Study of SPM 962 in Patients With Restless Legs Syndrome (RLS)
Primary Purpose
Idiopathic Restless Legs Syndrome
Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
SPM 962
SPM 962
Placebo of SPM 962
Sponsored by
About this trial
This is an interventional treatment trial for Idiopathic Restless Legs Syndrome
Eligibility Criteria
Inclusion Criteria:
- Patients whose condition has been diagnosed as RLS by meeting all 4 of the International Restless legs Syndrome Study Group/ National Institute of Health (IRLSSG/NIH) criteria
Patients who meet any of the following criteria relating to RLS treatment:
- Patients who have never received treatment for RLS
- Patients who have received treatment for RLS in the past and responded to L-dopa or dopamine agonists (Response to other RLS medicines is irrelevant.)
- Patients who have an IRLS total score of >=15 at baseline
- Patients who experience symptoms in the evening or during the night on at least two days a week within 14 days prior to commencement of study treatment
- Patients and their partners can practice contraception at the end of follow-up observation period or by 1 week after the end of treatment
Exclusion Criteria:
- Patients who have previously participated in a clinical trial of SPM962 and taken the investigational product (IP)
- Patients with secondary RLS induced by renal impairment (uremia), iron deficiency anemia, drugs, pregnancy, etc.
- Patients who currently suffer, are at risk of developing, or have a history of sleep disorder such as sleep apnea syndrome, narcolepsy, and sleep attacks/sudden onset of sleep
- Patients who have concomitant diseases or symptoms which may affect the symptoms of RLS, such as polyneuropathy (including diabetic neuropathy), akathisia, claudication, varicoses, muscle fasciculation, painful legs and moving toes syndrome, radiculopathy and folate deficiency
- Patients who have other CNS diseases such as Parkinson's disease, dementia, progressive supranuclear paresis, multisystem atrophy, Huntington's Chorea, amyotrophic lateral sclerosis, and Alzheimer's disease
- Patients who have psychiatric conditions such as confusion, hallucination, delusion, and excitation, or patients who have abnormal behavior such as delirium, obsessive compulsive disorder, and impulse control disorder at the time of the screening test or baseline examination
- Patients whose SBP declines by at least 30 mmHg from supine to standing position based on the orthostatic hypotension assessment, or patients who develop orthostatic hypotension at baseline
- Patients who have a history of epilepsy, convulsion, etc
- Patients who have complications or a history of serious cardiac diseases or arrhythmia (eg, congestive heart failure of class 3 or 4 in the NYHA classification, second or third degree atrioventricular block, complete left bundle branch block, sick sinus syndrome, ventricular fibrillation, myocardial infarction within 12 months prior to the screening test, or a complication of angina pectoris)
- Patients with arrhythmia who have been taking Class 1a antiarrhythmic drugs (eg., quinidine, procainamide) or Class 3 antiarrhythmic drugs (eg., amiodarone, sotalol)
Patients who have a serious ECG abnormality at the screening test and at the baseline examination
- Patients who show QTc intervals exceeding 450 ms in both ECGs in the screening test
- Patients who have an average QTc interval from the two ECGs in the baseline assessment that exceeds 470 ms (for females) or 450 ms (for males)
- Patients with congenital long QT syndrome
- Patients whose serum potassium level is < 3.5mEq/L at the screening test
- Patients whose total bilirubin is >= 3.0mg/dL, or whose AST(GOT) and ALT(GPT) are equal or more than 2.5 times the reference range of the clinical site (or >= 100IU/L) at the screening test
- Patients whose BUN level is >= 30mg/dL, or whose serum creatinine level is >= 2.0mg/dL at the screening test
- Patients who have a history of allergy to topical agents such as transdermal patch
- Patients who are pregnant or nursing or who wish to become pregnant during the study period
- Patients who habitually drink alcohol or smoke excessively
- Patients who engage in evening shift work or other such shift work, or whose work or circumstances makes it difficult to maintain a regular period of sleep
- Patients who engage in hazardous work such as driving a vehicle, operating machinery, or working in a high location.
