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Efficacy of Ramelteon in Subjects With Chronic Insomnia

Primary Purpose

Sleep Initiation and Maintenance Disorders

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Ramelteon
Ramelteon
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sleep Initiation and Maintenance Disorders focused on measuring Chronic Insomnia, DIMS (Disorders of Initiating and Maintaining Sleep), Disorders of Initiating and Maintaining Sleep, Insomnia Disorder Sleep Initiation Dysfunction, Transient Insomnia, Drug Therapy, Sleep Disorders, Intrinsic

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Participant has participated in an allowed Ramelteon study and has completed all final visit procedures for the previous study within 21 days of the Treatment Initiation Visit for this study.
  • Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.
  • Investigator believes that participant requires long-term treatment for insomnia.
  • Primary insomnia as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised for at least 3 months and a history of daytime complaint(s) associated with disturbed sleep.
  • Subjective sleep latency greater than or equal to 45 minutes and a subjective total sleep time less than or equal to 6.5 hours per night for at least 3 nights during the week of the Baseline Lead-in Period.
  • Habitual bedtime is between 8:30PM and 12:00AM.
  • Body mass index between 18 and 34, inclusive.

Exclusion Criteria

  • Known hypersensitivity to Ramelteon or related compounds, including melatonin.
  • Participated in any other investigational study, and/or taken any investigational drug within 30 days or five half-lives prior to Day 1 of study medication, whichever is longer. The only exception to this is prior participation in an allowed Ramelteon study.
  • Sleep schedule changes required by employment (eg, shift worker) within three months prior to Day 1 of study medication, or has flown across greater than three time zones within seven days prior to screening.
  • Participated in a weight loss program or has substantially altered their exercise routine within 30 days prior to Day 1 of study medication.
  • Ever had a history of seizures, sleep apnea, chronic obstructive pulmonary disease, restless leg syndrome, schizophrenia, bipolar disorder, mental retardation, or cognitive disorder.
  • History of psychiatric disorder (including anxiety or depression) within the past 12 months.
  • History of drug addiction or drug abuse with the past 12 months.
  • History of alcohol abuse within the past 12 months, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised and/or regularly consumes 4 or more alcoholic drinks per day.
  • Current significant neurological, hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, hematologic, or metabolic disease, unless currently controlled and stable with protocol-allowed medication 30 days prior to Day 1 of study medication.
  • Uses tobacco products during nightly awakenings.
  • Any clinically important abnormal finding as determined by a medical history, physical examination, electrocardiogram, or clinical laboratory tests, as determined by the investigator.
  • Positive hepatitis panel.
  • Any additional condition(s) that in the Investigator's opinion would:

    • affect sleep/wake function
    • prohibit the subject from completing the study, or
    • not be in the best interest of the subject to participate in the study.
  • Morning serum cortisol at the Baseline visit of less than 7.0 micro-g per dl.
  • Is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication, including:

    • Anxiolytics
    • Hypnotics
    • Antidepressants
    • Anticonvulsants
    • Sedating H1 antihistamines
    • Systemic steroids
    • Respiratory stimulants (eg, theophylline)
    • Decongestants
    • Over-the-counter and prescription stimulants
    • Over-the-counter and prescription diet aids
    • Central nervous system active drugs
    • Narcotic analgesics
    • Beta blockers
    • St. John's Wort
    • Kava-kava
    • Gingko biloba
    • Melatonin

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Ramelteon 8 mg QD

Ramelteon 16 mg QD

Arm Description

Outcomes

Primary Outcome Measures

Adverse Events.
Change from Baseline in Vital Signs.
Change from Baseline in Hematology Laboratory Tests.
Change from Baseline in Chemistry Laboratory Tests.
Change from Baseline in Urinalysis Laboratory Tests.
Electrocardiograms.
Menstrual Diary Results.
Physical Examinations.

Secondary Outcome Measures

Change from Baseline in Subjective Total Sleep Time.
Change from Baseline in Subjective Sleep Latency.
Clinical Global Impression Scale.

