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Non-24-Hour Sleep-Wake DisorderPhase 3NCT01163032

Efficacy and Safety of Tasimelteon Compared With Placebo in Totally Blind Subjects With Non-24-Hour Sleep-Wake Disorder

A Phase 3 study testing tasimelteon in people with Non-24-Hour Sleep-Wake Disorder, run by Vanda Pharmaceuticals at 28 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to evaluate the efficacy and safety of a six month double-mask treatment of tasimelteon or placebo in male and female subjects with Non-24-Hour Sleep-Wake Disorder Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Non-24-Hour Sleep-Wake Disorder
What is being tested?
tasimelteon
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
136 participants
Where
28 sitesin 2 countries
Study dates
Aug 2010to Nov 2012
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Ability and acceptance to provide informed consent;
  • No perception of light by the subject's own report;
  • Diagnosis of N24HSWD as determined by:
  • History (within the last 3 months) of trouble sleeping at night difficulty initiating sleep or staying asleep), difficulty awakening in the morning, or daytime sleepiness as determined by answering yes to at least one question in the Sleep Complaint Questionnaire and
  • Urinary aMT6s demonstrates a progressive delay of the aMT6 acrophase time.
  • Willing and able to comply with study requirements and restrictions including a commitment to a fixed 9-hour sleep opportunity during the study;
  • Fluent in English;

Who cannot join

  • Have a probable diagnosis of a current sleep disorder other than N24HSWD that is the primary cause of the sleep disturbance based on clinical investigator medical judgment;
  • Current clinically significant cardiovascular, respiratory, neurologic, hepatic, hematopoietic, renal, gastrointestinal or metabolic dysfunction unless currently controlled and stable;
  • History (within the 12 months prior to screening) of psychiatric disorders including Major Depressive Disorder, Generalized Anxiety Disorder, Axis II Disorders, delirium or any other psychiatric disorder that in the opinion of the clinical investigator would affect participation in the study or full compliance with study procedures;
  • History of intolerance and/or hypersensitivity to melatonin or melatonin agonists;
  • Worked night, rotating, or split (period of work, followed by break, and then return to work) shift work within 1 month of the screening visit or plan to work these shifts during the study;
  • Unable to perform calls to the study IVR system to report questionnaire results;
Show all 9Show fewer
  • Exposure to any investigational drug, including placebo, within 30 days or 5 half lives (whichever was longer) of screening;
  • Use of central nervous system prescription or OTC medications, other than melatonin, that affects the sleep-wake cycle
  • Use of melatonin or melatonin agonist

Trial locations and contacts

28 sites in 2 countries.

28 sites in 2 countries

United States23 sites
  • Michigan Head-Pain Neurological Institute

    Ann Arbor, Michigan, 48104

  • Sleep Disorders Center Of Georgia

    Atlanta, Georgia, 30342

  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • PAB Clinical Research Inc.

    Brandon, Florida, 33511

  • St. Luke's Sleep Medicine and Research Center (St. Louis Metropolitan Area)

    Chesterfield, Missouri, 63017

  • The Center for Sleep and Wake Disorders (Washington, D.C. Metropolitan Area)

    Chevy Chase, Maryland, 20815

  • Tri-State Sleep Disorders Center

    Cincinnati, Ohio, 45246

  • SleepMed, Inc. - Columbia

    Columbia, South Carolina, 29201

  • Radiant Research - Denver

    Denver, Colorado, 80239

  • Ohio Sleep Medicine Institute (Columbus Metropolitan Area)

    Dublin, Ohio, 43017

  • Suburban Lung Associates SC (Chicago Metropolitan Area)

    Elk Grove Village, Illinois, 60007

  • Todd J. Swick, M.D., P.A.

    Houston, Texas, 77063

  • Kendall South Medical Center, Inc.

    Miami, Florida, 33175

  • New York Eye and Ear Infirmary

    New York, New York, 10003

  • Lynn Health Science Institute

    Oklahoma City, Oklahoma, 73112

  • SDS Clinical Trials Inc.

    Orange, California, 92868

  • Ocean Sleep Disorders Center - Ormond Beach

    Ormond Beach, Florida, 32174

  • VA Palo Alto Health Care System/PAIRE (San Fransisco Bay Area)

    Palo Alto, California, 94304

  • Center For Sleep Medicine at Chestnut Hill Hospital

    Philadelphia, Pennsylvania, 19118

  • Pulmonary Associates, PA

    Phoenix, Arizona, 85006

  • Consolidated Clinical trials

    Pittsburgh, Pennsylvania, 15221

  • Columbia Research Group Inc.

