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NCT04310423

An Inflammatory Challenge Using Endotoxin

Completed Phase 2 Results posted Last updated 1 May 2025
What this trial tests

Phase 2 trial testing Placebo in Alcohol Use Disorder in 20 participants. Completed in 14 November 2023.

Timeline
19 October 2021
Primary endpoint
14 November 2023
14 November 2023

Quick facts

Lead sponsorUniversity of California, Los Angeles
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposediagnostic
Enrollment20
Start date19 October 2021
Primary completion14 November 2023
Estimated completion14 November 2023
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of California, Los Angeles

Who can join

Adults 21 to 45, any sex, with Alcohol Use Disorder or Inflammatory Response. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Cue-induced Craving Primary · The cue-reactivity paradigm is conducted at baseline and at 2 hours post-infusion of placebo or low dose endotoxin during the experimental visit.

Alcohol Urge Questionnaire (AUQ) score is the primary outcome for the cue-reactivity paradigm. The AUQ is comprised of eight items rated on a 7-point Likert scale with items related to the subjective experience of alcohol craving. The minimum value is 8 and the maximum value is 56 with a higher score indicating greater subjective alcohol craving. Phasic craving for alcohol following alcohol cue exposure was assessed using the first and last items from the AUQ during an alcohol cue reactivity paradigm at baseline and at time of expected peak cytokine response (T2). This subscale of 2 items abou

Baseline
GroupValue95% CI
Placebo4.5004± 0.9622
Endotoxin7.9081± 0.9604
Two Hours Post-Baseline
GroupValue95% CI
Placebo4.5004± 0.9622
Endotoxin5.6178± 0.9858
Change in Negative Mood Primary · The POMS will be completed at 5 timepoints during the experimental visit. Specifically, negative mood will be assessed at baseline (prior to infusion) and 1 hour, 2 hours, 3 hours, and 4 hours post-infusion of placebo or low dose endotoxin.

The Profile of Mood States (POMS) is a self-report questionnaire that measures dimensions of mood. Four items from the POMS were summed to calculate the negative mood subscale. The items included "discouraged," downhearted," "uneasy," and "anxious." Participants rated the extent that they felt items "right now" on a scale from 0-4, with higher scores indicating more endorsement of the items. Items were summed to calculate negative mood subscale with the score ranging from 0-16, with higher scores indicating higher negative mood. The investigators were interested in whether low dose endotoxin w

Baseline
GroupValue95% CI
Placebo0.60± 0.27
Endotoxin0.80± 0.36
One Hour Post-Baseline
GroupValue95% CI
Placebo0.50± 0.34
Endotoxin0.90± 0.43
Two Hours Post-Baseline
GroupValue95% CI
Placebo0.50± 0.27
Endotoxin0.90± 0.31
Three Hours Post-Baseline
GroupValue95% CI
Placebo1.70± 0.88
Endotoxin1.70± 0.72
Four Hours Post-Baseline
GroupValue95% CI
Placebo0.90± 0.53
Endotoxin1.70± 0.79
Change in Reward Responsiveness Secondary · The RRS will be completed at 2 timepoints during the experimental visit. Specifically, reward responsiveness will be assessed at baseline (prior to infusion) and 2 hours post-infusion of placebo or low dose endotoxin.

The Reward Responsiveness Scale (RRS) measures self-report reward responsiveness. The RRS scale consists of 8 items on a 4-point scale, with the sum total score of items ranging from 8-32, where higher scores indicate higher reward responsiveness. The measure was completed electronically. The investigators are interested in whether low dose endotoxin will decrease reward responsiveness as compared to placebo.

RRS Baseline
GroupValue95% CI
Placebo25.60± 1.11
Endotoxin26.20± 0.98
RRS Two Hours Post-Baseline
GroupValue95% CI
Placebo25.50± 1.27
Endotoxin26.22± 1.24
Change in Reward Responsiveness Secondary · The PRT will be completed at 2 timepoints during the experimental visit. Specifically, reward responsiveness will be assessed at baseline (prior to infusion) and 2 hours post-infusion of placebo or low dose endotoxin.

