Methadone Dose Monitoring With a Remote Medication Monitor

NCT06837571 — Not yet recruiting, 30 participants, Cari Health Inc.

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Assessment of Methadone Dose Taken

RegistryNCT06837571
StatusNot yet recruiting
Study typeObservational
Enrollment30 (Estimated)
SponsorCari Health Inc. (Other)
ConditionsMethadone Toxicity, Methadone Overdose, Pain, Chronic, Drug Metabolism, Poor, CYP2D6-Related, Metabolism Medication Toxicity
InterventionsMeasurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo, Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo, ISF Extraction Device 2 (Diagnostic test, drug, device)
Datesstart 2025-04-26 (estimated), primary completion 2025-05-01 (estimated), completion 2025-06-01 (estimated), first posted 2025-02-20, last updated 2025-02-20
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Methadone Toxicity All trials for Methadone Overdose All trials of Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo All trials of Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo

-Summary

Proof of concept: Pilot Study

A Pilot, proof of concept, observational study with a long-term goal to develop a minimally invasive wearable Remote Medication Monitor (RMM) that provides continuous, real-time data on methadone levels in interstitial fluid (ISF). An RMM could be used as a medication adherence monitor and would allow for the physician, counselor, patient, or family member to remotely verify that a physician-prescribed dose has been taken.

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+Detailed description

The investigator will conduct a non-randomized, non-blinded, feasibility study at a single center in the United States. The study will include up to 20 subjects of an equal number of male and female adults (ages 18-70) who have a prescription for methadone.

In Aim 1, the investigators will determine if an RMM can continuously assess the status of taking a prescribed dose of methadone over time, by inserting the dermal ISF sensing elements into the subjects' abdominal skin. Biosample collections (i.e., ISF, blood) and pharmacokinetic monitoring will occur over a 6-hour period. By completing this aim, the investigator will determine if a physician is able to recognize the pharmacokinetic profile of a taken dose of methadone. The physician will see a dosing curve display generated from dermal ISF dialysis fluid sampling using an external fiberoptic sensor system that is worn continuously on the abdomen similar to continuous glucose monitors.

+Arms and interventions

ArmTypeInterventionsDescription
Visit 1Device: ISF Extraction Device 2AIM 2 : Determine if an RMM can assess the status of taking a prescribed dose of methadone. To complete this aim, the peak and trough concentrations of a witnessed methadone dose will be assessed in dermal ISF collected through the surface of the skin using existing ISF extraction methods and assessed outside the body via with and dermal ISF dialysis tube and external aptamer switch based fiberoptic sensor continuously for 6 hours. Methadone and protein binding factors are independently assessed in the collected ISF samples using (LC-MS and Lateral Flow Assays). We hypothesize that the methadone peak and trough levels in the blood samples will correlate with the levels of methadone in ISF. The Investigators hypothesize that the methadone peak and trough levels in the blood samples will correlate with the levels of methadone in ISF.
Visit 2Diagnostic Test: Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo; Drug: Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo; Device: ISF Extraction Device 2AIM 3: Determine if an RMM can continuously assess the status of taking a prescribed dose of methadone over time. To complete this aim, the pharmacokinetic profile of a witnessed methadone dose will be assessed in ISF dialysate continuously from the surface of the skin using the RMM for up to 12 hours (Aim 3a) and over 3 days (Aim 3b). Methadone will also be assessed over these three time points in the continuously collected ISF samples using LC-MS and Lateral Flow Assays. The Investigators hypothesize that a clinician can recognize a dose taken from the RMM generated measurements of dialyzed ISF.
  • Measurement of Methadone in the Interstitial Fluid (ISF) before and after prescribed dose taken ex vivo (Diagnostic test), also known as dose taken peak-trough test: Measurement of Methadone and its metabolites in interstitial fluid with Liquid Chromatography - Mass Spectroscopy (LC-MS) and Aptamer based Assay
  • Measurement of Methadone in the Interstitial Fluid before and after prescribed dose taken in vivo (Drug), also known as In vivo Continuous molecular monitoring: Measurement of Methadone and its metabolites in ISF with LC-MS and RMM
  • ISF Extraction Device 2 (Device), also known as Ascilion: Up to 15 minute periods of continuous ISF collection for analysis

+Outcome measures

Primary outcomes

  • Methadone Concentration in ISF before and after a dose [1 day]: measure dermal interstitial fluid with LC-MS for methadone before and after a daily dose
  • Methadone Concentration in blood before and after a dose [1 day]: measure blood for methadone with LC-MS before and after a daily dose
  • Concentration of Methadone in ISF with LC-MS versus Fluorescent Aptamer Switch [2 days]: measure ISF with two procedures (Liquid Chromatography - Mass Spectroscopy and Fluoroscopy
  • Concentration of Methadone in blood with LC-MS versus Fluorescent Aptamer Switch [2 days]: measure blood with two procedures (Liquid Chromatography - Mass Spectroscopy and Fluoroscopy
  • Pearson Correlation of Methadone between ISF and Blood [2 days]: measure blood and ISF methadone with LC-MS and determine pearson correlation
  • Pearson Correlation between Fluoroscopy and LC-MS ISF Methadone [2 days]: measure ISF for methadone by LC-MS and Fluoroscopy and determine Pearson correlation

+Eligibility

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* Age 18-70
* A prescription for methadone at a dose of 10mg or more for at least one week.
* Taking methadone as prescribed during the last 4 days before consent to participate in the study.

Exclusion Criteria:

* Age <18 or >70
* A condition preventing or complicating ISF collection
* dermatological (skin) condition
* immunodeficiency
* recent blood donation
* anemia
* end stage renal disease
* liver cirrhosis
* cancer
* congestive heart failure
* bleeding diathesis
* tuberculosis (TB)
* Any active severe depression
* suicidal ideation
* mania symptoms
* Pregnancy
* Intending to become pregnant during the course of the study
* Enrolled in a substance use disorder treatment program
* Under a conservatorship.

+Locations (1)

FacilityCityCountryStatus
SynergyLemon Grove, CaliforniaUnited States

+Publications

  • Friedel M, Werbovetz B, Drexelius A, Watkins Z, Bali A, Plaxco KW, Heikenfeld J. Continuous molecular monitoring of human dermal interstitial fluid with microneedle-enabled electrochemical aptamer sensors. Lab Chip. 2023 Jul 12;23(14):3289-3299. doi: 10.1039/d3lc00210a. PMID 37395135
  • Gomes NO, Raymundo-Pereira PA. On-Site Therapeutic Drug Monitoring of Paracetamol Analgesic in Non-Invasively Collected Saliva for Personalized Medicine. Small. 2023 Mar;19(12):e2206753. doi: 10.1002/smll.202206753. Epub 2023 Jan 15. PMID 36642790
  • Ribet F, Bendes A, Fredolini C, Dobielewski M, Bottcher M, Beck O, Schwenk JM, Stemme G, Roxhed N. Microneedle Patch for Painless Intradermal Collection of Interstitial Fluid Enabling Multianalyte Measurement of Small Molecules, SARS-CoV-2 Antibodies, and Protein Profiling. Adv Healthc Mater. 2023 May;12(13):e2202564. doi: 10.1002/adhm.202202564. Epub 2023 Feb 21. PMID 36748807

+Investigators