ClinicalTrials.gg
Status unknownNCT05503147CanPanUpdated Sep 21, 2022

Sativex® and Gentamicin for Optimized Pharmagological Treatment in Older Patients (CanPan)

A Phase 1 interventional study of Sativex in Malnutrition, Anorexia and Cannabis, sponsored by Ove Andersen. Status unknown at 1 site in Denmark. Open to participants aged 65 Years and older. Per ClinicalTrials.gov, last updated 2022-09-21.

Sponsored by Ove Andersen · Phase 1, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Sep 2022), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 1
Study type
Interventional
Enrollment
17
Allocation
Randomized
Ages
65 Years and older
Sex
All
01

Study summary

Malnutrition and inappropriate prescribing of renally excreted drugs are common among older persons and are associated with severe consequences such as complicated courses of treatment, mortality, and reduced quality of life. The overall purpose of CanPan is to optimize treatment of older persons with malnutrition with a focus on appetite stimulation and optimized prescribing of renal risk drugs.

The CanPan trial consists of two sub-studies. Substudy 1 will provide knowledge on appetite and appetite stimulation and together, sub study 1 and 2 will offer unique knowledge on how body composition, renal function and biomarkers of organ function influence pharmacokinetics for a highly lipophilic (Sativex®) and hydrophilic (Hexamycin®) drug in older medical patients with malnutrition.

Read the detailed description

The CanPan trial consists of sub study 1 and sub study 2. Subjects who meet all the inclusion criteria and none of the exclusion criteria are invited to participate in both sub studies. Sub study 1 consist of trial days 1 and 2 and sub study 2 consists of trial day 3.

Sub study 1:

Sub study 1 is a double-blinded, randomized, placebo-controlled, multidose, crossover trial that evaluates the appetite stimulating effect as well as the pharmacokinetics of Sativex®. The primary purpose of sub study 1 is to 1) uncover whether Sativex® has appetite stimulating properties defined as increased energy intake compared to placebo, 2) to develop a pharmacokinetic-pharmacodynamic model, and gain knowledge about the effect of Sativex® on other markers of appetite, the intraocular pressure of the eye and safety parameters.

In sub study 1, subjects receive both Sativex® and placebo. Both Sativex® and placebo are administered as an oromucosal spray. Sativex consists of 2.7 mg tetrahydrocannabinol (THC) and 2.5 mg cannabidiol (CBD) per dose of spray (Cannabis sativa L. extract, cannabis leaf and flower). Subjects receive three dose of spray two times during a trial day. Trial day 1 is planned \<14 days after inclusion and there is a 2-week break between trial days 1 and 2 due to a wash-out period. Follow-up visits/phonecalls are made on days 1, 2 and 7 after trial days 1 and 2.

Sub study 2:

Sub-study 2 is a single-dose pharmacokinetic study using gentamicin (Hexamycin®) as a renally excreted model drug. The purpose of sub study 2 is to compare the prediction accuracy of clearance estimates between eGFRpanel (creatinine-cystatinC-beta-2_microglobulin-beta_trace_protein, eGFRcomb (creatinine-cystatinC), eGFRcreatinine (creatinine), uCrCl (24-hour urine creatinine clearance) and mGFR (measured GFR) as covariates in population based pharmacokinetic modeling of gentamicin.

On trial day 3, gentamicin is used as the model substance for a drug that is excreted > 90% renally. Gentamicin is administered as a single dose of 5 mg/kg as an intravenous injection (bolus). The marketed drug, Hexamycin® (40 mg / mL), is used for this purpose. Trial day 3 is held within 4 weeks after trial day 2. Follow-up visits are made on day 1 and 2 after trial day 3.

02

Conditions studied

  • Malnutrition
  • Anorexia
  • Cannabis
  • Aging
  • Emergency Service, Hospital
  • Renal Function
  • Pharmacokinetics
03

In context

Malnutrition

1,277 studies on the registry are indexed under Malnutrition; 230 are open to participants now.

This study's planned enrollment of 17 is below the median of 118 across 843 interventional studies indexed under Malnutrition.

