Treatment of Refractory Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome (OSA/HS) Using Nasal Continuous Positive Airway Pressure (nCPAP) Therapy (0249-015)
Primary Purpose
Sleep Apnea, Obstructive, Hypopnea Syndrome, Excessive Daytime Sleepiness
Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Comparator: MK0249
Comparator: placebo
Comparator: modafinil
Sponsored by
About this trial
This is an interventional treatment trial for Sleep Apnea, Obstructive
Eligibility Criteria
Inclusion Criteria:
- Patient is male or female and is at least 18 years old and less than 65 years old
- Patient must have a diagnosis of Obstructive Sleep Apnea/Hypopnea Syndrome
- Patient has been using nCPAP treatment for at least 2 months prior to Visit 1
- Patient is willing to stay at a sleep laboratory for 4 full days and nights for observation and assessments
- Patient is willing to refrain from napping for the duration of the study
Exclusion Criteria:
- Patient is pregnant, breastfeeding, or planning to become pregnant within the next 4 months
- Patient is or has participated in a study with an investigational compound or device within 30 days of signing the informed consent
- Patient has had asthma-related visit to the emergency room or hospitalization within 6 months of Visit 1
- Patient has donated or received blood products within 8 weeks of signing consent or is planning on doing either for the duration of the study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm Type
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Arm Label
1
2
3
4
5
6
Arm Description
Arm 1: Treatment period 1: MK0249; Treatment period 2: Placebo; Treatment period 3: modafinil
Arm 2: Treatment period 1: Placebo; Treatment period 2: modafinil; Treatment period 3: MK0249
Arm 3: Treatment period 1: modafinil; Treatment period 2: MK0249; Treatment period 3: Placebo
Arm 4: Treatment period 1: MK0249; Treatment period 2: modafinil; Treatment period 3: Placebo
Arm 5: Treatment period 1: Placebo; Treatment period 2: MK0249; Treatment period 3: modafinil
Arm 6: Treatment period 1: modafinil; Treatment period 2: Placebo; Treatment period 3: MK0249
Outcomes
Primary Outcome Measures
Mean of Average Maintenance of Wakefulness Test Early for The Mode Dose of MK0249 Versus Placebo
The Maintenance of Wakefulness Test (MWT) is an objective assessment of sleepiness that measures the ability of a patient to remain awake. The primary endpoint was the mean of sleep latency (average of the first 4 MWTs which were at 0900, 1100, 1300, and 1500), where latency for each MWT was defined as the time to onset of the first 16 continuous seconds of any stage of sleep; if no sleep was observed according to these rules, then latency was defined as 30 minutes. The comparison was for the mode dose of MK0249 versus placebo.
Secondary Outcome Measures
Mean of Average Maintenance of Wakefulness Test Early for the Mode Dose of MK0249 Versus Modafinil
The Maintenance of Wakefulness Test (MWT) is an objective assessment of sleepiness that measures the ability of a patient to remain awake. The primary endpoint was the mean of sleep latency (average of the first 4 MWTs which were at 0900, 1100, 1300, and 1500), where latency for each MWT was defined as the time to onset of the first 16 continuous seconds of any stage of sleep; if no sleep was observed according to these rules, then latency was defined as 30 minutes. The comparison was for the mode dose of MK0249 versus modafinil.
Mean of Average Maintenance of Wakefulness Test Early for Top 2 Doses Pooled of MK0249 Versus Modafinil
The Maintenance of Wakefulness Test (MWT) is an objective assessment of sleepiness that measures the ability of a patient to remain awake. The primary endpoint was the mean of sleep latency (average of the first 4 MWTs which were at 0900, 1100, 1300, and 1500), where latency for each MWT was defined as the time to onset of the first 16 continuous seconds of any stage of sleep; if no sleep was observed according to these rules, then latency was defined as 30 minutes. The comparison was for the top 2 doses pooled of MK0249 versus modafinil.
Clinical Global Impressions Scale of Severity Score as it Relates to Excessive Daytime Sleepiness (CGIS-EDS) for the Mode Dose of MK0249 Versus Placebo
Clinical Global Impressions Scale of Severity (CGI-S) is a subscale of the CGI which is a standard psychometric scale used to demonstrate changes and improvements in illness. CGI-S consists of a 7-point scale rated from 1 to 7. The investigator or sponsor-approved clinician judged how ill the patient was with respect to Excessive Daytime Sleepiness (EDS) at the time of the CGI-S rating (CGIS-EDS), with higher scores indicating more severe illness.
