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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
United States
Study Type
Interventional
Intervention
Ramelteon and Placebo (9 possible combinations total)
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 Insomnia

Eligibility Criteria

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

Inclusion Criteria

  • Male or a post-menopausal female.
  • Primary insomnia as defined by the Diagnostic and Statistical Manual of Mental Disorders, Text Revision for at least 3 months and as defined by subjective sleep latency greater than or equal to 30 minutes, subjective total sleep time less than or equal to 6.5 hours per night, and daytime complaint(s) associated with disturbed sleep.
  • Mean latency of greater than or equal to 20 minutes per polysomnography on two consecutive screening nights with neither night less than 15 minutes. Also, a mean of 60 minutes of wake time during the 480 minutes in bed across two nights with no night less than 45 minutes.
  • Habitual bedtime is between 8:30 p.m. and 12:00 a.m.
  • 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 taken any investigational drug within 30 days or five half-lives prior to Day 1 of single-blind study medication, whichever is longer.
  • Sleep schedule changes required by employment (eg, shift worker) within three months prior to Day 1 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 has substantially altered their exercise routine within 30 days prior to Day 1 of single-blind study medication.
  • Ever had a history of seizures, sleep apnea, chronic obstructive pulmonary disease, 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 within the past 12 months.
  • History of alcohol abuse within the past 12 months.
  • Had an acute clinically significant illness, as determined by the investigator, within 30 days prior to Day 1 of single-blind study medication.
  • Current significant neurological (including cognitive and psychiatric disorders), 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 single-blind study medication.
  • Used tobacco products within 90 days prior to Day 1 of single-blind study medication.
  • Used melatonin, or other drugs or supplements known to affect sleep/wake function, or has consumed grapefruit or grapefruit juice within 5 days (or 5 half lives, whichever is longer) prior to Day 1 of single-blind study medication.
  • Used any central nervous system medication within 3 weeks (or 5 half lives of the drug, whichever is longer) prior to Day 1 of singleblind study medication. These medications must not have been used to treat psychiatric disorders.
  • 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 including anti-hepatitis A virus (only immunoglobulin M is exclusionary), anti- hepatitis B surface (except in subjects who have received hepatitis B virus vaccination), hepatitis B surface antigen, anti- hepatitis B core (only immunoglobulin M is exclusionary), or anti-hepatitis C virus.
  • Positive urine drug screen including alcohol at screening and each check-in or a positive breathalyzer test at each check-in.
  • Apnea hypopnea index (per hour of sleep) greater than 15 as seen on polysonography, on the first night of the polysonography screening.
  • Periodic leg movement with arousal index (per hour of sleep) greater than 20 as seen on polysonography, on the first night of polysonography screening.
  • Any additional condition(s) that in the Investigator.s opinion would: a) affect sleep/wake function, b) prohibit the subject from completing the study, or c) not be in the best interest of the subject to participate in the study.
  • Is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:

    • Within 3 weeks prior to Day 1 of single-blind study medication and during the study:

      • anxiolytics
      • hypnotics
      • antidepressants
      • anticonvulsants
      • sedating H1 antihistamines
      • systemic steroids
      • respiratory stimulants (eg, theophylline) and decongestants
      • over-the counter and prescription stimulants
      • over-the counter and prescription diet aids
      • central nervous system active drugs (including herbal preparations with central nervous system effects)
      • narcotic analgesics
      • beta blockers
      • St. John.s wort
      • kava-kava
      • gingko biloba, any other supplements
    • Within 5 days prior to Day 1 of single-blind study medication and during the study:

      • melatonin, or other drugs or supplements known to affect sleep/wake function.

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ramelteon and Placebo QD (9 possible combinations total)

Arm Description

Outcomes

Primary Outcome Measures

Mean latency to persistent sleep of 2-night per polysomnogram recordings, from nights 1 and 2 of each Treatment Period.

Secondary Outcome Measures

Total Sleep Time.
Sleep Efficiency.
Wake Time after Sleep Onset.
Number of Awakenings after Persistent Sleep Onset.
Subjective Sleep Latency.
Subjective Total Sleep Time.
Subjective Wake Time after Sleep Onset.
Subjective Number of Awakenings.
Subjective Ease of Falling Back to Sleep after Awakening.
Subjective Sleep Quality.

