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Safety of Ramelteon in Subjects With Mild to Moderate Chronic Obstructive Pulmonary Disease

Primary Purpose

Chronic Obstructive Pulmonary Disease, COPD

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ramelteon and Placebo
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease focused on measuring Chronic Obstructive Pulmonary Disease, COPD, Insomnia, Drug Therapy

Eligibility Criteria

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

Inclusion Criteria

  • 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.
  • Clinical history of chronic obstructive pulmonary disease and a confirmatory diagnosis based on pulmonary function tests at screening.
  • Moderate: forced expiratory volume in one second/ forced vital capacity less than 70% and forced expiratory volume 135-75% of predicted.
  • Post-bronchodilator forced expiratory volume in one second change from baseline of less than 12%.
  • Negative chest x-ray at screening, other than findings consistent with mild to moderate chronic obstructive pulmonary disease, within the last 6 months.
  • Arterial oxygen saturation during sleep greater than 85% for at least 99% of the recording period, with no arterial oxygen saturation readings less than 80% as assessed by pulse oximetry at polysomnography screening.
  • Arterial oxygen saturation during wakefulness greater than 91% (both supine and sitting) as assessed by pulse oximetry at screening.
  • Habitual bedtime is between 8:30 p.m. and 12:00 a.m.
  • Body mass index between 18 and 34, inclusive.
  • Agrees to remain in the study center for three overnight stays.

Exclusion Criteria:

  • Known hypersensitivity to ramelteon or related compounds, including melatonin.
  • Known hypersensitivity to Ventolin® or related compounds.
  • 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 study medication, whichever is longer.
  • Clinical history of acute or chronic respiratory failure, severe chronic obstructive pulmonary disease, or hypercapnia (Partial Pressure of Oxygen in Arterial Blood greater than or equal to45 mmHg).
  • History of or currently has right ventricular hypertrophy on electrocardiogram or right heart failure.
  • Periodic leg movement with arousal index (per hour of sleep) greater than 20 as seen at polysomnography screening.
  • Apnea hypopnea index greater than 15 as seen at polysomnography screening.
  • Acute clinically significant illness within 2 weeks or has been hospitalized within 4 weeks of study participation.
  • Sleep schedule changes required by employment 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 medications.
  • History of seizures, sleep apnea, restless leg syndrome, period limb movement disorder, other known sleep disorders, schizophrenia, bipolar disease, 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 and/or regularly consumes 4 or more alcoholic drinks per day.
  • Unable to discontinue the use of hypnotics for the duration of the study.
  • Any clinically important abnormal finding, other than chronic obstructive pulmonary disease, as determined by medical history, physical examination, electrocardiogram, or clinical laboratory tests, as determined by the investigator.
  • 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.
  • Hematocrit value greater than 55% at screening.
  • 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
    • Decongestants
    • Over-the-counter and prescription stimulants
    • Over-the-counter and prescription diet aids
    • Central nervous system active drugs and narcotic analgesics
    • Lipophilic beta blockers
    • Melatonin
    • St. John's Wort
    • Kava-kava
    • Gingko biloba

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ramelteon 16 mg QD and Placebo QD

Arm Description

Outcomes

Primary Outcome Measures

Mean Oxygen Saturation during sleep for the entire night.

Secondary Outcome Measures

Mean Oxygen Saturation for each hour of the night.
Mean Oxygen Saturation for awake Time Sleep Stage.
Mean Oxygen Saturation for Nonrapid Eye Movement Sleep Stage.
Mean Oxygen Saturation for Rapid Eye Movement Sleep Stage.
Percentage of night when arterial oxygen percent saturation was less than 85%.
Percentage of night when arterial oxygen percent saturation was less than 90%.
Apnea Hypopnea Index measured by respiratory inductance plethysmography (RIP).
Latency to Persistent Sleep.
Total Sleep Time.
Sleep Efficiency.
Wake Time after Persistent Sleep Onset.
Number of Awakenings after Persistent Sleep Onset.
Subjective Sleep Latency.
Subjective Total Sleep Time.
Subjective Sleep Quality.
Subjective Awake Time.
Subjective Number of Awakenings.
Subjective Ease of Falling Back to Sleep.
Subjective Level of Alertness.
Subjective Ability to Concentrate.

