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Safety and Efficacy Study of Dronabinol to Treat Obstructive Sleep Apnea (PACE)

Primary Purpose

Sleep Apnea, Obstructive

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Dronabinol
Placebo (for Dronabinol)
Sponsored by
University of Illinois at Chicago
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sleep Apnea, Obstructive

Eligibility Criteria

21 Years - 64 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult 21 to 64 years of age;
  • 15≤AHI ≤ 50 on screening polysomnogram (PSG)
  • ESS score ≥ 7
  • Able to understand and complete informed consent and all study assessments and forms, presented in an English-speaking format;
  • Women of child-bearing potential (WCBP) must have a negative urine pregnancy test. In addition sexually active WCBP must agree to use adequate contraceptive methods (oral, injectable or implantable hormonal contraceptive; tubal ligation; intra-uterine devices; barrier contraceptive with spermicide; or vasectomized partner).

Exclusion Criteria:

  • Arterial oxygen saturation < 75% for > 5% of sleep period time on screening PSG;
  • Occupation or life situation that may impart risk by study participation (e.g. commercial driver, pilot, police officer, fireman);
  • Motor vehicle accident or "near-miss" related to sleepiness (self-report) within 2 years of the first dose of study drug (Day 8);
  • Body mass index > 45 kg/m2
  • Severe obstructive sleep apnea syndrome (OSAS) that, based on the clinical judgment of the Investigator, precludes delaying positive airway pressure treatment;
  • History of shift work or rotating shifts within the month prior to the first dose of study drug (Day 8);
  • Prior upper airway surgery for snoring or OSAS as an adult (≥ 18 years of age);
  • Prior non-invasive treatment for OSAS within 6 months prior to the first dose of study drug (Day 8);
  • Major surgery within 6 months prior to the first dose of study drug (Day 8);
  • Bariatric surgery within 2 years prior to the first dose of study drug (Day 8). If post-bariatric surgery, weight must be stable ±5% (self-report) for at least 6 months prior to first dose of study drug (Day 8).
  • Any form of medically managed weight loss program within 6 months prior to the first dose of study drug (Day 8);
  • Significant defect in nasal patency due to anatomical abnormalities or uncontrolled or recurrent episodes of rhinitis;
  • Any clinically significant unstable or progressive medical condition;
  • Any primary sleep disorder other than OSAS as determined by history, physical examination, or Visit 2 PSG (after 7-day screening run-in period);
  • Clinically significant or uncontrolled: chronic obstructive pulmonary disease (COPD), cardiovascular disease, gastrointestinal, respiratory, pancreatic, hepatic, renal, hematologic, endocrine [including insulin-dependent diabetes mellitus (IDDM)], neurological, urogenital, connective tissue, dermatological, thyroid, or other medical disorder;
  • Any clinically significant psychiatric disorder;
  • History of seizure disorder;
  • Treatment with any prescription antidepressant medication within 1 month prior to the first dose of study drug (Day 8);
  • Treatment with sedatives, hypnotics or other psychoactive drugs within 30 days prior to the first dose of study drug (Day 8);
  • Any complete blood count (CBC) or liver function test (LFT) laboratory value outside the normal range which, in the clinical judgment of the Investigator renders a subject inappropriate for randomization to treatment;
  • Pregnancy [as demonstrated by positive urine human chorionic gonadotropin (hCG) test] or lactation;
  • Allergic to cannabinoids or sesame oil;
  • History of substance abuse (including alcohol abuse or dependence) or laboratory evidence of drug abuse on the Visit 1 drug-screening panel;
  • Use of dietary supplements which in the judgment of the Investigator may impact sleep or breathing behaviors;
  • Average daily caffeine consumption > 500 mg/day (~5 cups of coffee);
  • Average weekly alcohol consumption > 10 units;
  • Unwillingness to abstain from caffeine and alcohol on all days when overnight or daytime testing will be performed;
  • Participation in any other investigational protocol within the 30 days prior to the first dose of study drug (Day 8);
  • Any condition which, in the opinion of the Investigator, places the patient at unacceptable risk if he or she were to participate in the study.