The Probabilistic Reward Task (PRT) is a signal detection learning task that assesses reward learning from which two subscales were derived: logd is a measure of discriminability, or how difficult it is for the subjects to discriminate between the signals, while logb is a measure of response bias, or subjects' preference for the response paired with the more frequent reward. Higher logd values indicate a better ability to discriminate between reward signals (logd=1⁄2 log(Richcorrect\*Leancorrect)/(Richincorrect\*Leanincorrect)). Higher logb values indicate better reward sensitivity (logb=1⁄2 l

PRT logd Baseline
GroupValue95% CI
Placebo1.46± 0.13
Endotoxin1.29± 0.16
PRT logd Two Hours Post-Basleine
GroupValue95% CI
Placebo1.98± 0.33
Endotoxin1.27± 0.16
PRT logb Baseline
GroupValue95% CI
Placebo-0.07± 0.03
Endotoxin0.16± 0.05
PRT logb Two Hours Post-Baseline
GroupValue95% CI
Placebo0.31± 0.38
Endotoxin0.20± 0.04
Effect on Neural Alcohol Cue-reactivity Secondary · The fMRI scan will be completed during the experimental visit. Specifically, participants will undergo the neuroimaging scan at 3 hours post-infusion of placebo or low dose endotoxin.

The fMRI scan will include a cue-reactivity paradigm in which participants will view images of alcoholic beverages, non-alcoholic beverages, negative images, and fixation cross. Participants will be asked to rate their alcohol craving before the scan and after each cue block. The investigators are interested in determining the effects of endotoxin on neural alcohol cue-reactivity. An alcohol beverage \> non-alcohol beverage contrast was specified in the first-level model for each subject, and FSL's FLAME 1 was used to conduct group-level analyses (endotoxin vs. placebo) to identify significant

Left Postcentral Gyrus Significant Cluster
GroupValue95% CI
Placebo > Endotoxin (Alcohol vs. Beverage Cues) at T33190
Right Thalamus Significant Cluster
GroupValue95% CI
Placebo > Endotoxin (Alcohol vs. Beverage Cues) at T31942
Left Inferior Temporal Gyrus Cluster
GroupValue95% CI
Placebo > Endotoxin (Alcohol vs. Beverage Cues) at T3931
Left/Right Precuneus Cluster
GroupValue95% CI
Placebo > Endotoxin (Alcohol vs. Beverage Cues) at T3920
Right Precentral Gyrus
GroupValue95% CI
Placebo > Endotoxin (Alcohol vs. Beverage Cues) at T3518

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse event data were collected throughout the study duration from 2021-2023.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo
Serious: 0/10 (0%)
Deaths: 0/10
Endotoxin
Serious: 0/10 (0%)
Deaths: 0/10
Other adverse events (12 terms — click to expand)

ReactionSystemPlaceboEndotoxin
ShiveringImmune system disorders
FatigueImmune system disorders
NauseaImmune system disorders
Muscle PainImmune system disorders
FeverImmune system disorders
Shortness of BreathImmune system disorders
HeadacheImmune system disorders
Injection Site PainImmune system disorders
Arm RashImmune system disorders
HypertensionImmune system disorders
LightheadednessImmune system disorders
Low Back PainImmune system disorders

Data from ClinicalTrials.gov NCT04310423 adverse events section.

Sponsor's own description

The study design consists of a randomized, double-blind, placebo-controlled trial of low dose endotoxin. The low dose endotoxin challenge induces a transient systemic inflammatory response with normalization of cytokine levels within hours. This "phasic" inflammation is distinct from chronic ("tonic") levels of inflammation that may be present with AUD. A total of 38 non-treatment seeking heavy drinking men and women and 38 light drinking healthy controls will participate in the study. Recruitment will be monitored to ensure the two groups are matched by gender. Eligible participants will be randomly assigned, stratified by gender and BDI-II severity, to receive a single I.V. infusion of either low dose endotoxin (0.8 ng/kg of body weight) or placebo (same volume of 0.9% saline solution) at the UCLA Outpatient Clinical and Translational Research Center (CTRC). All participants will complete an alcohol cue-exposure paradigm and reward responsiveness assessment 2 hours post infusion, which is the time of expected peak cytokine response. All participants will also complete an fMRI alcohol cue-reactivity paradigm at 3 hours post infusion. Plasma levels of proinflammatory cytokines \[i.e., Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF- α)\], mood, and alcohol craving, will be assessed at baseline and then hourly for four hours post infusion.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Inflammatory endotoxin challenge in individuals with alcohol use disorder and controls.
    McManus KR, Grodin EN, Burnette E, Castillo Y, et al · · 2025 · cited 2× · PMID 40451996 · DOI 10.1111/acer.70090

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