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Study of Efficacy of Ramelteon in Adults With Chronic Insomnia

Primary Purpose

Chronic Insomnia

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Ramelteon
Ramelteon
Placebo
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 Sleep Disorder, Insomnia, Drug Therapy

Eligibility Criteria

18 Years - 64 Years (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.
  • Females who are not of childbearing potential must be postmenopausal for 1 year or have history of hysterectomy and/or oophorectomy.
  • Primary insomnia as defined by the DSM-IV-TRTM for at least 3 months and as defined by subjective sleep latency (sSL) greater than or equal to 30 minutes, subjective total sleep time (sTST) 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 on 2 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 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 the first night single-blind study medication, whichever is longer.
  • Sleep schedule changes required by employment (e.g. shift worker) within three months prior to the first night 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 the first night 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, as defined in Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised and/or regularly consumes 4 or more alcoholic drinks per day.
  • 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 the first night of single-blind study medication.
  • Uses tobacco products during nightly awakenings.
  • Used melatonin, or other drugs or supplements known to affect sleep/wake function within 1 week (or 5 half lives of the drug, whichever is longer) prior to the first day of single-blind study medication.
  • Used any central nervous system medication within 1 week (or 5 half lives of the drug, whichever is longer) prior to the first day of single-blind 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.
  • Positive urine drug screen including alcohol at screening or a positive breathalyzer test at each check-in.
  • Apnea hypopnea index (per hour of sleep) greater than 10 as seen on polysomnogram, on the first night of the polysomnogram screening.
  • Periodic leg movement with arousal index (per hour of sleep) greater than 10 as seen on polysomnogram, on the first night of polysomnogram screening.
  • 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
    • Respiratory stimulants (eg, theophylline)
    • 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
    • All beta blockers
    • Melatonin
    • St. John's Wort
    • Kavakava
    • Gingko biloba

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Ramelteon 8 mg QD

Ramelteon 16 mg QD

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Mean Latency to Persistent Sleep.

Secondary Outcome Measures

Mean Latency to Persistent Sleep.
Total Sleep Time.
Sleep Efficiency.
Awake Time after Persistent Sleep.
Number of Awakenings after Persistent Sleep.
Subjective Sleep Latency.
Subjective Total Sleep Time.
Subjective Sleep Quality.
Subjective Awake Time.
Subjective Number of Awakenings.
Subjective Ease of Falling Back to Sleep.

