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Efficacy and Safety Study of Propofol Infusion for Refractory Chronic Primary Insomnia

Primary Purpose

Insomnia, Sleep Disorder, Dyssomnia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
propofol injectable emulsion
Sponsored by
Life Extension Foundation Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Insomnia focused on measuring Propofol, Insomnia, Sleep disorder, Sleep deprivation, Chronic insomnia, Refractory insomnia, Primary insomnia

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Ambulatory, male or non-pregnant, non-lactating female, 18-65 years of age.
  • Overall healthy with no other sleep disorder such as sleep apnea or periodic limb movement disorder
  • Has not responded to conventional pharmacologic therapies (benzodiazepines and non-benzodiazepines) within the past 90 days. The non-benzodiazepine therapies can include melatonin and melatonin receptor agonists, antihistamines, antidepressants, over-the-counter medications, supplements or herbs for sleep
  • Have refractory chronic primary insomnia (chronic-inadequate quantity or quality of sleep characterized by a subjective report of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and results in some form of daytime impairment and has persisted for at least one month., primary-insomnia independent of any known physical or mental condition, refractory-not yielding, at least not yielding readily to treatment based upon polysomnography at baseline, total sleep time (sTST) of < 6 hr, a subjective wake time after sleep onset (WASO) of >1 hr, a subjective latency to sleep onset (SOL) of > 20 min
  • Willing and able to give written informed consent
  • Clearly understands the procedures and requirements for the study
  • Willing and able to comply with all study procedures and data recording obligations for the entire length of the study
  • Have no clinically significant abnormalities on the basis of medical history, physical examination and vital signs in the judgment of the investigator and/or sub-investigator
  • Ability and willingness to abstain from any pharmaceutical or over-the-counter medication for sleep as well as alcohol from 72 hours prior to baseline and the first dose until after completion of the Study Product Administration Follow-Up Visit (Day 6) as well as 72 hours prior to the Day 90 visit.
  • All values for hematology and for clinical chemistry tests of blood within the normal range for age and gender or showing no clinically relevant deviations as judged by the investigator
  • Nonsmoking or have quit smoking at least 6 months prior to dosing

Exclusion Criteria:

  • Having any medical conditions including diabetes, cardiovascular disease, pulmonary, renal, endocrine, hepatic, neurologic, psychiatric (including depression), immunologic, hematologic, gastrointestinal or metabolic disease requiring medical treatment that would preclude participation into the study in the judgment of the investigator/sub-investigator
  • Having ingested any pharmaceutical or over-the-counter sleep product within 72 hours of dosing as well as 72 hours prior to the Day 90 visit.
  • Taking any medication that can yield a moderate to major drug interaction with propofol including those with CNS (central nervous system)-depressant effects
  • Having had a history of any medical or surgical procedure that would preclude participation into the study in the judgment of the investigator/sub-investigator
  • Being pregnant, planning on becoming pregnant, breast feeding or unwilling to use a medically acceptable form of birth control during the study (with at least one acceptable barrier for a period of one month prior to the beginning of the study until at least three months after study completion) or are surgically sterile or postmenopausal (at least 12 months without a period).
  • Having a systolic blood pressure >160 mmHg, diastolic blood pressure >90 mmHg, or blood pressure that would preclude participation in the judgment of the investigator/sub-investigator
  • Having a previous history of abnormal screening laboratory test values: bilirubin > 2 x ULN (upper limit of normal), AST(aspartate aminotransferase) and ALT (alanine aminotransferase) > 2 x ULN (upper limit of normal), serum creatinine > 1.5 mg/dl, fasting blood glucose below 85mg/dl or above 110 mg/dl, calcium level < 8.6 mg/dl and triglycerides >200.0mg/dl.
  • Any type of active malignancy (except non-melanomatous skin malignancies) within the past 5 years
  • History of known or suspected substance abuse
  • Currently consume more than 7 standard alcoholic drinks per week and unable to refrain from consuming an alcoholic beverage during the course of the study dosing period.
  • Currently consume more than 14 caffeinated beverages per week and unable to refrain from consuming a caffeinated beverage within 8 hours prior to dosing.
  • History of allergy to any anesthetic, eggs, egg products, soybeans or soy products as well as hypersensitivity to Propofol or any of its components
  • Unable to avoid engaging in a hazardous occupation requiring complete mental alertness and/or motor coordination after receiving the study product.
  • Participation in another study within 30 days prior to dosing.
  • Donated blood within 30 days prior to dosing.
  • Illness within five days prior to dosing
  • Having a pacemaker or any internal medical device
  • In the opinion of the investigator, not suitable for entry into the study.