Sites / Locations

  • Northwestern University
  • University of Illinois at Chicago

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Sugar Pill

2.5 mg/day

10 mg/day

Arm Description

Placebo, once per day (QD) by mouth, 60 minutes before bedtime for 6 weeks after 1-week run-in

Dronabinol, 2.5 mg QD by mouth, 60 minutes before bedtime for 6 weeks after 1-week placebo run-in

Dronabinol, 10 mg QD by mouth, 60 minutes before bedtime for 4 weeks after 1-week placebo run-in and 2-week dose escalation

Outcomes

Primary Outcome Measures

Change in Apnea/Hypopnea Index (AHI)
Change in AHI derived as: AHI (end of treatment) minus AHI (pre-treatment)
Change in Epworth Sleepiness Scale (ESS)
Change in ESS derived as: ESS (end of treatment) minus ESS (pre-treatment). The ESS scale has a range of 0 to 24, with 0 representing the least degree of sleepiness and 24 the greatest degree of sleepiness. There are no subscales.
Change in Sleep Latency: Maintenance of Wakefulness Test (MWT)
Change in MWT derived as: MWT (end of treatment) minus MWT (pre-treatment). The Maintenance of Wakefulness Test measures a person's ability to stay awake in a quiet, dark and nonstimulating room for a period of time.

Secondary Outcome Measures

Tolerability by Treatment Satisfaction Questionnaire for Medications (TSQM) Overall Score.
The TSQM measures a person's satisfaction with treatment based on a 7-point scale ranging from "Extremely Dissatisfied" to "Extremely Satisfied" in response to the question, "Taking all things into account, how satisfied or dissatisfied are you with this medication?".
Adverse Events (AEs)
AEs will be evaluated and tracked throughout subject participation (up to 8 weeks)
Change in Desaturation Time (DT)
Change in DT (total minutes with arterial oxygen saturation below 85% during 8-hour polysomnography) derived as: DT (end of treatment) minus DT (pre-treatment)

Full Information

First Posted
December 18, 2012
Last Updated
July 27, 2021
Sponsor
University of Illinois at Chicago
Collaborators
Northwestern University, University of Chicago, Hektoen Institute for Medical Research, National Heart, Lung, and Blood Institute (NHLBI)
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1. Study Identification

Unique Protocol Identification Number
NCT01755091
Brief Title
Safety and Efficacy Study of Dronabinol to Treat Obstructive Sleep Apnea
Acronym
PACE
Official Title
Cannabimimetic Treatment of Obstructive Sleep Apnea: A Proof of Concept Trial
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
February 2013 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
December 31, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Illinois at Chicago
Collaborators
Northwestern University, University of Chicago, Hektoen Institute for Medical Research, National Heart, Lung, and Blood Institute (NHLBI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a proof of concept study to determine the safety and efficacy of dronabinol for the treatment of obstructive sleep apnea syndrome (OSA).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sleep Apnea, Obstructive

