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"Pilot Study of Armodafinil in Patients With Dementia With Lewy Bodies"

Primary Purpose

Dementia With Lewy Bodies

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Armodafinil
Sponsored by
Mayo Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dementia With Lewy Bodies focused on measuring Dementia with Lewy Bodies, hypersomnolence, cognition, neuropsychiatric morbidity, quality of life

Eligibility Criteria

50 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of clinically possible or probable DLB using established criteria
  • Age 50-90 inclusive
  • Epworth Sleepiness Scale score of 8 or greater
  • MMSE score between 10 and 26 inclusive
  • No active medical disorder that could preclude participation in a drug treatment trial over a 12 week protocol
  • Stable medication regimen over previous four weeks
  • Absence of psychotropic medications at doses viewed by the clinician to be significantly impacting the patient's alertness during wakefulness
  • Absence of clinically significant primary sleep-related breathing disorder causing sleepiness as demonstrated by polysomnography (PSG) [ie, no significant upper airway resistance syndrome (UARS), obstructive sleep apnea (OSA), nor central sleep apnea (CSA) as reflected by a combined respiratory disturbance index (RDI) <15] OR adequate documentation of efficacy of treatment for UARS, OSA, and CSA
  • Caregiver that is with the patient at least 4 hours/day for at least 5 days per week
  • Patient and caregiver willing and able to participate in all study-related procedures
  • Patient is capable of giving informed consent, or if appropriate, has caregiver capable of giving consent on the subject's behalf.

Exclusion Criteria:

  • Does not fulfill criteria for clinically possible or probable DLB
  • Age <50 or >90
  • Women with intact uterus and not post-menopausal unless pregnancy test performed at screening is negative
  • Epworth Sleepiness Scale score less than 8
  • MMSE score <10 or >26
  • Active medical disorder that could preclude participation in a drug treatment trial over a 52 week protocol, such as:

    • Hypertension with BP readings exceeding 150 mm Hg systolic and 90 mm Hg diastolic
    • Hypersensitivity to modafinil, armodafinil, or any other conventional stimulants
    • Myocardial infarction or cerebral infarct over preceding year, stable or unstable angina, known symptomatic coronary artery disease
    • History of left ventricular hypertrophy or mitral valve prolapse
    • History of chronic or paroxysmal atrial fibrillation, chronic or paroxysmal atrial flutter, ventricular fibrillation, or ventricular tachycardia
    • History of cancer over preceding 1 year (excluding squamous or basal cell carcinoma of the skin)
    • History of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug rash with eosinophilia and systemic symptoms (DRESS)
    • Pulmonary disease requiring oral or inhalatory medications
    • Any other medical disorder considered by the study physicians as inappropriate for any wake-promoting medication
  • Medication regimen has not been stable over preceding four weeks
  • Concurrent use of lamotrigine or oxcarbazepine
  • Presence of over-the-counter and prescription psychotropic medications at doses viewed by the clinician to be significantly impacting the patient's alertness during wakefulness, such as:

    • Clonazepam > 1 mg/night
    • Seroquel > 100 mg/night
    • Zyprexa > 10 mg/night
  • Presence of another clinically-significant primary sleep disorder (eg, UARS, OSA, CSA) that is not being treated
  • Clinically significant abnormalities on screening ECG or laboratory tests
  • Patient or caregiver unwilling or unable to participate in all study-related procedures
  • Caregiver is not with patient at least 4 hours/day for at least 5 days/week
  • Patient or caregiver unwilling or unable to provide informed consent
  • CT or MRI evidence of a clinically significant structural lesion that could account for the participants dementia