Full Information

First Posted
May 1, 2008
Last Updated
November 8, 2012
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00671125
Brief Title
Study of Efficacy of Ramelteon in Adults With Chronic Insomnia
Official Title
A Phase III, Randomized, Double-Blind Placebo-Controlled, PSG Plus Outpatient Study to Determine the Safety and Efficacy of TAK-375 in Adults With Chronic Insomnia
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
January 2003 (undefined)
Primary Completion Date
September 2003 (Actual)
Study Completion Date
September 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
The purpose of this study is to determine the safety and efficacy of Ramelteon, once daily (QD), in the treatment of chronic insomnia using polysomnography and subjective measures of sleep
Detailed Description
Insomnia is characterized by 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 selective melatonin-1 receptor agonist 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 will determine the safety and efficacy of 35-day treatment of chronic insomnia with Ramelteon using polysomnography and subjective measures of sleep. 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
Sleep Disorder, Insomnia, Drug Therapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ramelteon 8 mg QD
Arm Type
Experimental
Arm Title
Ramelteon 16 mg QD
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem™, TAK-375
Intervention Description
Ramelteon 8 mg, tablets, orally, once nightly for up to 5 weeks.
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem™, TAK-375
Intervention Description
Ramelteon 16 mg, tablets, orally, once nightly for up to 5 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Ramelteon placebo-matching tablets, orally, once nightly for up to 5 weeks.
Primary Outcome Measure Information:
Title
Mean Latency to Persistent Sleep.
Time Frame
Week 1
Secondary Outcome Measure Information:
Title
Mean Latency to Persistent Sleep.
Time Frame
Weeks 3 and 5 or Final Visit
Title
Total Sleep Time.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Sleep Efficiency.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Awake Time after Persistent Sleep.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Number of Awakenings after Persistent Sleep.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Subjective Sleep Latency.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Subjective Total Sleep Time.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Subjective Sleep Quality.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Subjective Awake Time.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Subjective Number of Awakenings.
Time Frame
Weeks 1, 3 and 5 or Final Visit
Title
Subjective Ease of Falling Back to Sleep.
Time Frame
Weeks 1, 3 and 5 or Final Visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
64 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. Females who are not of childbearing potential must be postmenopausal for 1 year or have history of hysterectomy and/or oophorectomy. Primary insomnia as defined by the DSM-IV-TRTM for at least 3 months and as defined by subjective sleep latency (sSL) greater than or equal to 30 minutes, subjective total sleep time (sTST) 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 on 2 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 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 the first night single-blind study medication, whichever is longer. Sleep schedule changes required by employment (e.g. shift worker) within three months prior to the first night 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 the first night 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, as defined in Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised and/or regularly consumes 4 or more alcoholic drinks per day. 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 the first night of single-blind study medication. Uses tobacco products during nightly awakenings. Used melatonin, or other drugs or supplements known to affect sleep/wake function within 1 week (or 5 half lives of the drug, whichever is longer) prior to the first day of single-blind study medication. Used any central nervous system medication within 1 week (or 5 half lives of the drug, whichever is longer) prior to the first day of single-blind 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. Positive urine drug screen including alcohol at screening or a positive breathalyzer test at each check-in. Apnea hypopnea index (per hour of sleep) greater than 10 as seen on polysomnogram, on the first night of the polysomnogram screening. Periodic leg movement with arousal index (per hour of sleep) greater than 10 as seen on polysomnogram, on the first night of polysomnogram screening. 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 Respiratory stimulants (eg, theophylline) 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 All beta blockers Melatonin St. John's Wort Kavakava 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
Scottsdale
State/Province
Arizona
Country
United States
City
Hot Springs
State/Province
Arkansas
Country
United States
City
Anaheim
State/Province
California
Country
United States
City
Oakland
State/Province
California
Country
United States
City
San Diego
State/Province
California
Country
United States
City
San Francisco
State/Province
California
Country
United States
City
Santa Monica
State/Province
California
Country
United States
City
Miami
State/Province
Florida
Country
United States
City
Pembroke Pines
State/Province
Florida
Country
United States
City
Atlanta
State/Province
Georgia
Country
United States
City
Chicago
State/Province
Illinois
Country
United States
City
Overland Park
State/Province
Kansas
Country
United States
City
Crestview Hills
State/Province
Kentucky
Country
United States
City
Chevy Chase
State/Province
Maryland
Country
United States
City
Newton
State/Province
Massachusetts
Country
United States
City
Troy
State/Province
Michigan
Country
United States
City
Lincoln
State/Province
Nebraska
Country
United States
City
Las Vegas
State/Province
Nevada
Country
United States
City
New York
State/Province
New York
Country
United States
City
Winston-Salem
State/Province
North Carolina
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States
City
Lafayette Hill
State/Province
Pennsylvania
Country
United States
City
Austin
State/Province
Texas
Country
United States
City
Plano
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17803013
Citation
Zammit G, Erman M, Wang-Weigand S, Sainati S, Zhang J, Roth T. Evaluation of the efficacy and safety of ramelteon in subjects with chronic insomnia. J Clin Sleep Med. 2007 Aug 15;3(5):495-504. Erratum In: J Clin Sleep Med. 2007 Oct 15;3(6):table of contents. J Clin Sleep Med. 2008 Oct 15;4(5):table of contents.
Results Reference
result
PubMed Identifier
18691991
Citation
Mini L, Wang-Weigand S, Zhang J. Ramelteon 8 mg/d versus placebo in patients with chronic insomnia: post hoc analysis of a 5-week trial using 50% or greater reduction in latency to persistent sleep as a measure of treatment effect. Clin Ther. 2008 Jul;30(7):1316-23. doi: 10.1016/s0149-2918(08)80056-2.
Results Reference
result
Citation
Osborne, T, Louis, M, Wang-Weigand, S and Jie, Z. Treatment of insomnia in women and the melatonin receptor agonist ramelteon (Rozerem). Women's Health Care: A Practical Journal for Nurse Practitioners. 2008; 7: (6): 24-30
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

Learn more about this trial

Study of Efficacy of Ramelteon in Adults With Chronic Insomnia

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