Sites / Locations

  • Broward Health Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

propofol infusion

Arm Description

Induction of sleep is accomplished with a bolus of propofol (up to 0.5mg/kg over one minute, concurrently with a constant infusion of propofol starting at 25 ug/kg/min titrated to a maximum of 100ug/kg/min, to maintain the subject at a Modified Ramsay Score of 3-4 for a total of 120 minutes. An additional bolus may be given by the investigator in order to maintain the level of sleep. This procedure will be conducted over 5 consecutive nights.

Outcomes

Primary Outcome Measures

Mean change in the scores on the subjective assessment from the Leeds Sleep Evaluation Questionnaire
Mean change in the scores on the objective measurements of sleep architecture and patterns from polysomnography

Secondary Outcome Measures

Changes in the scores on the SF(Short form)-35 quality of life questionnaire
Changes in safety parameters from the propofol infusion compared to baseline measured by laboratory markers, vital signs, electrocardiogram, pulse oximeter, physical exam and any adverse events
Laboratory markers including complete blood count/chemistry values. Vital signs including blood pressure, pulse and temperature.

Full Information

First Posted
January 14, 2014
Last Updated
August 26, 2016
Sponsor
Life Extension Foundation Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02043977
Brief Title
Efficacy and Safety Study of Propofol Infusion for Refractory Chronic Primary Insomnia
Official Title
An Open Label, Pilot Study Utilizing an IV Infusion of Propofol in Male and Female Volunteers With Refractory Chronic Primary Insomnia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
June 2013 (undefined)
Primary Completion Date
May 2015 (Actual)
Study Completion Date
May 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Life Extension Foundation Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Insomnia is a widespread condition in which approximately one-third of adults in the United States are symptomatic with 6% of the population meeting the diagnostic criteria for insomnia. There is an increased risk of insomnia in certain segments of the population including women, middle-aged and older adults, shift workers and individuals with medical or psychiatric disorders. Individuals with insomnia have a decreased quality of life compared to those who report other serious illnesses such as major depression and congestive heart failure. Chronic insomnia can be caused by medications, drug or alcohol abuse, psychiatric disorders, medical and neurologic disorders. It can impair cognitive and physical functioning. Propofol is an approved drug administered intravenously for use in the induction and maintenance of anesthesia or sedation. Some research suggests that propofol when administered as a two hour infusion may improve the ease of sleep onset, sleep quality, ease of awakening and the integrity of behavior following waking. This study will be conducted in the Broward Health Medical Center Sleep Lab, under the direct care of a Board Certified Anesthesiologist, dedicated to the study involving participants who have refractory chronic primary insomnia and have not responded to conventional pharmacologic therapies within the past 90 days. Each qualifying participant will receive an IV infusion of the study medication for 5 consecutive nights. Assessments including polysomnography with completion of questionnaires will occur at screening, Days 1 through 5 of study product administration, Day 6 and Day 90. Follow-up questionnaires will also be distributed on Day 180.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Insomnia, Sleep Disorder, Dyssomnia
Keywords
Propofol, Insomnia, Sleep disorder, Sleep deprivation, Chronic insomnia, Refractory insomnia, Primary insomnia