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
NCT00671294
Brief Title
Safety and Efficacy of Ramelteon in Elderly Subjects With Chronic Insomnia.
Official Title
A Phase III, Randomized, Double-Blind, Placebo-Controlled, Crossover Study to Determine the Safety and Efficacy 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
October 2002 (undefined)
Primary Completion Date
July 2003 (Actual)
Study Completion Date
July 2003 (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 assess the efficacy and safety of Ramelteon, once daily (QD), in elderly subjects with chronic insomnia.
Detailed Description
Insomnia is characterized by a complaint of difficulties initiating and maintaining sleep or 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 melatonin-1 receptor agonist under global development by Takeda Chemical Industries, Ltd., Osaka, Japan, for the treatment of transient and chronic insomnia and for the treatment of Circadian Rhythm Sleep Disorders. Participation in this study is anticipated to be about 2 months.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ramelteon and Placebo QD (9 possible combinations total)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Ramelteon and Placebo (9 possible combinations total)
Other Intervention Name(s)
Ramelteon, Rozerem, TAK-375
Intervention Description
Randomized sequence over two consecutive nights for a total of three treatment periods to include the following: Ramelteon 4 mg, tablets, orally over two nights Ramelteon 8 mg, tablets, orally over two nights Ramelteon placebo-matching tablets, orally over two nights
Primary Outcome Measure Information:
Title
Mean latency to persistent sleep of 2-night per polysomnogram recordings, from nights 1 and 2 of each Treatment Period.
Time Frame
Crossover Periods 1, 2, and 3 on Nights 1 and 2 or Final Visit.
Secondary Outcome Measure Information:
Title
Total Sleep Time.
Time Frame
Crossover Periods 1, 2, and 3 on Nights 1 and 2 or Final Visit.
Title
Sleep Efficiency.
Time Frame
Crossover Periods 1, 2, and 3 on Nights 1 and 2 or Final Visit.
Title
Wake Time after Sleep Onset.
Time Frame
Crossover Periods 1, 2, and 3 on Nights 1 and 2 or Final Visit.
Title
Number of Awakenings after Persistent Sleep Onset.
Time Frame
Crossover Periods 1, 2, and 3 on Nights 1 and 2 or Final Visit.
Title
Subjective Sleep Latency.
Time Frame
Crossover Periods 1, 2, and 3 on Mornings 2 and 3 or Final Visit.
Title
Subjective Total Sleep Time.
Time Frame
Crossover Periods 1, 2, and 3 on Mornings 2 and 3 or Final Visit.
Title
Subjective Wake Time after Sleep Onset.
Time Frame
Crossover Periods 1, 2, and 3 on Mornings 2 and 3 or Final Visit.
Title
Subjective Number of Awakenings.
Time Frame
Crossover Periods 1, 2, and 3 on Mornings 2 and 3 or Final Visit.
Title
Subjective Ease of Falling Back to Sleep after Awakening.
Time Frame
Crossover Periods 1, 2, and 3 on Mornings 2 and 3 or Final Visit.
Title
Subjective Sleep Quality.
Time Frame
Crossover Periods 1, 2, and 3 on Mornings 2 and 3 or Final Visit.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Male or a post-menopausal female. Primary insomnia as defined by the Diagnostic and Statistical Manual of Mental Disorders, Text Revision for at least 3 months and as defined by subjective sleep latency greater than or equal to 30 minutes, subjective total sleep time less than or equal to 6.5 hours per night, and daytime complaint(s) associated with disturbed sleep. Mean latency of greater than or equal to 20 minutes per polysomnography on two consecutive screening nights with neither night less than 15 minutes. Also, a mean of 60 minutes of wake time during the 480 minutes in bed across two nights with no night less than 45 minutes. Habitual bedtime is between 8:30 p.m. and 12:00 a.m. 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 taken any investigational drug within 30 days or five half-lives prior to Day 1 of single-blind study medication, whichever is longer. Sleep schedule changes required by employment (eg, shift worker) within three months prior to Day 1 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 has substantially altered their exercise routine within 30 days prior to Day 1 of single-blind study medication. Ever had a history of seizures, sleep apnea, chronic obstructive pulmonary disease, 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 within the past 12 months. History of alcohol abuse within the past 12 months. Had an acute clinically significant illness, as