Full Information

First Posted
May 1, 2008
Last Updated
February 27, 2012
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00671086
Brief Title
Efficacy of Ramelteon in Subjects With Chronic Insomnia
Official Title
A Phase 3, Open-label, Fixed-dose Study to Determine the Safety of Long-term Administration of TAK-375 in Subjects With Chronic Insomnia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
February 2003 (undefined)
Primary Completion Date
September 2004 (Actual)
Study Completion Date
September 2004 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the long-term safety of Ramelteon, once daily (QD), in subjects with chronic insomnia.
Detailed Description
Insomnia is characterized by difficulties initiating and maintaining sleep or complaints of non-restorative and non-refreshing sleep. Transient insomnia affects approximately one-third to one-half of the US population, based on the results of 2 surveys of representative samples of the adult US population conducted by the Gallup Organization in which respondents were asked if they had "ever had difficulty sleeping." Based on reports of "regular" or "frequent" sleep difficulty, results from the same studies suggest that approximately one-tenth of the US population experiences chronic insomnia. The ideal treatment for insomnia would reduce the latency to onset of sleep and increase total sleep time, without a negative impact on sleep architecture and without safety concerns or next-day effects. Ramelteon is selective melatonin-1 receptor agonist under global development by Takeda Chemical Industries, Ltd., for the treatment of transient and chronic insomnia and for the treatment of Circadian Rhythm Sleep Disorders. The purpose of this study is to obtain data in support the safety of long-term use of Ramelteon for insomnia, and to determine whether there are any adverse effects associated with extended use. Participation in this study is expected to be about. Participation in this study is anticipated to be approximately 13 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sleep Initiation and Maintenance Disorders
Keywords
Chronic Insomnia, DIMS (Disorders of Initiating and Maintaining Sleep), Disorders of Initiating and Maintaining Sleep, Insomnia Disorder Sleep Initiation Dysfunction, Transient Insomnia, Drug Therapy, Sleep Disorders, Intrinsic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
1213 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ramelteon 8 mg QD
Arm Type
Experimental
Arm Title
Ramelteon 16 mg QD
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem, TAK-375
Intervention Description
Subjects 65 yrs of age and older will take Ramelteon 8 mg, tablets, orally, once nightly for up to one year.
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem, TAK-375
Intervention Description
Subjects between 18 and 64 years of age will take Ramelteon 16 mg, tablets, orally, once nightly for up to one year.
Primary Outcome Measure Information:
Title
Adverse Events.
Time Frame
Week 1, Months 1, 2, 3, 4, 6, 8, 10, and 12 or Final Visit.
Title
Change from Baseline in Vital Signs.
Time Frame
Week 1, Months 1, 2, 3, 4, 6, 8, 10, and 12 or Final Visit
Title
Change from Baseline in Hematology Laboratory Tests.
Time Frame
Week 1, Months 1, 2, 4, 6, 8, 10, and 12 or Final Visit.
Title
Change from Baseline in Chemistry Laboratory Tests.
Time Frame
Week 1, Months 1, 2, 4, 6, 8, 10, and 12 or Final Visit.
Title
Change from Baseline in Urinalysis Laboratory Tests.
Time Frame
Week 1, Months 1, 2, 4, 6, 8, 10, and 12 or Final Visit.
Title
Electrocardiograms.
Time Frame
Month 6 and 12 or Final Visit.
Title
Menstrual Diary Results.
Time Frame
Week 1, Months 1, 2, 4, 6, 8, 10, and 12 or Final Visit.
Title
Physical Examinations.
Time Frame
Months 2, 4, 8, 10, and 12 or Final Visit.
Secondary Outcome Measure Information:
Title
Change from Baseline in Subjective Total Sleep Time.
Time Frame
Week 1, Months 1, 2, 3, 4, 6, 8, 10, 12, and 12 or Final Visit.
Title
Change from Baseline in Subjective Sleep Latency.
Time Frame
Week 1, Months 1, 2, 3, 4, 6, 8, 10, 12, and 12 or Final Visit.
Title
Clinical Global Impression Scale.
Time Frame
Months 6 and 12 or Final Visit.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Participant has participated in an allowed Ramelteon study and has completed all final visit procedures for the previous study within 21 days of the Treatment Initiation Visit for this study. Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study. Investigator believes that participant requires long-term treatment for insomnia. Primary insomnia as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised for at least 3 months and a history of daytime complaint(s) associated with disturbed sleep. Subjective sleep latency greater than or equal to 45 minutes and a subjective total sleep time less than or equal to 6.5 hours per night for at least 3 nights during the week of the Baseline Lead-in Period. Habitual bedtime is between 8:30PM and 12:00AM. Body mass index between 18 and 34, inclusive. Exclusion Criteria Known hypersensitivity to Ramelteon or related compounds, including melatonin. Participated in any other investigational study, and/or taken any investigational drug within 30 days or five half-lives prior to Day 1 of study medication, whichever is longer. The only exception to this is prior participation in an allowed Ramelteon study. Sleep schedule changes required by employment (eg, shift worker) within three months prior to Day 1 of study medication, or has flown across greater than three time zones within seven days prior to screening. Participated in a weight loss program or has substantially altered their exercise routine within 30 days prior to Day 1 of study medication. Ever