- Patients with autoimmune disease, chronic active hepatitis, or immune deficiency disorder
- Patients who have a complication or history of malignant neoplastic disease, or received treatment for the disease within 12 months prior to the screening test
- Patients who are unable to properly record information in a patient diary
- Patients who received other IPs within 12 weeks prior to commencement of study treatment
- Patients who have been judged by the investigator or the sub-investigator to be inappropriate for inclusion in the study for any other reasons
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Placebo Comparator
Arm Label
SPM 962 4.5
SPM 962 6.75
placebo
Arm Description
started at 2.25 mg/day to 4.5 mg/day for 13 weeks
started at 2.25 mg/day to 6.75 mg/day for 13 weeks
for 13 weeks
Outcomes
Primary Outcome Measures
International Restless Legs Syndrome Rating Scale (IRLS) Total Score
Change from the baseline to the end of dose-titration/dose-maintenance period. IRLS is a scale for assessing severity of restless legs syndrome symptoms. IRLS consists of ten questions. Each question is scored from 4 for the first (top) answer (usually 'very severe') to 0 for the last answer (usually none).
The sum of the score of each question serves as the scale score. The scale scoring criteria are: Mild (score 1-10); Moderate (score 11-20); Severe (score 21-30); Very severe (score 31-40). A decrease in the scores means improvement.
Secondary Outcome Measures
Clinical Global Impression (CGI) Improvement
CGI improvement is a clinician-reported scale for assessing how much the patient's illness has improved or worsened from baseline.
The scale scoring criteria are 1: very much improved, 2: much improved, 3: minimally improved, 4: no change, 5: minimally worse, 6: much worse, 7: very much worse.
Patient Global Impression (PGI) Improvement
PGI improvement is a patient-reported scale for assessing how much the patient's illness has improved or worsened from baseline.
The scale scoring criteria are 1: very much better, 2: much better, 3: a little better, 4: no change, 5: a little worse, 6: much worse, 7: very much worse.
The Pittsburgh Sleep Quality Index (PSQI)
Change of PSQI from baseline to the end of dose-titration/dose-maintenance period.
PSQI is a scale for assessing severity of sleep disorders. The score ranges from 0 to 21. 0 indicates "no difficulty" and 21 indicates "severe difficulty". A decrease in the scores means improvement.
Each Item of IRLS (10 Items)
IRLS is a scale for assessing severity of restless legs syndrome symptoms. IRLS consists of ten questions. Each question is scored from 4 for the first (top) answer (usually 'very severe') to 0 for the last answer (usually none).
Numbers of subjects with -4 or -3 score change from baseline in each item of IRLS. A decrease in the scores means improvement.
Incidence of RLS Symptoms
Incidence rate of RLS symptoms is calculated as the number of days with RLS symptoms in the week / the number of evaluation days in the week* 100%
Average Duration of RLS Symptoms
Change of average duration of RLS symptoms in a week from baseline to the end of dose-titration/dose-maintenance period. Only the days with RLS symptoms are used for calculation.
Incidence of RLS Symptoms in the Evening and Night
Incidence rate of RLS symptoms is calculated as the number of days with RLS symptoms / the number of days of evaluation * 100%.
Average Duration of RLS Symptoms in the Evening and Night in a Week
Change of average duration of RLS symptoms in a week from baseline to the end of dose-titration/dose-maintenance period. Only the days with RLS symptoms are used for calculation.
Nocturnal Awakenings Due to RLS Symptoms in a Week
Nocturnal awakening rate is calculated as the number of days with nocturnal awakenings / the number of days of evaluation * 100%.
Average Sleep Time in a Week
Change of average sleep time in a week from baseline to the end of dose-titration/dose-maintenance period.
Full Information
NCT ID
NCT01084551
First Posted
March 4, 2010
Last Updated
May 28, 2014
Sponsor
Otsuka Pharmaceutical Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT01084551
Brief Title
Study of SPM 962 in Patients With Restless Legs Syndrome (RLS)
Official Title
A Phase 3 Multi-Center, Placebo-Controlled, Double Blind, 3-Armed Parallel Group, Comparative Study of SPM 962 4.5 and 6.75 mg/Day to Investigate Superiority to Placebo in Patients With Restless Legs Syndrome
Study Type
Interventional
2. Study Status
Record Verification Date
May 2014
Overall Recruitment Status
Completed
Study Start Date
February 2010 (undefined)
Primary Completion Date
September 2011 (Actual)
Study Completion Date
September 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Otsuka Pharmaceutical Co., Ltd.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective of this study is to evaluate the clinical efficacy and safety of SPM962 in patients with restless legs syndrome (RLS) with once-daily repeated doses of 4.5mg and 6.75mg during a 13-week dose-titration and maintenance period. This is a multi-center, randomized, placebo-controlled, double-blind, 3-armed parallel group comparison study.
