RecruitingPhase 2NCT05378100

Ketamine for Multiple Sclerosis Fatigue

Low-Dose Ketamine Infusion for the Treatment of Multiple Sclerosis Fatigue (INKLING-MS)


Sponsor

Johns Hopkins University

Enrollment

110 participants

Start Date

Jan 1, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

The proposed study is a single-center, phase II, randomized, double-blind, parallel-group, active-placebo-controlled trial of intravenous low-dose ketamine in patients with MS fatigue.


Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria7

  • Subject must be a man or woman, 18 to 65 years of age, inclusive.
  • Subject must be medically stable based on physical examination, medical history, and vital signs
  • Subject must meet McDonald 2017 diagnostic criteria for multiple sclerosis based on the PI review of the medical records
  • Subject must complain from fatigue as one of their main symptoms and have a screening MFIS score equal or higher than the cutoff based on gender, age, and education displayed in Table-226
  • Subject must be ambulatory (able to walk at least 20 feet using bilateral assistance)
  • Subject must have internet and email access and ability to use a computer or tablet or smartphone
  • Subjects that are currently taking medication for alleviating fatigue (such as amantadine, modafinil and armodafinil, and amphetamine-like psychostimulants) at Screening are eligible to participate unless the medication is one of the disallowed therapies (Table 3). Subjects taking a fatigue medication at the Screening visit must have been receiving a stable dose for at least four weeks before the Screening visit and be willing to continue the medication at the same dose for the duration of the study.

Exclusion Criteria16

  • BDI-II score of more than 29 (indicating severe depression)
  • Having a known clear cause for secondary fatigue, such as untreated sleep apnea, untreated hypothyroidism, chronic liver disease, history of moderate to severe anemia (hemoglobin concentration of less than 9 gr/dl in men or less than 8 gr/dl in women).
  • Neurodegenerative disorders other than relapsing or progressive MS
  • Breastfeeding or pregnant
  • History of coronary artery disease or congestive heart failure
  • Uncontrolled hypertension at Screening (history of high blood pressure and screening systolic blood pressure \>160 or diastolic blood pressure\>100)
  • History of severe liver disease, including cirrhosis
  • Terminal medical conditions
  • Currently treated for active malignancy
  • Alcohol or substance abuse in the past year (except marijuana or other cannabinoids)
  • A history of intolerance or allergic or anaphylactic reaction to ketamine or midazolam
  • Clinically unstable medical or psychiatric disorders that require acute treatment as determined by the PI
  • History of severe or untreated coronary artery disease or history of congestive heart failure
  • History of prior ischemic or hemorrhagic stroke and cerebral vascular aneurysms.
  • History of recurrent seizures or epilepsy
  • Taking any disallowed therapy(ies), as noted in the protocol.

Interventions

DRUGKetamine

Infusion of ketamine 0.5 mg/kg over 40 minutes

DRUGMidazolam

Infusion of midazolam 0.05 mg/kg over 40 minutes


Locations(1)

Johns Hopkins University

Baltimore, Maryland, United States

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NCT05378100


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