had a history of seizures, sleep apnea, chronic obstructive pulmonary disease, restless leg syndrome, schizophrenia, bipolar disorder, mental retardation, or cognitive disorder. History of psychiatric disorder (including anxiety or depression) within the past 12 months. History of drug addiction or drug abuse with the past 12 months. History of alcohol abuse within the past 12 months, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised and/or regularly consumes 4 or more alcoholic drinks per day. Current significant neurological, hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, hematologic, or metabolic disease, unless currently controlled and stable with protocol-allowed medication 30 days prior to Day 1 of study medication. Uses tobacco products during nightly awakenings. Any clinically important abnormal finding as determined by a medical history, physical examination, electrocardiogram, or clinical laboratory tests, as determined by the investigator. Positive hepatitis panel. Any additional condition(s) that in the Investigator's opinion would: affect sleep/wake function prohibit the subject from completing the study, or not be in the best interest of the subject to participate in the study. Morning serum cortisol at the Baseline visit of less than 7.0 micro-g per dl. Is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication, including: Anxiolytics Hypnotics Antidepressants Anticonvulsants Sedating H1 antihistamines Systemic steroids Respiratory stimulants (eg, theophylline) Decongestants Over-the-counter and prescription stimulants Over-the-counter and prescription diet aids Central nervous system active drugs Narcotic analgesics Beta blockers St. John's Wort Kava-kava Gingko biloba Melatonin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
VP Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
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Birmingham
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Mobile
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Phoenix
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Tempe
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Hot Springs
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Little Rock
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Northridge
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San Diego
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Denver
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Wheat Ridge
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Lincoln
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Newark
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Toma River
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Brooklyn
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Kingston
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Lake Success
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Rochester
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White Plains
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Cary
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Raleigh
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Salisbury
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Wilmington
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Winston-Salem
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Beachwood
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Cincinnati
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Columbus
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Dublin
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Toledo
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Oklahoma City
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Eugene
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Portland
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Duncansville
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Jenkintown
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Lafayette Hill
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Philadelphia
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Warwick
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Anderson
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Columbia
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Greer
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Bristol
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Cordova
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Austin
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Houston
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Plano
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San Antonio
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Salt Lake City
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Charlottesville
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Fairfax
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Oakland
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Seattle
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Tacoma
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Milwaukee
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Wauwatosa
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United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19284927
Citation
Richardson GS, Zammit G, Wang-Weigand S, Zhang J. Safety and subjective sleep effects of ramelteon administration in adults and older adults with chronic primary insomnia: a 1-year, open-label study. J Clin Psychiatry. 2009 Apr;70(4):467-76. doi: 10.4088/jcp.07m03834. Epub 2009 Mar 10.
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Efficacy of Ramelteon in Subjects With Chronic Insomnia

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