New Hope for Cocaine Addiction Treatment

There is new hope for individuals struggling with cocaine addiction. In a recent clinical trial, an experimental drug initially developed by Novartis has been found to reduce cocaine use in people with cocaine use disorder.

Clinical Trial Results

The Phase II trial, led by scientists at Novartis, involved 68 people with diagnosed cocaine use disorder. The results showed that those taking the experimental treatment, called mavoglurant, used cocaine and drank alcohol less often over a period of three months, compared to those on a placebo. Although further validation is required, mavoglurant could potentially become the first approved drug for treating cocaine use disorder.

The Need for Effective Treatment

Cocaine and similar substances, such as methamphetamine and prescription stimulants, are frequently abused. In the United States, it is estimated that 10.2 million Americans over the age of 12 misused stimulants in 2022, with approximately 4.5 million people meeting the criteria for a stimulant use disorder. Stimulant misuse is on the rise and is contributing to increasing overdose deaths, particularly when combined with other substances like opioids.

Current Treatment Options

Currently, the primary treatments available for stimulant misuse are psychosocial, including counseling and cognitive behavioral therapy. There are no approved medications for reducing the urge to use cocaine, and off-label options, such as disulfiram, have shown limited effectiveness. Therefore, there is a pressing need to fill this treatment gap, which mavoglurant may potentially address.

The Development of Mavoglurant

Mavoglurant was initially developed to treat the genetic condition Fragile X, but it ultimately failed to do so in large clinical trials. However, the drug is known to block a receptor called mGluR5, which is believed to play a role in regulating the reward response to stimulants. Researchers hoped that mavoglurant could be repurposed as a treatment for stimulant use disorder.

Trial Methodology and Results

In the latest trial, participants with cocaine use disorder were randomized to receive either a placebo or mavoglurant (taken as a pill) twice a day for 98 days. Cocaine use was measured through self-reported use, as well as urine and hair tests that detected known byproducts of the drug in the body. The results showed that mavoglurant significantly reduced cocaine use compared to the placebo, which was supported by urine tests. Additionally, there was evidence that it reduced alcohol use, although the findings were not as clear. The drug was generally safe and tolerated, with common adverse events including headache, dizziness, and nausea.

Conclusion and Future Directions

As the researchers noted, "In this small and short trial, mavoglurant reduced cocaine and alcohol use in patients with chronic cocaine use disorder." Although this is only one small trial, the findings could be an important step forward in the treatment of stimulant use disorder. Larger, more diverse, and longer-lasting trials are needed to confirm the results. Given the current lack of options, this research could be a significant breakthrough, and the effects of mavoglurant on alcohol use may also open up new avenues of research. In 2023, mavoglurant was licensed out to the biotech company Stalicla SA for further development in this area.