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Safety and Efficacy of Ramelteon in Elderly Subjects With Chronic Insomnia

Primary Purpose

Chronic Insomnia

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

About this trial

This is an interventional treatment trial for Chronic Insomnia focused on measuring Chronic Insomnia, Drug Therapy, Elderly

Eligibility Criteria

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

Inclusion Criteria

  • Subject is a male or a post-menopausal female.
  • 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 lead-in period.
  • Habitual bedtime is between 8:30 PM and 12:00 AM.
  • Body mass index between 18 and 34, inclusive.

Exclusion Criteria

  • Known hypersensitivity to ramelteon or related compounds, including melatonin.
  • Previously participated in a study involving ramelteon.
  • Participated in any other investigational study, and/or took any investigational drug within 30 days or five half-lives prior to the first day of single-blind study medication, whichever is longer.
  • Sleep schedule changes required by employment (eg, shift worker) within three months prior to the first day of single-blind study medication, or has flown across greater than three time zones within seven days prior to screening.
  • Participated in a weight loss program or substantially altered exercise routine within 30 days prior to the first day of single blind study medication.
  • Has 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 within the past 12 months.
  • History of drug addiction or drug abuse within 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.
  • 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
    • not be in the best interest of the subject.
  • 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
    • Decongestants
    • Over-the-counter and prescription stimulants
    • Over-the-counter and prescription diet aids
    • Central nervous system active drugs
    • Narcotic analgesics
    • All beta blockers
    • Melatonin
    • St. John's Wort
    • Kava-kava
    • Gingko biloba

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Ramelteon 4 mg QD

Ramelteon 8 mg QD

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Mean Subjective Sleep Latency per subject diary, from Nights 1 through 7 of double-blind Treatment

Secondary Outcome Measures

Subjective Total Sleep Time.
Subjective Number of Awakenings.
Subjective Ease of Falling Back to Sleep after Awakening.
Subjective Sleep Quality.
Clinical Global Impression Change of Condition.
Clinical Global Impression Severity of Illness.
Clinical Global Impression Therapeutic Effect.
Clinical Global Impression Side Effects.
Average Subjective Sleep Latency over the week preceding the Day 15, Day 22, Day 29, and Day 36 Visits.

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
NCT00671255
Brief Title
Safety and Efficacy of Ramelteon in Elderly Subjects With Chronic Insomnia
Official Title
A Phase III, Randomized, Double-Blind, Placebo-Controlled, Outpatient, Safety and Efficacy Study of TAK-375 in Elderly Subjects With Chronic Insomnia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
December 2002 (undefined)
Primary Completion Date
January 2004 (Actual)
Study Completion Date
January 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
This purpose of this study is to evaluate the safety and effectiveness of Ramelteon, once daily (QD), in elderly participants with chronic insomnia.
Detailed Description
Insomnia is characterized by a complaint of initiating and maintaining sleep or complaints of nonrestorative 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 a selective melatonin-1 receptor agonist under development by Takeda Chemical Industries, Ltd., for the treatment of transient and chronic insomnia and for the treatment of Circadian Rhythm Sleep Disorders. Ramelteon is the first candidate in a novel class of drugs based on this mechanism. Based on non-clinical and clinical studies completed to date, TAK-375 has the potential to offer unique advantages relative to approved hypnotics in terms of its pharmacological profile and its selectivity to the melatonin-1 receptor. This study is designed to determine the safety and efficacy of 35-day treatment of chronic insomnia with ramelteon. Participation in this study is anticipated to be approximately 2 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Insomnia
Keywords
Chronic Insomnia, Drug Therapy, Elderly