Browse Malnutrition studies →

Lead sponsor

Ove Andersen is the lead sponsor of 9 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • ≥65 years of age
  • Admitted to the acute medical department, Hvidovre Hospital
  • Can cooperate cognitively and physically (patient reported)
  • Low appetite/anorexia of ageing measures by SNAQ score ≤14
  • ≤30 (screening)
  • Able to read and understand Danish
  • defined as missed periods for at least 12 months before the start of the trial

Exclusion criteria

Exclusion Criteria:

  • Regular use of medical cannabis (patient reported)
  • Use of medical cannabis within 14 days at baseline (patient reported)
  • Recognized or suspected psychotic illness in the subject or the subjects family (medical record and patient report)
  • Severe personality disorders (journal)
  • Significant psychiatric disorder in addition to mild to moderate depression (medical record)
  • Allergy to the ingredients of Sativex®, placebo and Hexamycin® (patient reported)
  • Terminal diagnosis (journal)
  • Liver transplant (journal)
  • Chronic ≤15 mL / min2 or dialysis treatment (medical record)
  • High risk of nephrotoxicity due to existing drug treatment (medical assessment)
  • Pacemaker (journal)
  • Epilepsy (journal)
  • Recurrent seizures (journal)
  • Uncontrolled hypertension (journal)
  • Food intolerance to the ingredients in the test meals (patient-reported)
  • Vegetarian and vegan (patient-reported)
  • Unwilling to avoid driving for up to 72 hours after administration of Sativex® (patient-reported)
  • Unwilling to avoid alcohol 24 hours up to test days (patient-reported)
  • Patients with ascites ( journal)
  • Patients with significant edema on the days of the trial (journal / visual inspection)
  • In active treatment of cancer or have disseminated cancer (journal)
  • Known with brain - or kidney tumor (journal)
  • Known with angina pectoris or intermittent claudication
  • Known with stroke, AMI, or heart failure ( III-IV) within the past 5 years (journal)
  • In isolation
  • Obs. Covid-19
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
17 participants (estimated)

Study arms

  • Experimental
    Sativex first (blinded) (3 dose of spray)

    Trial day 1: Sativex (3 dose of spray x 2) Trial day 2: Placebo (3 dose of spray x 2) Trial day 3: Voluntary

    Drug: Sativex

  • Experimental
    Placebo first (blinded) (3 dose of spray)

    Trial day 1: Placebo (3 dose of spray x 2) Trial day 2: Sativex (3 dose of spray x 2) Trial day 3: Voluntary

    Drug: Sativex

Interventions

  • Sativex® is administered as an oromucosal spray and consists of 2.7 mg tetrahydrocannabinol (THC) and 2.5 mg cannabidiol (CBD) per dosis spray (Cannabis sativa L. extract, cannabis leaf and flower). The dose (3 sprays) is administered twice, at breakfast and lunch, respectively, with approximately 4 hours between each administration.

    Also known as: nabiximols

06

What researchers measure

Primary outcomes

  1. Difference in energy intake (kJ) between Sativex® and placebo

    Measured at test meal

    Time frame: Trial days 1 and 2.

  2. Differences in the objective function value of the population-based pharmacokinetic model when implementing renal clearance assessed by measured GFR (mL/min), or GFR estimates based on different endogenous markers, as covariates on gentamicin clearance

    The objective function value (minus two times the log-likelihood) describes the prediction accuracy (goodness-of-fit) of a population pharmacokinetic model. A drop in the objective function value of 6.63 in a model with one (1) added covariate implemented on any specific parameter compared to a base model corresponds to a significant improvement in model fit with a p-value of 0.01 in a chi-squared test. Population-based pharmacokinetic modelling is an analysis method performed on pharmacokinetic data, i.e., plasma concentrations over time. Relevant pharmacokinetic parameters are estimated simultaneously by fitting the data to the model. The model structure is found through the analysis and determines which pharmacokinetic parameters are estimated. As a minimum, the clearance and distribution volume of the central compartment are estimated

    Time frame: Trial day 3.