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
propofol infusion
Arm Type
Experimental
Arm Description
Induction of sleep is accomplished with a bolus of propofol (up to 0.5mg/kg over one minute, concurrently with a constant infusion of propofol starting at 25 ug/kg/min titrated to a maximum of 100ug/kg/min, to maintain the subject at a Modified Ramsay Score of 3-4 for a total of 120 minutes. An additional bolus may be given by the investigator in order to maintain the level of sleep. This procedure will be conducted over 5 consecutive nights.
Intervention Type
Drug
Intervention Name(s)
propofol injectable emulsion
Primary Outcome Measure Information:
Title
Mean change in the scores on the subjective assessment from the Leeds Sleep Evaluation Questionnaire
Time Frame
180 days
Title
Mean change in the scores on the objective measurements of sleep architecture and patterns from polysomnography
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Changes in the scores on the SF(Short form)-35 quality of life questionnaire
Time Frame
180 days
Title
Changes in safety parameters from the propofol infusion compared to baseline measured by laboratory markers, vital signs, electrocardiogram, pulse oximeter, physical exam and any adverse events
Description
Laboratory markers including complete blood count/chemistry values. Vital signs including blood pressure, pulse and temperature.
Time Frame
5 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Ambulatory, male or non-pregnant, non-lactating female, 18-65 years of age. Overall healthy with no other sleep disorder such as sleep apnea or periodic limb movement disorder Has not responded to conventional pharmacologic therapies (benzodiazepines and non-benzodiazepines) within the past 90 days. The non-benzodiazepine therapies can include melatonin and melatonin receptor agonists, antihistamines, antidepressants, over-the-counter medications, supplements or herbs for sleep Have refractory chronic primary insomnia (chronic-inadequate quantity or quality of sleep characterized by a subjective report of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and results in some form of daytime impairment and has persisted for at least one month., primary-insomnia independent of any known physical or mental condition, refractory-not yielding, at least not yielding readily to treatment based upon polysomnography at baseline, total sleep time (sTST) of < 6 hr, a subjective wake time after sleep onset (WASO) of >1 hr, a subjective latency to sleep onset (SOL) of > 20 min Willing and able to give written informed consent Clearly understands the procedures and requirements for the study Willing and able to comply with all study procedures and data recording obligations for the entire length of the study Have no clinically significant abnormalities on the basis of medical history, physical examination and vital signs in the judgment of the investigator and/or sub-investigator Ability and willingness to abstain from any pharmaceutical or over-the-counter medication for sleep as well as alcohol from 72 hours prior to baseline and the first dose until after completion of the Study Product Administration Follow-Up Visit (Day 6) as well as 72 hours prior to the Day 90 visit. All values for hematology and for clinical chemistry tests of blood within the normal range for age and gender or showing no clinically relevant deviations as judged by the investigator Nonsmoking or have quit smoking at least 6 months prior to dosing Exclusion Criteria: Having any medical conditions including diabetes, cardiovascular disease, pulmonary, renal, endocrine, hepatic, neurologic, psychiatric (including depression), immunologic, hematologic, gastrointestinal or metabolic disease requiring medical treatment that would preclude participation into the study in the judgment of the investigator/sub-investigator Having ingested any pharmaceutical or over-the-counter sleep product within 72 hours of dosing as well as 72 hours prior to the Day 90 visit. Taking any medication that can yield a moderate to major drug interaction with propofol including those with CNS (central nervous system)-depressant effects Having had a history of any medical or surgical procedure that would preclude participation into the study in the judgment of the investigator/sub-investigator Being pregnant, planning on becoming pregnant, breast feeding or unwilling to use a medically acceptable form of birth control during the study (with at least one acceptable barrier for a period of one month prior to the beginning of the study until at least three months after study completion) or are surgically sterile or postmenopausal (at least 12 months without a period). Having a systolic blood pressure >160 mmHg, diastolic blood pressure >90 mmHg, or blood pressure that would preclude participation in the judgment of the investigator/sub-investigator Having a previous history of abnormal screening laboratory test values: bilirubin > 2 x ULN (upper limit of normal), AST(aspartate aminotransferase) and ALT (alanine aminotransferase) > 2 x ULN (upper limit of normal), serum creatinine > 1.5 mg/dl, fasting blood glucose below 85mg/dl or above 110 mg/dl, calcium level < 8.6 mg/dl and triglycerides >200.0mg/dl. Any type of active malignancy (except non-melanomatous skin malignancies) within the past 5 years History of known or suspected substance abuse Currently consume more than 7 standard alcoholic drinks per week and unable to refrain from consuming an alcoholic beverage during the course of the study dosing period. Currently consume more than 14 caffeinated beverages per week and unable to refrain from consuming a caffeinated beverage within 8 hours prior to dosing. History of allergy to any anesthetic, eggs, egg products, soybeans or soy products as well as hypersensitivity to Propofol or any of its components Unable to avoid engaging in a hazardous occupation requiring complete mental alertness and/or motor coordination after receiving the study product. Participation in another study within 30 days prior to dosing. Donated blood within 30 days prior to dosing. Illness within five days prior to dosing Having a pacemaker or any internal medical device In the opinion of the investigator, not suitable for entry into the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Edward A Czinn, M.D.
Organizational Affiliation
Anesco North Broward LLC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Broward Health Medical Center
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33316
Country
United States

12. IPD Sharing Statement

Citations:
Citation
American College of Chest Physicians. Diagnosis and Treatment of Insomnia. http://chestnet.org/accp/pccsu/diagnosis-and-treatment-insomnia?page=0.3. Published September 3, 2007. Accessed February 6, 2012.
Results Reference
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http://www.drugs.com/pro/propofol
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Katz DA, McHorney CA. The relationship between insomnia and health-related quality of life in patients with chronic illness. J Fam Pract. 2002 Mar;51(3):229-35.
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Efficacy and Safety Study of Propofol Infusion for Refractory Chronic Primary Insomnia

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