Efficacy will be determined by investigating the superiority of SPM962 to placebo in terms of the primary efficacy variable, change in International Restless Legs Syndrome Rating Scale (IRLS) total score from baseline to the end of the dose-maintenance period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Restless Legs Syndrome
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
284 (Actual)
8. Arms, Groups, and Interventions
Arm Title
SPM 962 4.5
Arm Type
Experimental
Arm Description
started at 2.25 mg/day to 4.5 mg/day for 13 weeks
Arm Title
SPM 962 6.75
Arm Type
Experimental
Arm Description
started at 2.25 mg/day to 6.75 mg/day for 13 weeks
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
for 13 weeks
Intervention Type
Drug
Intervention Name(s)
SPM 962
Intervention Description
once a daily transdermal administration started at 2.25 mg/day to 4.5 mg/day for 13 weeks
Intervention Type
Drug
Intervention Name(s)
SPM 962
Intervention Description
once a daily transdermal administration started at 2.25 mg/day to 6.75 mg/day for 13 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo of SPM 962
Intervention Description
once a daily transdermal administration for 13 weeks
Primary Outcome Measure Information:
Title
International Restless Legs Syndrome Rating Scale (IRLS) Total Score
Description
Change from the baseline to the end of dose-titration/dose-maintenance period. IRLS is a scale for assessing severity of restless legs syndrome symptoms. IRLS consists of ten questions. Each question is scored from 4 for the first (top) answer (usually 'very severe') to 0 for the last answer (usually none).
The sum of the score of each question serves as the scale score. The scale scoring criteria are: Mild (score 1-10); Moderate (score 11-20); Severe (score 21-30); Very severe (score 31-40). A decrease in the scores means improvement.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Secondary Outcome Measure Information:
Title
Clinical Global Impression (CGI) Improvement
Description
CGI improvement is a clinician-reported scale for assessing how much the patient's illness has improved or worsened from baseline.
The scale scoring criteria are 1: very much improved, 2: much improved, 3: minimally improved, 4: no change, 5: minimally worse, 6: much worse, 7: very much worse.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
Patient Global Impression (PGI) Improvement
Description
PGI improvement is a patient-reported scale for assessing how much the patient's illness has improved or worsened from baseline.
The scale scoring criteria are 1: very much better, 2: much better, 3: a little better, 4: no change, 5: a little worse, 6: much worse, 7: very much worse.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
The Pittsburgh Sleep Quality Index (PSQI)
Description
Change of PSQI from baseline to the end of dose-titration/dose-maintenance period.
PSQI is a scale for assessing severity of sleep disorders. The score ranges from 0 to 21. 0 indicates "no difficulty" and 21 indicates "severe difficulty". A decrease in the scores means improvement.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
Each Item of IRLS (10 Items)
Description
IRLS is a scale for assessing severity of restless legs syndrome symptoms. IRLS consists of ten questions. Each question is scored from 4 for the first (top) answer (usually 'very severe') to 0 for the last answer (usually none).
Numbers of subjects with -4 or -3 score change from baseline in each item of IRLS. A decrease in the scores means improvement.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
Incidence of RLS Symptoms
Description
Incidence rate of RLS symptoms is calculated as the number of days with RLS symptoms in the week / the number of evaluation days in the week* 100%
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
Average Duration of RLS Symptoms
Description
Change of average duration of RLS symptoms in a week from baseline to the end of dose-titration/dose-maintenance period. Only the days with RLS symptoms are used for calculation.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (weeks 13)
Title
Incidence of RLS Symptoms in the Evening and Night
Description
Incidence rate of RLS symptoms is calculated as the number of days with RLS symptoms / the number of days of evaluation * 100%.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
Average Duration of RLS Symptoms in the Evening and Night in a Week
Description
Change of average duration of RLS symptoms in a week from baseline to the end of dose-titration/dose-maintenance period. Only the days with RLS symptoms are used for calculation.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (weeks 13)
Title
Nocturnal Awakenings Due to RLS Symptoms in a Week
Description
Nocturnal awakening rate is calculated as the number of days with nocturnal awakenings / the number of days of evaluation * 100%.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (week 13)
Title
Average Sleep Time in a Week
Description
Change of average sleep time in a week from baseline to the end of dose-titration/dose-maintenance period.
Time Frame
Baseline, the end of dose-titration/dose-maintenance period (weeks 13)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients whose condition has been diagnosed as RLS by meeting all 4 of the International Restless legs Syndrome Study Group/ National Institute of Health (IRLSSG/NIH) criteria
Patients who meet any of the following criteria relating to RLS treatment:
Patients who have never received treatment for RLS
Patients who have received treatment for RLS in the past and responded to L-dopa or dopamine agonists (Response to other RLS medicines is irrelevant.)
