E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
insomnia characterized by sleep maintenance difficulties |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 11.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10027590 |
E.1.2 | Term | <Manually entered code. Term in E.1.1> |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the efficacy of eplivanserin 5mg/day in comparison to placebo after 6 weeks of treatment on sleep maintenance of insomniac patients, as measured by Polysomnography Wake Time After Sleep Onset (PSG-WASO) and Polysomnography Number of Awakenings (PSG-NAW). |
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E.2.2 | Secondary objectives of the trial |
•To evaluate the effects of eplivanserin 5mg/day as compared to placebo after 6 weeks of treatment on other sleep parameters measured by PSG recordings and reported by patients •To evaluate the effects of eplivanserin 5mg/day on sleep architecture compared to placebo •To evaluate the effect of eplivanserin 5mg/day on daytime functioning, as compared with placebo after 6 weeks of treatment •To evaluate patient’s impression of treatment effects •To evaluate the potential for next-day residual effects with eplivanserin 5mg/day as compared to placebo •To evaluate the potential for rebound insomnia following abrupt discontinuation of eplivanserin 5mg/day in comparison with placebo •To evaluate the effect of eplivanserin, compared to placebo, on the quality of life of patients with primary insomnia •To evaluate the clinical safety and tolerability of eplivanserin 5mg/day compared to placebo |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written, signed and dated informed consent obtained. 2. Primary insomnia based on DSM-IV-TR with difficulty initiating or maintaining sleep, or nonrestorative sleep for at least one month preceding the study visit, and having clinically significant distress or impairment in social, occupational or other important areas of functioning. |
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E.4 | Principal exclusion criteria |
1. Based on patient’s information, the patient has spent less than 6.5 hours or more than 9.0 hours, in bed, each night, over the preceding two weeks 2. Based on patient’s information, the patient complains of less than 1 hour of wakefulness after sleep onset for at least 3 nights per week over the preceding month 3. Patient responds to question 3 of Insomnia Severity Index at screening visit and randomization visit either: 0 (=Not at all interfering), or 1 (=A little interfering). 4. Mean screening PSG-WASO: calculated on SN1 and SN2 < 45mn, or a screening night with PSG-WASO < 30mn 5. Mean screening PSG-Total Sleep Time: calculated on SN1 and SN2 ≥7 hours or ≤3 hours 6. Mean screening PSG-Latency to Persistent Sleep: calculated on SN1 and SN2 > 30mn 7. Patients under 18 years of age 8. In-patients 9. Patients presenting with acute or chronic pain resulting in insomnia 10. Patients with current psychiatric disturbances according to DSM-IV-TR criteria including but not limited to psychosis and /or bipolar disorder, obsessive compulsive disorder, major depression, anxiety disorders, panic disorders, eating disorder, alcohol or substance abuse or dependence –except nicotine-, or a history of lifetime psychosis and /or bipolar disorder 11. Body mass index >32 calculated from patient’s height (m) and weight (kg); weight (kg)/square height (m²) 12. Patients with mental retardation or dementia 13. Patients with a history of epilepsy or seizures (not including benign neonatal and childhood convulsions) 14. Evidence of any clinically significant, severe or unstable, acute or chronically progressive medical or surgical disorder, or any condition that may interfere with the absorption, metabolism, distribution or excretion of the study drug, or may affect patient safety 15. Clinically significant and abnormal ECG (including QTcF ≥500ms) 16. Serious head injury or stroke within the past year 17. Positive qualitative urine drug screen (opiates, cocaine, amphetamine, cannabinoids, barbiturates, phencyclidine, benzodiazepines, methadone, propoxyphene), at screening 18. Consumption of xanthine-containing beverages (i.e. tea, coffee, or cola) comprising usually more than 5 cups or glasses/day 19. Use of any over-the-counter including tryptophan, valerian root, kava, melatonin, St John’s Wort, Alluna (herbal sleep supplement with valerian root) or prescription sleep medication, including hypnotics and sedatives (N05C), and anxiolytics (N05B), within 1 week or five half-lives (whichever is longer), prior to screening 20. Use of any substance with psychotropic effects or properties known to affect sleep/wake, including, but not limited to: neuroleptics (N05A), morphine/opioid derivatives (N02A), antihistamines (R06A), stimulants (N06B) antidepressants (N06A), clonidine, within one week or five half-lives (whichever is longer), prior to screening 21. Previous participation in a clinical trial (i.e., randomization) with eplivanserin 22. Participation in any other trial within 1 month before the screening visit 23. Patients unable to complete the study questionnaire 24. Patients who are unable to participate for the entire duration of the study, or in the opinion of the investigator, are likely to be non-compliant with the obligations inherent in the trial participation 25. Patient not able to understand and follow the requirements of the study and to comply 26. Night shift workers, and individuals who nap 3 or more times per week over the preceding month 27. Based on medical history and /or PSG: (i) primary hypersomnia, (ii) narcolepsy, (iii) breathing-related sleep disorder (apnea-hypopnea index >10/hours of sleep), (iv) circadian rhythm sleep disorder, (v) parasomnia (e.g. somnambulism), (vi) dyssomnia not otherwise specified, i.e. periodic leg movement syndrome (A leg movement is defined as a burst of anterior tibialis muscle activity with a duration between onset and resolution of 0.5-5.0 seconds, with an amplitude of at least 25% of the baseline amplitude. The leg movement must be separated from a subsequent leg movement by at least 5 sec and not more than 90 seconds. The leg movement must be associated with an arousal or awakening to be considered an event, and the arousal/awakening must follow the leg movement onset by not more than 3 seconds. Periodic leg movement exclusion criteria are defined as a PLMAI ≥10 events/hours of sleep. Leg movements associated with “wake” and “respiratory events” are not counted) 28. Severe respiratory and/or severe hepatic insufficiency 29. Lifetime history of diverticulitis/sigmoiditis 30. Females who are lactating or who are pregnant 31. Woman of childbearing potential (less than two years post-menopausal or not surgically sterile), with a positive urine beta-human chorionic gonadotropin pregnancy test at screening and not using an acceptable form of contraception |
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E.5 End points |
E.5.1 | Primary end point(s) |
•Change from baseline of mean PSG-WASO on N41/N42. •Change from baseline of mean PSG-NAW on N41/N42. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 28 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 10 |