Epworth Sleepiness Scale (ESS) Score for the Mode Dose of MK0249 Versus Placebo
The Epworth Sleepiness Scale (ESS) is a self-administered questionnaire that provides subjective reports that equate with sleep propensity, not with 'subjective sleepiness'. Having a high sleep propensity means having a history of dozing in situations that have a relatively low soporific nature, in which normal subjects seldom doze. The ESS consists of eight items, which are rated from 0 ("would never dose") to 3 ("high chance of dozing"). The ESS score is the total score of the 8 individual items; this total score ranges from 0 to 24 (higher total score is worse).
Full Information
NCT ID
NCT00620659
First Posted
January 10, 2008
Last Updated
April 27, 2015
Sponsor
Merck Sharp & Dohme LLC
1. Study Identification
Unique Protocol Identification Number
NCT00620659
Brief Title
Treatment of Refractory Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome (OSA/HS) Using Nasal Continuous Positive Airway Pressure (nCPAP) Therapy (0249-015)
Official Title
Phase IIa, Randomized, Double-blind, Placebo-controlled, 3-period Crossover, Adaptive Dose Design, Clinical Trial to Evaluate Safety & Efficacy of MK0249 in Treating Refractory Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome Appropriately Using nCPAP Therapy.
Study Type
Interventional
2. Study Status
Record Verification Date
April 2015
Overall Recruitment Status
Terminated
Study Start Date
February 2008 (undefined)
Primary Completion Date
February 2009 (Actual)
Study Completion Date
February 2009 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck Sharp & Dohme LLC
4. Oversight
5. Study Description
Brief Summary
The purpose of this study is to determine the safety and efficacy of MK0249 in treating refractory excessive daytime sleepiness (EDS) in patients with Obstructive Sleep Apnea/Hypopnea Syndrome (OSA/HS) using nasal continuous positive airway pressure (nCPAP) therapy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sleep Apnea, Obstructive, Hypopnea Syndrome, Excessive Daytime Sleepiness
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
125 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Experimental
Arm Description
Arm 1: Treatment period 1: MK0249; Treatment period 2: Placebo; Treatment period 3: modafinil
Arm Title
2
Arm Type
Experimental
Arm Description
Arm 2: Treatment period 1: Placebo; Treatment period 2: modafinil; Treatment period 3: MK0249
Arm Title
3
Arm Type
Experimental
Arm Description
Arm 3: Treatment period 1: modafinil; Treatment period 2: MK0249; Treatment period 3: Placebo
Arm Title
4
Arm Type
Experimental
Arm Description
Arm 4: Treatment period 1: MK0249; Treatment period 2: modafinil; Treatment period 3: Placebo
Arm Title
5
Arm Type
Experimental
Arm Description
Arm 5: Treatment period 1: Placebo; Treatment period 2: MK0249; Treatment period 3: modafinil
Arm Title
6
Arm Type
Experimental
Arm Description
Arm 6: Treatment period 1: modafinil; Treatment period 2: Placebo; Treatment period 3: MK0249
Intervention Type
Drug
Intervention Name(s)
Comparator: MK0249
Intervention Description
Patients will be assigned to receive MK0249 film coated tablet (FCT). The doses of MK0249 that are included for possible investigation (depending upon an adaptive allocation process) are 3 mg, 5 mg, 8 mg, 10 mg, and 12 mg. Study medication will be taken for 14 days, during each of the 3 treatment periods, by mouth (po) once a day (qd).
Intervention Type
Drug
Intervention Name(s)
Comparator: placebo
Intervention Description
Placebo; Patients will be assigned to receive placebo, across 3 treatment periods. Study medication will be taken for 14 days, during each of the 3 treatment periods, po qd.
Intervention Type
Drug
Intervention Name(s)
Comparator: modafinil
Intervention Description
Patients will be assigned to receive modafinil 200mg oral compressed tablet (OCT), across 3 treatment periods. Study medication will be taken for 14 days, during each of the 3 treatment periods, po qd.
Primary Outcome Measure Information:
Title
Mean of Average Maintenance of Wakefulness Test Early for The Mode Dose of MK0249 Versus Placebo
Description
The Maintenance of Wakefulness Test (MWT) is an objective assessment of sleepiness that measures the ability of a patient to remain awake. The primary endpoint was the mean of sleep latency (average of the first 4 MWTs which were at 0900, 1100, 1300, and 1500), where latency for each MWT was defined as the time to onset of the first 16 continuous seconds of any stage of sleep; if no sleep was observed according to these rules, then latency was defined as 30 minutes. The comparison was for the mode dose of MK0249 versus placebo.