    Portland, Oregon, 97239

  • St. Johns Sleep Disorder Center - St. Johns Medical Plaza

    Santa Monica, California, 90404

Other trials in United States

Germany5 sites
  • Advanced Sleep Research GmbH

    Berlin, 10117

  • Bergmannsheil University Hospital - Medical Clinic III

    Bochum, 44789

  • Klinische-Forschung Hannover Mitte

    Hanover, 30159

  • Universitaetsklinikum Glesen and Marburg gmbH/Schlaflabor - Sleep Lab University Marburg

    Marburg, 35043

  • Bonomed Studiezentrum

    Munich, 80331

Other trials in Germany

About this study

Official title: A Multicenter, Randomized, Double-Mask, Placebo-Controlled, Parallel Study to Investigate the Efficacy and Safety of 20 mg Tasimelteon Versus Placebo in Totally Blind Subjects With N24HSWD Followed by an OLE Phase

The purpose of this study is to evaluate the efficacy and safety of a six month double-mask treatment of tasimelteon or placebo in male and female subjects with Non-24-Hour Sleep-Wake Disorder

Read the detailed description

Non-24-Hour Sleep-Wake Disorder (N24HSWD) occurs when individuals, primarily those without light perception, are unable to synchronize their endogenous circadian pacemaker to the 24-hour light-dark cycle, and the timing of their circadian rhythm instead reflects the intrinsic period of their endogenous circadian pacemaker. As a result, the circadian rhythm of sleep-wake propensity in these individuals moves gradually later and later each day if there circadian period is > 24 hours and earlier and earlier if < 24 hours. These individuals will be able to sleep well at night when their sleep-wake propensity rhythm is approximately aligned with the 24-hour light-dark and social cycle. However, after a short time, the endogenous sleep-wake propensity rhythm and the 24-hour light-dark cycle will move out of synchrony with each other, and they may have difficulty falling asleep until well into the night. In addition to problems sleeping at the desired time, the subjects experience daytime sleepiness and daytime napping.

This will be a multicenter, randomized, double-masked, placebo-controlled, parallel study. The study has two phases: the pre-randomization phase followed by either the randomization phase or the open-label extension (OLE). The pre-randomization phase comprises a screening visit where subject's initial eligibility will be evaluated, a circadian period (τ) estimation segment, and a variable-length in-phase transition segment in which subjects will wait to start treatment until their circadian phase is aligned with their target bedtime. Subjects that meet all entry criteria for the study will enter the randomization phase. During the randomization phase, subjects will be asked to take either 20 mg tasimelteon or placebo approximately 1 hour prior to their target bedtime for 26 weeks in a double-masked fashion. Subjects who have a τ greater than 24.0 and meet all entry criteria but that are ineligible for the randomization phase due to their τ estimate may be given the opportunity to participate in the OLE phase. During the OLE phase, subjects will take open-label 20mg tasimelteon for 26 weeks.

Being tested
tasimelteon, Placebo
Keywords
Blindness, Eye Diseases, Nap Disorders, Circadian Rhythm Disorders, Sleep disorders, Circadian Rhythm Sleep Disorders, Dyssomnias, Nervous System Diseases
Medical subject headings
Sleep Disorders, Circadian Rhythm, Blindness, Eye Diseases, Chronobiology Disorders, Sleep Wake Disorders, Dyssomnias, Nervous System Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • tasimelteonDrug

    Also called VEC-162

    20 mg tasimelteon capsules, PO daily for 6 months

  • PlaceboDrug

    Placebo capsules, PO daily for 6 months

Study groups in NCT01163032
Study groupRoleWhat they receive
tasimelteonExperimental20 mg tasimelteon capsules, PO daily for 6 months
Receives: Drug: tasimelteon
placeboPlacebo comparatorPlacebo capsules, PO daily for 6 months
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Patients Entrained as Assessed by Urinary aMT6

    Entrainment is a measure of synchronization of the master body clock to the 24-hour day. The circadian period (τ) was calculated using urinary aMT6s collected over four 48 hour periods , collected approximately 1 week apart for 4 separate weeks, during the screening and month 1 of the randomization phase of the trial. Entrainment was defined as having a post-baseline τ value less than 24.1 and a 95% CI that included 24.0.

    Measured: 1 month

  2. Proportion of Patients With a Clinical Response: Entrainment of aMT6 and Score of ≥ 3 on N24CRS

    Clinical response is defined as the coincident demonstration of entrainment (aMT6) and a score ≥ 3 on the Non-24 Clinical Response Scale (N24CRS). N24CRS measures improvement in sleep-wake measures and overall functioning (LQ-nTST, UQ-dTSD, MoST and CGI-C). Each assessment is scored as a 1 or 0 depending on the pre-specified threshold (see below).

