterol (<50 mg/dL in women or <40 mg/dL in men) within the prior 12 months - Current tobacco smoker 5. Patients who have completed a washout (2-weeks or 5 half-lives, whichever is longer) of the prohibited concomitant medication(s) at screening 6. Subject willing to comply with daily completion of an eDiary using a mobile smartphone application
Exclusion Criteria
- Using prescription medications, other than Contrave/Mysimba, or surgical or medical device interventions for weight loss 2. History of MI or stroke within 90 days prior to screening 3. Uncontrolled hypertension, defined as systolic BP ≥160 mmHg and/or >100 mmHg diastolic BP on the average of 3 seated BP measurements after the patient has been at rest for at least 5 minutes 4. Meets any of the following criteria: - Confirmed end-stage renal disease (ie, a degree of kidney failure severe enough to require dialysis or kidney transplantation for survival characterized by a severe reduction in glomerular filtration rate [<15 mL/minute/1.73 m2] and other manifestations including increased serum creatinine), - Severe hepatic impairment (Child-Pugh score 10 to 15 [Class C]), - Hemodynamic instability, including patients with severe heart failure (New York Heart Association Class IV) 5. Seizure disorders or history of seizures, not including subjects with a history of pediatric febrile seizures 6. Use of other bupropion-containing products (including but not limited to Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Aplenzin) 7. Active anorexia nervosa or bulimia 8. Chronic opioid or opiate agonist (eg, methadone) or partial agonists (eg, buprenorphine) use, or acute opioid withdrawal or has a positive urine drug result for opioids at screening 9. Undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs 10. Concomitant administration of MAOIs. This also includes use of reversible MAOIs, such as linezolid or intravenous methylene blue. At least 14 days should elapse between discontinuation of MAOIs and initiation of treatment with Contrave/Mysimba. 11. Subject has any disease or condition, or use of any pharmacological agent to treat the disease/condition, that, in the opinion of the investigator, would contraindicate study participation 12. Known allergy to bupropion, naltrexone, or any other component of Contrave/Mysimba 13. Pregnant or nursing 14. Known life-threatening arrythmias, including Brugada syndrome 15. Participation in any other concurrent investigational trial
Study Design
- Phase
- Phase 4
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Supportive Care
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
- Masking Description
- Sponsor will be blinded
Arm Groups
Arm | Description | Assigned Intervention |
---|---|---|
Active Comparator Naltrexone/Bupropion (NB) |
Patients will be randomly assigned to NB (naltrexone 8 mg and bupropion 90 mg) extended-release oral tablet. |
|
Placebo Comparator Placebo |
Patients will be randomly assigned to placebo. |
|
Recruiting Locations
Birmingham, Alabama 35216
Mobile, Alabama 36608
Glendale, Arizona 85306
Phoenix, Arizona 85006
Tempe, Arizona 85283
Anderson, California 90247
Chula Vista, California 91911
Huntington Park, California 90255
La Mesa, California 91942
Lancaster, California 93534
San Bernardino, California 92408
West Covina, California 91790
Englewood, Colorado 80110
Coral Gables, Florida 33134
Cutler Bay, Florida 33189
Delray Beach, Florida 33445
Edgewater, Florida 32132
Fort Lauderdale, Florida 33316
Fort Myers, Florida 33907
Hialeah, Florida 33010
Hialeah, Florida 33013
Kissimmee, Florida 34744
Melbourne, Florida 32934
Miami Beach, Florida 33141
Miami, Florida 33156
Miami, Florida 33165
Miami, Florida 33173
Miami, Florida 33176
Miami, Florida 33186
Miramar, Florida 33027
North Miami, Florida 33169
Palmetto Bay, Florida 33157
Palmetto Bay, Florida 33176
Pembroke Pines, Florida 33024
The Villages, Florida 32162
Atlanta, Georgia 30309
Columbus, Georgia 31904
Decatur, Georgia 30030
Savannah, Georgia 31406
Valparaiso, Indiana 46383
Sioux City, Iowa 51106
El Dorado, Kansas 67042
Wichita, Kansas 67207
Wichita, Kansas 67214
Baton Rouge, Louisiana 70809
Covington, Louisiana 70433
Lafayette, Louisiana 70508
New Orleans, Louisiana 70119
Rockville, Maryland 20850
Rockville, Maryland 20854
Methuen, Massachusetts 01844
Gulfport, Mississippi 39503
Kansas City, Missouri 64151
Saint Louis, Missouri 63119
Grand Island, Nebraska 68803
Lincoln, Nebraska 68510
Norfolk, Nebraska 68701
Omaha, Nebraska 68134
Las Vegas, Nevada 89102
North Las Vegas, Nevada 89119
Portsmouth, New Hampshire 03801
Albuquerque, New Mexico 87107
Binghamton, New York 13905
New York City, New York 10017
Durham, North Carolina 27701
Beachwood, Ohio 44122
Cincinnati, Ohio 45219
Cincinnati, Ohio 45242
Cincinnati, Ohio 45246
Tulsa, Oklahoma 74136
Medford, Oregon 97504
Philadelphia, Pennsylvania 19111
East Greenwich, Rhode Island 02818
Anderson, South Carolina 29621
Columbia, South Carolina 29204
Gaffney, South Carolina 29340
North Charleston, South Carolina 29405
Spartanburg, South Carolina 29303
Union, South Carolina 29379
Abilene, Texas 79606
Austin, Texas 78705
Austin, Texas 78759
Beaumont, Texas 77702
Houston, Texas 77022
Houston, Texas 77058
Port Arthur, Texas 77642
Sugarland, Texas 77479
Waco, Texas 76712
West Jordan, Utah 84088
Charlottesville, Virginia 22911
Hampton, Virginia 23666
Norfolk, Virginia 23502
Suffolk, Virginia 23435
Eau Claire, Wisconsin 54701
More Details
- NCT ID
- NCT06098079
- Status
- Recruiting
- Sponsor
- Currax Pharmaceuticals
Detailed Description
This multi-center, prospective, randomized, pragmatic, double-blinded study has been designed to capture cardiovascular (CV) outcomes during the real-world use of NB after initial randomization. The aim of the study is to assess whether patients receiving treatment with NB are at an elevated risk of experiencing MACE compared with patients receiving placebo. Both patient groups will also be counselled to lose weight via a reduced-calorie diet and increased physical activity.