Time Frame
At Week 2
Secondary Outcome Measure Information:
Title
Mean of Average Maintenance of Wakefulness Test Early for the Mode Dose of MK0249 Versus Modafinil
Description
The Maintenance of Wakefulness Test (MWT) is an objective assessment of sleepiness that measures the ability of a patient to remain awake. The primary endpoint was the mean of sleep latency (average of the first 4 MWTs which were at 0900, 1100, 1300, and 1500), where latency for each MWT was defined as the time to onset of the first 16 continuous seconds of any stage of sleep; if no sleep was observed according to these rules, then latency was defined as 30 minutes. The comparison was for the mode dose of MK0249 versus modafinil.
Time Frame
At Week 2
Title
Mean of Average Maintenance of Wakefulness Test Early for Top 2 Doses Pooled of MK0249 Versus Modafinil
Description
The Maintenance of Wakefulness Test (MWT) is an objective assessment of sleepiness that measures the ability of a patient to remain awake. The primary endpoint was the mean of sleep latency (average of the first 4 MWTs which were at 0900, 1100, 1300, and 1500), where latency for each MWT was defined as the time to onset of the first 16 continuous seconds of any stage of sleep; if no sleep was observed according to these rules, then latency was defined as 30 minutes. The comparison was for the top 2 doses pooled of MK0249 versus modafinil.
Time Frame
At Week 2
Title
Clinical Global Impressions Scale of Severity Score as it Relates to Excessive Daytime Sleepiness (CGIS-EDS) for the Mode Dose of MK0249 Versus Placebo
Description
Clinical Global Impressions Scale of Severity (CGI-S) is a subscale of the CGI which is a standard psychometric scale used to demonstrate changes and improvements in illness. CGI-S consists of a 7-point scale rated from 1 to 7. The investigator or sponsor-approved clinician judged how ill the patient was with respect to Excessive Daytime Sleepiness (EDS) at the time of the CGI-S rating (CGIS-EDS), with higher scores indicating more severe illness.
Time Frame
At Week 2
Title
Epworth Sleepiness Scale (ESS) Score for the Mode Dose of MK0249 Versus Placebo
Description
The Epworth Sleepiness Scale (ESS) is a self-administered questionnaire that provides subjective reports that equate with sleep propensity, not with 'subjective sleepiness'. Having a high sleep propensity means having a history of dozing in situations that have a relatively low soporific nature, in which normal subjects seldom doze. The ESS consists of eight items, which are rated from 0 ("would never dose") to 3 ("high chance of dozing"). The ESS score is the total score of the 8 individual items; this total score ranges from 0 to 24 (higher total score is worse).
Time Frame
At Week 2
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
64 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient is male or female and is at least 18 years old and less than 65 years old
Patient must have a diagnosis of Obstructive Sleep Apnea/Hypopnea Syndrome
Patient has been using nCPAP treatment for at least 2 months prior to Visit 1
Patient is willing to stay at a sleep laboratory for 4 full days and nights for observation and assessments
Patient is willing to refrain from napping for the duration of the study
Exclusion Criteria:
Patient is pregnant, breastfeeding, or planning to become pregnant within the next 4 months
Patient is or has participated in a study with an investigational compound or device within 30 days of signing the informed consent
Patient has had asthma-related visit to the emergency room or hospitalization within 6 months of Visit 1
Patient has donated or received blood products within 8 weeks of signing consent or is planning on doing either for the duration of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
12. IPD Sharing Statement
Citations:
PubMed Identifier
23920422
Citation
Herring WJ, Liu K, Hutzelmann J, Snavely D, Snyder E, Ceesay P, Lines C, Michelson D, Roth T. Alertness and psychomotor performance effects of the histamine-3 inverse agonist MK-0249 in obstructive sleep apnea patients on continuous positive airway pressure therapy with excessive daytime sleepiness: a randomized adaptive crossover study. Sleep Med. 2013 Oct;14(10):955-63. doi: 10.1016/j.sleep.2013.04.010. Epub 2013 Aug 3.
Results Reference
result
Learn more about this trial
Treatment of Refractory Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome (OSA/HS) Using Nasal Continuous Positive Airway Pressure (nCPAP) Therapy (0249-015)
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