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
829 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ramelteon 4 mg QD
Arm Type
Experimental
Arm Title
Ramelteon 8 mg QD
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem™, TAK-375
Intervention Description
Ramelteon 4 mg, tablets, orally, once daily for up to 5 weeks.
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem™, TAK-375
Intervention Description
Ramelteon 8 mg, tablets, orally, once daily for up to 5 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Ramelteon placebo-matching, tablets, orally, each night for up to 35 consecutive days.
Primary Outcome Measure Information:
Title
Mean Subjective Sleep Latency per subject diary, from Nights 1 through 7 of double-blind Treatment
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Secondary Outcome Measure Information:
Title
Subjective Total Sleep Time.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Subjective Number of Awakenings.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Subjective Ease of Falling Back to Sleep after Awakening.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Subjective Sleep Quality.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Clinical Global Impression Change of Condition.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Clinical Global Impression Severity of Illness.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Clinical Global Impression Therapeutic Effect.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Clinical Global Impression Side Effects.
Time Frame
Weeks 1, 2, 3, 4 and 5 or Final Visit.
Title
Average Subjective Sleep Latency over the week preceding the Day 15, Day 22, Day 29, and Day 36 Visits.
Time Frame
Weeks 2, 3, 4 and 5 or Final Visit.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Subject is a male or a post-menopausal female. 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 lead-in period. Habitual bedtime is between 8:30 PM and 12:00 AM. Body mass index between 18 and 34, inclusive. Exclusion Criteria Known hypersensitivity to ramelteon or related compounds, including melatonin. Previously participated in a study involving ramelteon. Participated in any other investigational study, and/or took any investigational drug within 30 days or five half-lives prior to the first day of single-blind study medication, whichever is longer. Sleep schedule changes required by employment (eg, shift worker) within three months prior to the first day of single-blind study medication, or has flown across greater than three time zones within seven days prior to screening. Participated in a weight loss program or substantially altered exercise routine within 30 days prior to the first day of single blind study medication. Has 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 within the past 12 months. History of drug addiction or drug abuse within 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. 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 not be in the best interest of the subject. 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 Decongestants Over-the-counter and prescription stimulants Over-the-counter and prescription diet aids Central nervous system active drugs Narcotic analgesics All beta blockers Melatonin St. John's Wort Kava-kava Gingko biloba
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
VP Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Columbiana
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Alabama
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Mobile
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Muscle Shoals
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Tallahassee
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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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Anaheim
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Irvine
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La Jolla
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La Mesa
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Los Angeles
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Murrieta
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Northridge
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Oakland
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Redlands
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Riverside
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San Diego
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Vista
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Colorado Springs
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Denver
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Clearwater
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Hollywood
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Jacksonville
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Longwood
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Tulsa
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Eugene
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Portland
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Reading
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Scotland
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Anderson
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Greer
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Mt. Pleasant
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Fayetteville
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Johnson City
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Norfolk
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Madison
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New Berlin
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Calgary
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Edmonton
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Medicine Hat
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Alberta
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North Vancouver
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British Columbia
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Winnipeg
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Manitoba
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St. John's
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Newfoundland and Labrador
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Corunna
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Ontario
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London
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Ontario
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North Bay
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Ontario
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Sarnia
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Toronto
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Parkdale
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Prince Edward Island
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Montreal
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Quebec
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Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
17996657
Citation
Mini LJ, Wang-Weigand S, Zhang J. Self-reported efficacy and tolerability of ramelteon 8 mg in older adults experiencing severe sleep-onset difficulty. Am J Geriatr Pharmacother. 2007 Sep;5(3):177-84. doi: 10.1016/j.amjopharm.2007.09.004.
Results Reference
result
PubMed Identifier
16709464
Citation
Roth T, Seiden D, Sainati S, Wang-Weigand S, Zhang J, Zee P. Effects of ramelteon on patient-reported sleep latency in older adults with chronic insomnia. Sleep Med. 2006 Jun;7(4):312-8. doi: 10.1016/j.sleep.2006.01.003. Epub 2006 May 18.
Results Reference
result

Learn more about this trial

Safety and Efficacy of Ramelteon in Elderly Subjects With Chronic Insomnia

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