Sites / Locations

  • Mayo Clinic

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Armodifinil

Arm Description

150-250 mg armodafinil by mouth daily

Outcomes

Primary Outcome Measures

Mean Initial Sleep Latency as Measured by the Maintenance of Wakefulness Test (MWT)
The MWT measures the subject's ability to stay awake while sitting quietly in a chair. The test has 4 parts, each lasting 40 minutes if the subject is able to remain awake that long each time, and the parts are spaced apart in 2 hour intervals through the day. The subject is placed in a dim room, with the only source of light slightly behind the subject's head and out of his/her field of vision, and back and neck supported. During this time the subject is monitored with the same measures that are used in a standard overnight sleep study called a polysomnogram. The sleep latency, or time it takes the subject to fall asleep, will be recorded. In healthy people, the time it takes to fall asleep may be approximately 30 minutes on the test. More than 97% of people will take eight minutes or longer to fall asleep. Therefore, sleep latency that is less than eight minutes is considered to be abnormal.

Secondary Outcome Measures

Full Information

First Posted
December 1, 2009
Last Updated
June 24, 2013
Sponsor
Mayo Clinic
Collaborators
Cephalon, National Institute on Aging (NIA)
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1. Study Identification

Unique Protocol Identification Number
NCT01023672
Brief Title
"Pilot Study of Armodafinil in Patients With Dementia With Lewy Bodies"
Official Title
An Open Label, Single-Center Pilot Study of Armodafinil in Patients With Dementia With Lewy Bodies
Study Type
Interventional

2. Study Status

Record Verification Date
June 2013
Overall Recruitment Status
Completed
Study Start Date
November 2009 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
March 2012 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Mayo Clinic
Collaborators
Cephalon, National Institute on Aging (NIA)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This research study is to examine the effects of the study medication Armodafinil in patients with dementia with Lewy bodies (DLB). DLB is associated with memory and other thinking problems, excessive daytime sleepiness, hallucinations, delusions, apathy, and reduced quality of life. One type of medication that could potentially improve daytime sleepiness, memory and thinking skills, hallucinations, delusions, apathy, and quality of life is known as a wake-promoting medication. Armodafinil is a wake-promoting medication that has been developed for treatment of patients with narcolepsy, sleep apnea, and other disorders which cause excessive daytime sleepiness. The drug used in this study is considered investigational, which means it has either not been approved by the Food and Drug Administration (FDA) for routine clinical use or for the use described in this study. However the FDA has allowed the use of this drug/device in this research study. In this study, patients with DLB will receive daily oral Armodafinil tablets, and their response to treatment will be assessed over 12 weeks. This study does not involve any placebo medication, so all patients will receive Armodafinil treatment.
Detailed Description
In patients with DLB, the following aims/objectives will be addressed by comparing data on key measures at baseline and at 4 and 12 weeks of therapy: Primary Aims - to test the hypotheses that armodafinil therapy at 150-250 mg every morning: will result in improvement in excessive daytime sleepiness as measured by the Epworth Sleepiness Scale (ESS) and Maintenance of Wakefulness Test (MWT) (Aim 1A) will result in improvement in the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog) (Aim 1B) will result in improvement in the Alzheimer's Disease Cooperative Study-Clinician's Global Impression of Change (ADCS-CGIC) (Aim 1C) will be well-tolerated with no significant side-effects present (Aim 1D) Secondary Aims - to test the hypotheses that armodafinil therapy at 150-250 mg every morning will result in improvement in: cognition as measured by the Mini-Mental State Examination (MMSE) and other focused neuropsychological tests (Aim 2A) neuropsychiatric morbidity, particularly apathy, depression, visual hallucinations, and delusions, as measured by the Neuropsychiatric Inventory (NPI) (Aim 2B) functional status as measured by the Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) (Aim 2C) patient and caregiver quality of life (QOL) as measured by the linear analog scale (LASA) (Aim 2D)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dementia With Lewy Bodies
Keywords
Dementia with Lewy Bodies, hypersomnolence, cognition, neuropsychiatric morbidity, quality of life