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sugar Pill
Arm Type
Placebo Comparator
Arm Description
Placebo, once per day (QD) by mouth, 60 minutes before bedtime for 6 weeks after 1-week run-in
Arm Title
2.5 mg/day
Arm Type
Experimental
Arm Description
Dronabinol, 2.5 mg QD by mouth, 60 minutes before bedtime for 6 weeks after 1-week placebo run-in
Arm Title
10 mg/day
Arm Type
Experimental
Arm Description
Dronabinol, 10 mg QD by mouth, 60 minutes before bedtime for 4 weeks after 1-week placebo run-in and 2-week dose escalation
Intervention Type
Drug
Intervention Name(s)
Dronabinol
Intervention Type
Drug
Intervention Name(s)
Placebo (for Dronabinol)
Primary Outcome Measure Information:
Title
Change in Apnea/Hypopnea Index (AHI)
Description
Change in AHI derived as: AHI (end of treatment) minus AHI (pre-treatment)
Time Frame
Baseline and Week 6
Title
Change in Epworth Sleepiness Scale (ESS)
Description
Change in ESS derived as: ESS (end of treatment) minus ESS (pre-treatment). The ESS scale has a range of 0 to 24, with 0 representing the least degree of sleepiness and 24 the greatest degree of sleepiness. There are no subscales.
Time Frame
Baseline and Week 6
Title
Change in Sleep Latency: Maintenance of Wakefulness Test (MWT)
Description
Change in MWT derived as: MWT (end of treatment) minus MWT (pre-treatment). The Maintenance of Wakefulness Test measures a person's ability to stay awake in a quiet, dark and nonstimulating room for a period of time.
Time Frame
Baseline and Week 6
Secondary Outcome Measure Information:
Title
Tolerability by Treatment Satisfaction Questionnaire for Medications (TSQM) Overall Score.
Description
The TSQM measures a person's satisfaction with treatment based on a 7-point scale ranging from "Extremely Dissatisfied" to "Extremely Satisfied" in response to the question, "Taking all things into account, how satisfied or dissatisfied are you with this medication?".
Time Frame
Week 6
Title
Adverse Events (AEs)
Description
AEs will be evaluated and tracked throughout subject participation (up to 8 weeks)
Time Frame
Up to 8 weeks
Title
Change in Desaturation Time (DT)
Description
Change in DT (total minutes with arterial oxygen saturation below 85% during 8-hour polysomnography) derived as: DT (end of treatment) minus DT (pre-treatment)
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
64 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult 21 to 64 years of age; 15≤AHI ≤ 50 on screening polysomnogram (PSG) ESS score ≥ 7 Able to understand and complete informed consent and all study assessments and forms, presented in an English-speaking format; Women of child-bearing potential (WCBP) must have a negative urine pregnancy test. In addition sexually active WCBP must agree to use adequate contraceptive methods (oral, injectable or implantable hormonal contraceptive; tubal ligation; intra-uterine devices; barrier contraceptive with spermicide; or vasectomized partner). Exclusion Criteria: Arterial oxygen saturation < 75% for > 5% of sleep period time on screening PSG; Occupation or life situation that may impart risk by study participation (e.g. commercial driver, pilot, police officer, fireman); Motor vehicle accident or "near-miss" related to sleepiness (self-report) within 2 years of the first dose of study drug (Day 8); Body mass index > 45 kg/m2 Severe obstructive sleep apnea syndrome (OSAS) that, based on the clinical judgment of the Investigator, precludes delaying positive airway pressure treatment; History of shift work or rotating shifts within the month prior to the first dose of study drug (Day 8); Prior upper airway surgery for snoring or OSAS as an adult (≥ 18 years of age); Prior non-invasive treatment for OSAS within 6 months prior to the first dose of study drug (Day 8); Major surgery within 6 months prior to the first dose of study drug (Day 8); Bariatric surgery within 2 years prior to the first dose of study drug (Day 8). If post-bariatric surgery, weight must be stable ±5% (self-report) for at least 6 months prior to first dose of study drug (Day 8). Any form of medically managed weight loss program within 6 months prior to the first dose of study drug (Day 8); Significant defect in nasal patency due to anatomical abnormalities or uncontrolled or recurrent episodes of rhinitis; Any clinically significant unstable or progressive medical condition; Any primary sleep disorder other than OSAS as determined by history, physical examination, or Visit 2 PSG (after 7-day screening run-in period); Clinically significant or uncontrolled: chronic obstructive pulmonary disease (COPD), cardiovascular disease, gastrointestinal, respiratory, pancreatic, hepatic, renal, hematologic, endocrine [including insulin-dependent diabetes mellitus (IDDM)], neurological, urogenital, connective tissue, dermatological, thyroid, or other medical disorder; Any clinically significant psychiatric disorder; History of seizure disorder; Treatment with any prescription antidepressant medication within 1 month prior to the first dose of study drug (Day 8); Treatment with sedatives, hypnotics or other psychoactive drugs within 30 days prior to the first dose of study drug (Day 8); Any complete blood count (CBC) or liver function test (LFT) laboratory value outside the normal range which, in the clinical judgment of the Investigator renders a subject inappropriate for randomization to treatment; Pregnancy [as demonstrated by positive urine human chorionic gonadotropin (hCG) test] or lactation; Allergic to cannabinoids or sesame oil; History of substance abuse (including alcohol abuse or dependence) or laboratory evidence of drug abuse on the Visit 1 drug-screening panel; Use of dietary supplements which in the judgment of the Investigator may impact sleep or breathing behaviors; Average daily caffeine consumption > 500 mg/day (~5 cups of coffee); Average weekly alcohol consumption > 10 units; Unwillingness to abstain from caffeine and alcohol on all days when overnight or daytime testing will be performed; Participation in any other investigational protocol within the 30 days prior to the first dose of study drug (Day 8); Any condition which, in the opinion of the Investigator, places the patient at unacceptable risk if he or she were to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David W Carley, PhD
Organizational Affiliation
University of Illinois at Chicago
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Illinois at Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29121334
Citation
Carley DW, Prasad B, Reid KJ, Malkani R, Attarian H, Abbott SM, Vern B, Xie H, Yuan C, Zee PC. Pharmacotherapy of Apnea by Cannabimimetic Enhancement, the PACE Clinical Trial: Effects of Dronabinol in Obstructive Sleep Apnea. Sleep. 2018 Jan 1;41(1):zsx184. doi: 10.1093/sleep/zsx184.
Results Reference
derived

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Safety and Efficacy Study of Dronabinol to Treat Obstructive Sleep Apnea

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