kevin walton, ph.d. · 2017-06-20 · kevin walton, ph.d. chief, clinical research grants branch...

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Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

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Page 1: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Kevin Walton, Ph.D.

Chief, Clinical Research Grants BranchDivision of Therapeutics and Medical Consequences

NIDA

No disclosures

Page 2: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

NIDA Organizational Chart

Office of Diversity & Health Disparities

Office of Translational Initiatives & Program 

Innovations

Division of Therapeutics and Medical Consequences

Center for the Clinical Trials Network

Division of Epidemiology, Services and Prevention Research

Division of Neuroscience and Behavior

Office of Management

Science Policy & Communications

Division of ExtramuralResearch

Intramural ResearchProgram

International Program

AIDS Research Program

Trans‐Division Research Teams

Office ofthe Director

Page 3: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

1.  Basic Science: Identify the biological, environmental, behavioral, and social causes and consequences of drug use and addiction across the lifespan.

2.  Prevention: Develop new and improved strategies to prevent drug use and its consequences.

3.  Treatment: Develop new and improved treatments to help people with substance use disorders achieve and maintain a meaningful and sustained recovery.

4.  Public Health: Increase the public health impact of NIDA research and programs.

Page 4: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

2016 Monitoring the Future StudyKey Findings‐ Prevalence (2015 to 2016)

Page 5: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Steady Decline in Past Month Cigarette Use 

Page 6: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Teens more likely to use e‐cigarettes than combusted cigarettes

Page 7: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Adult E‐cigarette Use

• Population Assessment of Tobacco and Health (PATH)– Longitudinal, comprehensive effort documenting tobacco use– 45,971 adults and youths, 12 years of age or older

• Current use ‐ daily or some days (weighted percentages)

• Based on US population numbers (Census bureau)– About 37 million use cigarettes daily– About 3 million use e‐cigarettes daily

18‐24 yo >25 yo 18‐24 yo(DAILY)

>25 yo(DAILY)

Cigarette 19.6% 17.9%  14.7% 16.2%E‐cigarette 8.9% 5.0%  1.3% 1.2%

Page 8: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Questions About E‐cigarettes 

How safe are they?   Are they addictive?  Are they a gateway to smoking?

Do they have a role for harm reduction and cessation?What are the issues for vulnerable populations: youth, 

mental illness, pregnancy? 

How to answer these questions?   • Often requires preclinical and clinical studies. 

• Need devices with known aerosol / delivery characteristics.

• Clinical studies often need FDA review, requiring a detailed data package describing the device.

• Uncertain availability of a commercial device thru a study.

Page 9: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

How is NIDA facilitating e‐cigarette research?

• In 2014, NIDA issued a contract solicitation (SBIR) to develop a Standardized Research E‐Cigarette (SREC) with an associated data package.

• Four companies received Phase 1 contracts, NJOY LLC will be the first to complete Phase 2.

• Devices and refills will be available by 4Q 2017.

• NJOY will sell the SREC directly to researchers together with permission to reference the data package for FDA submissions.

Page 10: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Key features of the SREC 

• E‐liquids made under GMP‐like conditions (to allow use in clinical studies). 

• Fully characterized e‐liquid and aerosol.

• Tobacco flavor, nicotine‐containing and placebo e‐liquids.

• Unique battery connector and sealed cartridges limit use to the characterized e‐liquid.

• Reproducible aerosol delivery from start to end of cartridge & battery charge.

• Demonstrated nicotine delivery (pharmacokinetics).

Page 11: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Technical Characteristics

1. https://www.drugabuse.gov/funding/supplemental‐information‐nida‐e‐cig2. 2016 El‐Hellani et al, Nicotine and Carbonyl Emissions From Popular Electronic Cigarette Products: 

Correlation to Liquid Composition and Design Characteristics. Nic Tob Res

SREC1 COMMERCIAL2

E‐LIQUIDPuffs (3 s) per Cartridge > 350 Variable

Nicotine Concentration 15 mg/mL 7‐21 mg/mL

AEROSOL CHARACTERISTICS (per 10 puffs)Nicotine 1 mg 0.3 – 3 mg

Formaldehyde 1 μg 0.6 ‐ 5 μgAcetaldehyde 0.9 μg  0.4 – 21 μg

Acrolein 0.2 μg ? – 1.4 μg

Page 12: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Nicotine Pharmacokinetic Profile(mean ± SD) 

t‐Test: Paired Two Sample for MeansCmax (ng/mL)

Own SRECMean 11.08 17.68

Variance 71.31 306.69Observations 14 14

P(T<=t) two‐tail 0.21

t‐Test: Paired Two Sample for MeansTmax (min)

Own SRECMean 9.07 5.71

Variance 42.69 0.99Observations 14 14P(T<=t) two‐tail 0.06

Tmax   (min)

Cmax   (ng/ml)

Own              SREC  11.08             17.6871.31           306.69        14                   140.21  

Own              SREC  9.07               5.7142.69              0.99        14                   140.06  

64

32

16

8

4

2

1

0.5

0.25

0         50        100        200  300  400  500 

Own Device

SREC

TIME   (min)

Ad lib useDefineduse

NICOTINE  IN

  PLA

SMA    

(ng/ml)

CmaxOwn Device SREC

Mean (ng/ml) 11.08 17.68

Variance 72.71 306.69

Observations 14 14

P(T<=t) two‐tail 0.21

TmaxOwn Device SREC

Mean (ng/ml) 9.07 5.71

Variance 42.69 0.99

Observations 14 14

P(T<=t) two‐tail 0.06

Page 13: Kevin Walton, Ph.D. · 2017-06-20 · Kevin Walton, Ph.D. Chief, Clinical Research Grants Branch Division of Therapeutics and Medical Consequences NIDA No disclosures

Harm Reduction is the current focus• These studies with tobacco products are reviewed by the FDA Center for Tobacco Products (CTP). − We expect a complete SREC Product Master File will support the device’s use as an Investigational Tobacco Product.

Smoking/Nicotine Cessation studies are a future goal• This is a therapeutic indication, regulated by the FDA Center for Drug Evaluation and Research (CDER).− Investigational New Drugs require evidence of safety in animals prior to “First in Human” studies.

Overall Research Direction