Patients who have an IRLS total score of >=15 at baseline
Patients who experience symptoms in the evening or during the night on at least two days a week within 14 days prior to commencement of study treatment
Patients and their partners can practice contraception at the end of follow-up observation period or by 1 week after the end of treatment
Exclusion Criteria:
Patients who have previously participated in a clinical trial of SPM962 and taken the investigational product (IP)
Patients with secondary RLS induced by renal impairment (uremia), iron deficiency anemia, drugs, pregnancy, etc.
Patients who currently suffer, are at risk of developing, or have a history of sleep disorder such as sleep apnea syndrome, narcolepsy, and sleep attacks/sudden onset of sleep
Patients who have concomitant diseases or symptoms which may affect the symptoms of RLS, such as polyneuropathy (including diabetic neuropathy), akathisia, claudication, varicoses, muscle fasciculation, painful legs and moving toes syndrome, radiculopathy and folate deficiency
Patients who have other CNS diseases such as Parkinson's disease, dementia, progressive supranuclear paresis, multisystem atrophy, Huntington's Chorea, amyotrophic lateral sclerosis, and Alzheimer's disease
Patients who have psychiatric conditions such as confusion, hallucination, delusion, and excitation, or patients who have abnormal behavior such as delirium, obsessive compulsive disorder, and impulse control disorder at the time of the screening test or baseline examination
Patients whose SBP declines by at least 30 mmHg from supine to standing position based on the orthostatic hypotension assessment, or patients who develop orthostatic hypotension at baseline
Patients who have a history of epilepsy, convulsion, etc
Patients who have complications or a history of serious cardiac diseases or arrhythmia (eg, congestive heart failure of class 3 or 4 in the NYHA classification, second or third degree atrioventricular block, complete left bundle branch block, sick sinus syndrome, ventricular fibrillation, myocardial infarction within 12 months prior to the screening test, or a complication of angina pectoris)
Patients with arrhythmia who have been taking Class 1a antiarrhythmic drugs (eg., quinidine, procainamide) or Class 3 antiarrhythmic drugs (eg., amiodarone, sotalol)
Patients who have a serious ECG abnormality at the screening test and at the baseline examination
Patients who show QTc intervals exceeding 450 ms in both ECGs in the screening test
Patients who have an average QTc interval from the two ECGs in the baseline assessment that exceeds 470 ms (for females) or 450 ms (for males)
Patients with congenital long QT syndrome
Patients whose serum potassium level is < 3.5mEq/L at the screening test
Patients whose total bilirubin is >= 3.0mg/dL, or whose AST(GOT) and ALT(GPT) are equal or more than 2.5 times the reference range of the clinical site (or >= 100IU/L) at the screening test
Patients whose BUN level is >= 30mg/dL, or whose serum creatinine level is >= 2.0mg/dL at the screening test
Patients who have a history of allergy to topical agents such as transdermal patch
Patients who are pregnant or nursing or who wish to become pregnant during the study period
Patients who habitually drink alcohol or smoke excessively
Patients who engage in evening shift work or other such shift work, or whose work or circumstances makes it difficult to maintain a regular period of sleep
Patients who engage in hazardous work such as driving a vehicle, operating machinery, or working in a high location.
Patients with autoimmune disease, chronic active hepatitis, or immune deficiency disorder
Patients who have a complication or history of malignant neoplastic disease, or received treatment for the disease within 12 months prior to the screening test
Patients who are unable to properly record information in a patient diary
Patients who received other IPs within 12 weeks prior to commencement of study treatment
Patients who have been judged by the investigator or the sub-investigator to be inappropriate for inclusion in the study for any other reasons
Facility Information:
City
Chubu Region
Country
Japan
City
Chugoku Region
Country
Japan
City
Hokkaido Region
Country
Japan
City
Kansai Region
Country
Japan
City
Kanto Region
Country
Japan
City
Kyushu Region
Country
Japan
City
Shikoku Region
Country
Japan
City
Tohoku Region
Country
Japan
12. IPD Sharing Statement
Citations:
PubMed Identifier
24055212
Citation
Inoue Y, Shimizu T, Hirata K, Uchimura N, Ishigooka J, Oka Y, Ikeda J, Tomida T, Hattori N; Rotigotine Trial Group. Efficacy and safety of rotigotine in Japanese patients with restless legs syndrome: a phase 3, multicenter, randomized, placebo-controlled, double-blind, parallel-group study. Sleep Med. 2013 Nov;14(11):1085-91. doi: 10.1016/j.sleep.2013.07.007. Epub 2013 Aug 21.
Results Reference
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Study of SPM 962 in Patients With Restless Legs Syndrome (RLS)
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