determined by the investigator, within 30 days prior to Day 1 of single-blind study medication. Current significant neurological (including cognitive and psychiatric disorders), 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 single-blind study medication. Used tobacco products within 90 days prior to Day 1 of single-blind study medication. Used melatonin, or other drugs or supplements known to affect sleep/wake function, or has consumed grapefruit or grapefruit juice within 5 days (or 5 half lives, whichever is longer) prior to Day 1 of single-blind study medication. Used any central nervous system medication within 3 weeks (or 5 half lives of the drug, whichever is longer) prior to Day 1 of singleblind study medication. These medications must not have been used to treat psychiatric disorders. 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 including anti-hepatitis A virus (only immunoglobulin M is exclusionary), anti- hepatitis B surface (except in subjects who have received hepatitis B virus vaccination), hepatitis B surface antigen, anti- hepatitis B core (only immunoglobulin M is exclusionary), or anti-hepatitis C virus. Positive urine drug screen including alcohol at screening and each check-in or a positive breathalyzer test at each check-in. Apnea hypopnea index (per hour of sleep) greater than 15 as seen on polysonography, on the first night of the polysonography screening. Periodic leg movement with arousal index (per hour of sleep) greater than 20 as seen on polysonography, on the first night of polysonography screening. Any additional condition(s) that in the Investigator.s opinion would: a) affect sleep/wake function, b) prohibit the subject from completing the study, or c) not be in the best interest of the subject to participate in the study. Is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including: Within 3 weeks prior to Day 1 of single-blind study medication and during the study: anxiolytics hypnotics antidepressants anticonvulsants sedating H1 antihistamines systemic steroids respiratory stimulants (eg, theophylline) and decongestants over-the counter and prescription stimulants over-the counter and prescription diet aids central nervous system active drugs (including herbal preparations with central nervous system effects) narcotic analgesics beta blockers St. John.s wort kava-kava gingko biloba, any other supplements Within 5 days prior to Day 1 of single-blind study medication and during the study: melatonin, or other drugs or supplements known to affect sleep/wake function.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
VP Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Hot Springs,
State/Province
Arkansas
Country
United States
City
Irvine
State/Province
California
Country
United States
City
Palm Springs
State/Province
California
Country
United States
City
San Diego
State/Province
California
Country
United States
City
Brandon
State/Province
Florida
Country
United States
City
Miami
State/Province
Florida
Country
United States
City
Naples
State/Province
Florida
Country
United States
City
Pembroke Pines
State/Province
Florida
Country
United States
City
St. Petersburg
State/Province
Florida
Country
United States
City
Atlanta
State/Province
Georgia
Country
United States
City
Overland Park
State/Province
Kansas
Country
United States
City
Crestview Hills
State/Province
Kentucky
Country
United States
City
Troy
State/Province
Michigan
Country
United States
City
St. Louis
State/Province
Missouri
Country
United States
City
Winston-Salem
State/Province
North Carolina
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States
City
Toledo
State/Province
Ohio
Country
United States
City
Houston
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17519067
Citation
Roth T, Seiden D, Wang-Weigand S, Zhang J. A 2-night, 3-period, crossover study of ramelteon's efficacy and safety in older adults with chronic insomnia. Curr Med Res Opin. 2007 May;23(5):1005-14. doi: 10.1185/030079907x178874.
Results Reference
result
PubMed Identifier
19327100
Citation
Wang-Weigand S, McCue M, Ogrinc F, Mini L. Effects of ramelteon 8 mg on objective sleep latency in adults with chronic insomnia on nights 1 and 2: pooled analysis. Curr Med Res Opin. 2009 May;25(5):1209-13. doi: 10.1185/03007990902858527.
Results Reference
result

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Safety and Efficacy of Ramelteon in Elderly Subjects With Chronic Insomnia.

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