Full Information

First Posted
May 2, 2008
Last Updated
February 27, 2012
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00672802
Brief Title
Safety of Ramelteon in Subjects With Mild to Moderate Chronic Obstructive Pulmonary Disease
Official Title
A Phase II Safety Study of TAK-375 in Subjects With Mild to Moderate Chronic Obstructive Pulmonary Disease
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
August 2003 (undefined)
Primary Completion Date
March 2004 (Actual)
Study Completion Date
March 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 assess the safety of ramelteon, once daily (QD), in subjects with chronic obstructive pulmonary disease.
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 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. This study is being conducted to assess the safety of ramelteon in subjects with chronic obstructive pulmonary disease. Participation in the study is anticipated to be about 1.5 months.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
26 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ramelteon 16 mg QD and Placebo QD
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Ramelteon and Placebo
Other Intervention Name(s)
Rozerem™, ramelteon, TAK-375
Intervention Description
Ramelteon 16 mg, tablet, orally, once daily for Periods 1 or 2 and ramelteon placebo-matching tablets, orally, once daily for Periods 1 or 2.
Primary Outcome Measure Information:
Title
Mean Oxygen Saturation during sleep for the entire night.
Time Frame
Periods 1 and 2.
Secondary Outcome Measure Information:
Title
Mean Oxygen Saturation for each hour of the night.
Time Frame
Periods 1 and 2.
Title
Mean Oxygen Saturation for awake Time Sleep Stage.
Time Frame
Periods 1 and 2.
Title
Mean Oxygen Saturation for Nonrapid Eye Movement Sleep Stage.
Time Frame
Periods 1 and 2.
Title
Mean Oxygen Saturation for Rapid Eye Movement Sleep Stage.
Time Frame
Periods 1 and 2.
Title
Percentage of night when arterial oxygen percent saturation was less than 85%.
Time Frame
Periods 1 and 2.
Title
Percentage of night when arterial oxygen percent saturation was less than 90%.
Time Frame
Periods 1 and 2.
Title
Apnea Hypopnea Index measured by respiratory inductance plethysmography (RIP).
Time Frame
Periods 1 and 2.
Title
Latency to Persistent Sleep.
Time Frame
Periods 1 and 2.
Title
Total Sleep Time.
Time Frame
Periods 1 and 2.
Title
Sleep Efficiency.
Time Frame
Periods 1 and 2.
Title
Wake Time after Persistent Sleep Onset.
Time Frame
Periods 1 and 2.
Title
Number of Awakenings after Persistent Sleep Onset.
Time Frame
Periods 1 and 2.
Title
Subjective Sleep Latency.
Time Frame
Periods 1 and 2.
Title
Subjective Total Sleep Time.
Time Frame
Periods 1 and 2.
Title
Subjective Sleep Quality.
Time Frame
Periods 1 and 2.
Title
Subjective Awake Time.
Time Frame
Periods 1 and 2.
Title
Subjective Number of Awakenings.
Time Frame
Periods 1 and 2.
Title
Subjective Ease of Falling Back to Sleep.
Time Frame
Periods 1 and 2.
Title
Subjective Level of Alertness.
Time Frame
Periods 1 and 2.
Title
Subjective Ability to Concentrate.
Time Frame
Periods 1 and 2.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria 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. Clinical history of chronic obstructive pulmonary disease and a confirmatory diagnosis based on pulmonary function tests at screening. Moderate: forced expiratory volume in one second/ forced vital capacity less than 70% and forced expiratory volume 135-75% of predicted. Post-bronchodilator forced expiratory volume in one second change from baseline of less than 12%. Negative chest x-ray at screening, other than findings consistent with mild to moderate chronic obstructive pulmonary disease, within the last 6 months. Arterial oxygen saturation during sleep greater than 85% for at least 99% of the recording period, with no arterial oxygen saturation readings less than 80% as assessed by pulse oximetry at polysomnography screening. Arterial oxygen saturation during wakefulness greater than 91% (both supine and sitting) as assessed by pulse oximetry at screening. Habitual bedtime is between 8:30 p.m. and 12:00 a.m. Body mass index between 18 and 34, inclusive. Agrees to remain in the study center for three overnight stays. Exclusion Criteria: Known hypersensitivity to ramelteon or related compounds, including melatonin. Known hypersensitivity to Ventolin® or related compounds. 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 study medication, whichever is longer. Clinical history of acute or chronic respiratory failure, severe chronic obstructive pulmonary disease, or hypercapnia (Partial Pressure of Oxygen in Arterial Blood greater than or equal to45 mmHg). History of or currently has right ventricular hypertrophy on electrocardiogram or right heart failure. Periodic leg movement with arousal index (per hour of sleep) greater than 20 as seen at polysomnography screening. Apnea hypopnea index greater than 15 as seen at polysomnography screening. Acute clinically significant illness within 2 weeks or has been hospitalized within 4 weeks of study participation. Sleep schedule changes required by employment 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 medications. History of seizures, sleep apnea, restless leg syndrome, period limb movement disorder, other known sleep disorders, schizophrenia, bipolar disease, 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 and/or regularly consumes 4 or more alcoholic drinks per day. Unable to discontinue the use of hypnotics for the duration of the study. Any clinically important abnormal finding, other than chronic obstructive pulmonary disease, as determined by medical history, physical examination, electrocardiogram, or clinical laboratory tests, as determined by the investigator. 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. Hematocrit value greater than 55% at screening. 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 Decongestants Over-the-counter and prescription stimulants Over-the-counter and prescription diet aids Central nervous system active drugs and narcotic analgesics Lipophilic 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
Birmingham
State/Province
Alabama
Country
United States
City
Santa Monica
State/Province
California
Country
United States
City
Miami Beach
State/Province
Florida
Country
United States
City
Winter Park
State/Province
Florida
Country
United States
City
Louisville
State/Province
Kentucky
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
18060441
Citation
Kryger M, Wang-Weigand S, Zhang J, Roth T. Effect of ramelteon, a selective MT(1)/MT (2)-receptor agonist, on respiration during sleep in mild to moderate COPD. Sleep Breath. 2008 Aug;12(3):243-50. doi: 10.1007/s11325-007-0156-4.
Results Reference
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Safety of Ramelteon in Subjects With Mild to Moderate Chronic Obstructive Pulmonary Disease

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