Secondary outcomes

  1. Differences in the objective function values of the population-based models of CBD and THC when implementing bodyweight, age, and body composition factors as covariates on the pharmacokinetic parameters of the model (e.g., clearance)

    The objective function value (minus two times the log-likelihood) describes the prediction accuracy (goodness-of-fit) of a population pharmacokinetic model. A drop in the objective function value of 6.63 in a model with one (1) added covariate implemented on any specific parameter compared to a base model corresponds to a significant improvement in model fit with a p-value of 0.01 in a chi-squared test. Population-based pharmacokinetic-pharmacodynamic modelling is an analysis method performed on pharmacokinetic data, i.e. plasma concentrations over time, coupled to pharmacodynamic data. Relevant pharmacokinetic and -dynamic parameters are estimated simultaneously by fitting the data to the model. The model structure is found through the analysis and determines which pharmacokinetic and -dynamic parameters are estimated. As a minimum, the clearance and distribution volume of the central compartment are estimated

    Time frame: Trial days 1 and 2.

  2. Difference in subjective appetite between Sativex® and placebo

    Using combined subjective appetite scores measured using 100-mm Visual Analogue Scales (VAS), with 0.0 as the minimum value and 10.0 as the maximum value. The following will be used to calculate a combined appetite score: \[desire to eat + hunger + prospective food consumption + (10.0 - fullness) + (10.0 - satiety)\], with higher scores indicating better appetite.

    Time frame: Trial days 1 and 2.

  3. Differences in the appetite hormones, total ghrelin and glucagon like peptide 1 (GLP-1) between Sativex® and placebo

    The appetite hormones (total ghrelin, GLP-1) is measured from blood samples

    Time frame: Trial days 1 and 2.

  4. Change in the intraocular pressure of the eye between Sativex® and placebo

    Measured by Icare ic100 tanometer

    Time frame: Trial days 1 and 2.

  5. Safety parameter (CNS effects) for Sativex®

    Measured using 100-mm Visual Analogue Scales (VAS), with 0.0 as the minimum value and 10.0 as the maximum value. Higher scores indicate a larger effect.

    Time frame: Trial days 1 and 2.

  6. Safety parameter (cognition) for Sativex®

    Measured using Hopkins Verbal Learning Test-Revised for a total score of the following sub-tests: 'Total recall', 'Delayed recall', 'Retention' and 'Recognition'. Higher scores indicate better performance.

    Time frame: Trial days 1 and 2.

  7. Safety parameter (balance disorders) for Sativex®

    Bergs Balance Test is used to measure balance disorders. Balance disorders are defined as a summerated score of ≤45.

    Time frame: Trial days 1 and 2.

  8. Safety parameter (blood pressure) for Sativex®

    Blood pressure is measured in millimeter of mercury (mmHg) using automatic standardized equipment.

    Time frame: Trial days 1 and 2.

  9. Safety parameter (heart rate) for Sativex®

    Heart rate is measured in beats per minute (bpm) using automatic standardized equipment.

    Time frame: Trial days 1 and 2.

  10. Correlation coefficient between clearance of gentamicin and clearance determined as mGFR or eGFR

    Pharmacokinetic modeling

    Time frame: Trial day 3.

  11. Change in plasma creatinine µmol/L between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkeres before and after administration of gentamicin

    Time frame: Trial day 3

  12. Change in plasma cystatin C mg/L between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkers before and after administration of gentamicin

    Time frame: Trial day 3

  13. Change in plasma NGAL ng/mL between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkers before and after administration of gentamicin

    Time frame: Trial day 3

  14. Change in plasma KIM-1 pg/mL between baseline and 22 hours after administration of gentamicin

    Changes in kidney biomarkers before and after administration of gentamicin

    Time frame: Trial day 3

07

Study locations

1 of 1 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 21, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05503147
Lead sponsor
Ove Andersen
Collaborators
University Hospital Bispebjerg and Frederiksberg, Regionshospital Nordjylland, University of Copenhagen, Region Hovedstadens Apotek, Glostrup University Hospital, Copenhagen
Responsible party
Ove Andersen (Research Director and Head of the Department of Clinical Research, Hvidovre University Hospital) — Sponsor-investigator
First posted
Aug 16, 2022
Start date
Mar 24, 2022
Primary completion
Aug 1, 2023 (estimated)
Completion
Sep 1, 2023 (estimated)
Last update
Sep 21, 2022

Study contacts

Olivia Bornæs
Contact
olivia.bornaes@regionh.dk
+4538623184
Morten B Houlind
Contact
morten.baltzer.houlind@regionh.dk
+4538623184
Ove Andersen
study chair · Hvidovre University Hospital
Rikke L Nielsen
study chair · Hvidovre University Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Nabiximols

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