    LQ-nTST: >45 minutes increase in average nighttime sleep duration; UQ-dTSD: >45 minutes decrease in average daytime sleep duration; MoST: >30 minutes increase and a standard deviation <2 hours during double-masked phase (6 months); CGI-C: <2.0 from the average of D112 and Day 183 compared to baseline

    For patients randomized to tasimelteon 20 mg and who also participated in the screening phase of Study 3203 (month 7 of treatment), the screening τ from Study 3203 was used if the patient did not become entrained in Study 3201 but did become entrained during the screening phase of Study 3203.

    Measured: 6 months

Secondary outcomes (7)
  1. Proportion of Patients Entrained as Assessed by Urinary Cortisol

    Entrainment is a measure of synchronization of the master body clock to the 24-hour day. The circadian period (τ) was calculated using urinary cortisol collected over four 48 hour periods, approximately 1 week apart for 4 separate weeks, during the screening and month 1 of the randomization phase of the trial. Entrainment was defined as having a post-baseline τ value less than 24.1 and a 95% CI that included 24.0.

    Measured: 1 month

  2. Average Clinical Global Impression of Change (CGI-C)

    CGI-C scores range from 1 (very much improved) to 7 (very much worse). The average post-randomization score was obtained for each patient by averaging the last 2 scheduled assessments (Day D112 and Day D183). Lower number indicates improvement.

    Measured: Day 112 and 183

  3. Proportion of Responders With a Combined Sleep/Wake Response for LQ-nTST (≥ 90 Minutes) and UQ-dTSD (≤ 90 Minutes)

    The sleep/wake response represents measurement of the combined improvement in the nighttime sleep duration and daytime sleep duration. Individuals that have an improvement in nighttime sleep and daytime sleep, defined as an increase of 90 minutes or more in the lower quartile of subjective nighttime total sleep time (LQ-nTST) and a decrease of 90 minutes or more in the upper quartile of daytime total sleep duration (UQ-dTSD) are considered to be a responder.

    Measured: 6 months

  4. Average Lower Quartile of Nights of Nighttime Total Sleep Time (LQ-nTST)

    LQ-nTST measures the difference in average nighttime sleep during the patient's worst 25% of nights (shortest total nighttime sleep) between the randomized phase (6 months)and the screening phase (~ 6 weeks). The higher number indicates improvement.

    Measured: 6 months

  5. Average Upper Quartile of Days of Subjective Daytime Sleep Duration (UQ-dTSD)

    UQ-dTSD measures the difference in average daytime sleep during the patient's worst 25% of days (longest total daytime sleep) between the randomized phase (6 months) and the screening phase (~ 6 weeks). Lower number indicates improvement.

    Measured: 6 months

  6. Average Midpoint of Sleep (MoST)

    Midpoint of Sleep Timing (MoST) is the measurement of the average midpoint of sleep time relative to bedtime. The average MoST value will trend to 0 as an individual's sleep becomes more fragmented. Improvement is defined as an increase in the average.

    Measured: 6 months

  7. Number of Patients With a Treatment Emergent Adverse Event (Open Label Extension Phase Only)

    Adverse events were recorded in the source documents from the time of the patient's informed consent signature until the end of the patient's study participation. An AE was defined as any untoward medical occurrence in a clinical investigation patient who does not necessarily have causal relationship with treatment.

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jul 2010 (estimated)
  2. Study startAug 2010
  3. Primary completionNov 2012
  4. Study completionNov 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
136 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01163032
Sponsor's protocol ID
VP-VEC-162-3201
Status last verified
Oct 2014
First submitted
2 Jul 2010
Last updated
16 Oct 2014
Data monitoring committee
No

Publications

  • Lockley SW, Dressman MA, Licamele L, Xiao C, Fisher DM, Flynn-Evans EE, Hull JT, Torres R, Lavedan C, Polymeropoulos MH. Tasimelteon for non-24-hour sleep-wake disorder in totally blind people (SET and RESET): two multicentre, randomised, double-masked, placebo-controlled phase 3 trials. Lancet. 2015 Oct 31;386(10005):1754-64. doi: 10.1016/S0140-6736(15)60031-9. Epub 2015 Aug 4.

    PubMed 26466871

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing tasimelteon in people with Non-24-Hour Sleep-Wake Disorder, run by Vanda Pharmaceuticals at 28 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Oct 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in United States, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 16 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Patients Entrained as Assessed by Urinary aMT6 (time frame: 1 month). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01163032, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2014.

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