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Armodifinil
Arm Type
Other
Arm Description
150-250 mg armodafinil by mouth daily
Intervention Type
Drug
Intervention Name(s)
Armodafinil
Other Intervention Name(s)
Nuvigil
Intervention Description
150-250 mg armodafinil by mouth daily
Primary Outcome Measure Information:
Title
Mean Initial Sleep Latency as Measured by the Maintenance of Wakefulness Test (MWT)
Description
The MWT measures the subject's ability to stay awake while sitting quietly in a chair. The test has 4 parts, each lasting 40 minutes if the subject is able to remain awake that long each time, and the parts are spaced apart in 2 hour intervals through the day. The subject is placed in a dim room, with the only source of light slightly behind the subject's head and out of his/her field of vision, and back and neck supported. During this time the subject is monitored with the same measures that are used in a standard overnight sleep study called a polysomnogram. The sleep latency, or time it takes the subject to fall asleep, will be recorded. In healthy people, the time it takes to fall asleep may be approximately 30 minutes on the test. More than 97% of people will take eight minutes or longer to fall asleep. Therefore, sleep latency that is less than eight minutes is considered to be abnormal.
Time Frame
baseline, 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of clinically possible or probable DLB using established criteria Age 50-90 inclusive Epworth Sleepiness Scale score of 8 or greater MMSE score between 10 and 26 inclusive No active medical disorder that could preclude participation in a drug treatment trial over a 12 week protocol Stable medication regimen over previous four weeks Absence of psychotropic medications at doses viewed by the clinician to be significantly impacting the patient's alertness during wakefulness Absence of clinically significant primary sleep-related breathing disorder causing sleepiness as demonstrated by polysomnography (PSG) [ie, no significant upper airway resistance syndrome (UARS), obstructive sleep apnea (OSA), nor central sleep apnea (CSA) as reflected by a combined respiratory disturbance index (RDI) <15] OR adequate documentation of efficacy of treatment for UARS, OSA, and CSA Caregiver that is with the patient at least 4 hours/day for at least 5 days per week Patient and caregiver willing and able to participate in all study-related procedures Patient is capable of giving informed consent, or if appropriate, has caregiver capable of giving consent on the subject's behalf. Exclusion Criteria: Does not fulfill criteria for clinically possible or probable DLB Age <50 or >90 Women with intact uterus and not post-menopausal unless pregnancy test performed at screening is negative Epworth Sleepiness Scale score less than 8 MMSE score <10 or >26 Active medical disorder that could preclude participation in a drug treatment trial over a 52 week protocol, such as: Hypertension with BP readings exceeding 150 mm Hg systolic and 90 mm Hg diastolic Hypersensitivity to modafinil, armodafinil, or any other conventional stimulants Myocardial infarction or cerebral infarct over preceding year, stable or unstable angina, known symptomatic coronary artery disease History of left ventricular hypertrophy or mitral valve prolapse History of chronic or paroxysmal atrial fibrillation, chronic or paroxysmal atrial flutter, ventricular fibrillation, or ventricular tachycardia History of cancer over preceding 1 year (excluding squamous or basal cell carcinoma of the skin) History of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug rash with eosinophilia and systemic symptoms (DRESS) Pulmonary disease requiring oral or inhalatory medications Any other medical disorder considered by the study physicians as inappropriate for any wake-promoting medication Medication regimen has not been stable over preceding four weeks Concurrent use of lamotrigine or oxcarbazepine Presence of over-the-counter and prescription psychotropic medications at doses viewed by the clinician to be significantly impacting the patient's alertness during wakefulness, such as: Clonazepam > 1 mg/night Seroquel > 100 mg/night Zyprexa > 10 mg/night Presence of another clinically-significant primary sleep disorder (eg, UARS, OSA, CSA) that is not being treated Clinically significant abnormalities on screening ECG or laboratory tests Patient or caregiver unwilling or unable to participate in all study-related procedures Caregiver is not with patient at least 4 hours/day for at least 5 days/week Patient or caregiver unwilling or unable to provide informed consent CT or MRI evidence of a clinically significant structural lesion that could account for the participants dementia
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bradley F Boeve, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States

12. IPD Sharing Statement

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"Pilot Study of Armodafinil in Patients With Dementia With Lewy Bodies"

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