E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Excessive Sleepiness associated with Narcolepsy |
|
E.1.1.1 | Medical condition in easily understood language |
Excessive Sleepiness associated with Narcolepsy (neurological sleep disorder) |
|
E.1.1.2 | Therapeutic area | Body processes [G] - Physiological processes [G07] |
MedDRA Classification |
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 |
The primary objective of this study is to characterize the single- and multiple-dose pharmacokinetics of armodafinil and its major circulating metabolites (R-modafinil acid and modafinil sulfone) in children and adolescents with excessive sleepiness associated with narcolepsy. |
|
E.2.2 | Secondary objectives of the trial |
characterize the safety of armodafinil following single- and multiple-dose administration in children and adolescents with excessive sleepiness associated with narcolepsy as assessed by:
-occurrence of adverse events (including protocol-defined expedited adverse events)
-clinical laboratory test results at the final assessment or early withdrawal
-vital signs measurements
-resting 12-lead electrocardiogram (ECG) findings at the final assessment or early withdrawal
-physical examination findings
-body weight measurements
-body temperature measurements
-skin examinations
-suicidality assessments
-concomitant medication usage
to explore the pharmacodynamics of armodafinil following single- and multiple-dose administration
in children and adolescents with excessive sleepiness associated with narcolepsy as assessed by the
multiple sleep latency test and the Clinical Global Impression of Change (CGI-C) ratings |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients are included in the study if all of the following criteria are met:
(a) Written informed consent is obtained from each patient’s parent or legal guardian and written
assent is obtained from each patient.
(b) The patient is male or female 6 through 17 years of age with a body mass index (BMI) equal or greater than 10th percentile for age and gender, inclusive.
(c) The patient has a diagnosis of narcolepsy with cataplexy or narcolepsy without cataplexy according
to the criteria established by the International Classification of Sleep Disorders (ICSD)-2 for
narcolepsy (347.0).
d) The patient is able to swallow 3 placebo tablets that match the armodafinil tablets to be
administered during the study with up to 240 mL of water within 5 minutes.
(e) The patient is in good health as determined by a medical and psychiatric history, physical
examination, ECG, and clinical laboratory tests.
(f) Inclusion criterion (f) is replaced by (f1)
(f1) Female patients who are postmenarche or sexually active or who are 10 years of age or older,
must have a negative pregnancy test prior to the baseline visit, must be using an acceptable method
of contraception, and agree to continued use of this method for the duration of the study and for
30 days after discontinuation of study drug. Acceptable methods of contraception include
abstinence or an intrauterine device (known to have a failure rate of less than 1% per year).
(g) The patent has a negative alcohol test and urine drug screen (UDS).
(h) The patient and parent/legal guardian must be willing and able to comply with study restrictions
and to remain at the clinic for the required duration at each visit. |
|
E.4 | Principal exclusion criteria |
The patient has
-any clinically significant uncontrolled medical condition other than narcolepsy.
-clinically significant deviation from normal in ECG, physical examination or vital sign findings as determined by the investigator or medical monitor
-patient is pregnant or lactating
patient has
-any history of seizures, including febrile seizures, or a family history of seizures which is not a consequence of trauma, stroke, or metabolic disturbance.
-history of head trauma associated with loss of consciousness
-current suicidal ideation, history of suicidal ideation, or history of suicide attempt.
-history of major depressive disorder, bipolar disorder, other significant mood disorders, schizophrenia and other psychotic disorders, eating disorders or has family history of suicide.
-left ventricular hypertrophy or patient has mitral valve prolapse and has experienced mitral valve prolapse syndrome
-received any investigational drug within 30 days or 5 half-lives (whichever is longer) before the 1st dose of study drug, or in the case of a new chemical entity, 3 months or 5 half-lives (whichever is longer) before 1st dose of study drug
-used any monoamine oxidase inhibitors or stimulants within 14 days or 5 halflives (whichever is longer) of the baseline visit
-used modafinil or armodafinil within 4 weeks of the baseline visit
-used inducer of cytochrome P450 enzyme 3A4/5 within 28 days prior to study drug administration
-used inhibitor of CYP3A4/5 within 14 days or 5 halflives (whichever is longer) prior to study drug administration
-habitually consumed, within past 12 month, more than 21 units of alcohol per week, or has history of alcohol, narcotic, or any other substance abuse as defined by the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition, Text Revision (DSM-IV-TRAmerican Psychiatric Association 2000).
-any disorder that may interfere with drug absorption, distribution, metabolism, or excretion
-known sensitivity or idiosyncratic reaction to any compound present in modafinil or armodafinil, their related compounds, or to any metabolites or compound listed as being present
in these medications
-history of any clinically significant cutaneous drug reaction, or a history of clinically significant hypersensitivity reaction, including multiple allergies or drug reactions
-donated blood or had significant blood loss within 56 days prior to 1st dose of study drug
-donated plasma within 7 days prior to the 1st dose of study drug
-1 or more clinical laboratory test values outside the range specified below, or any other clinically significant laboratory abnormality as determined by the investigator or medical monitor:
hemoglobin value of less than 11.0 g/dL, aspartate aminotransferase or alanine aminotransferase value more than twice the upper limit of the normal range (ULN), total bilirubin value of more than the ULN
-had a clinically significant excessive consumption of coffee, tea, and/or other
caffeine-containing beverage or food within 2 weeks before 1st dose of study drug, consumption
of 600 mg of caffeine or more per day (eg, twelve 12-ounce caffeinated sodas, 30 ounces of
chocolate, or 5 or more cups of coffee per day)
-had, within 4 weeks before 1st dose of study drug, clinically significant illness or, within 1 week before 1st dose of study drug, has had any acute illness, or at screening or on the day before 1st study drug administration, has symptoms of any clinically significant or acute illness
-pos. test result for hepatitis B surface antigen or antibodies to hepatitis C, or had known pos. human immunodeficiency virushistory
-patient is a user or former user of nicotine-containing products who stopped use or consumption of these nicotine-containing products less than 3 months before study drug administration or is using or has used topical or oral nicotine preparations for smoking cessation
within the past 3 months before study drug administration
-patient is unlikely to comply with study protocol, or is unsuitable for any other reasons, as judged by the investigator |
|
E.5 End points |
E.5.1 | Primary end point(s) |
The primary objective of this study is to characterize the single- and multiple-dose
pharmacokinetics of armodafinil and its major circulating metabolites (R-modafinil acid and modafinil
sulfone) in children and adolescents with excessive sleepiness associated with narcolepsy |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
throughout study:
-occurrence of adverse events (including protocol-defined expedited
adverse events)
-vital signs measurements
-physical examination findings
-body weight measurements
-body temperature measurements
-skin examinations
-suicidality assessments
-concomitant medication usage
at final assessment or early withdrawal:
-clinical laboratory test results
-resting 12-lead electrocardiogram findings
explore pharmacodynamics of armodafinil following single and multiple
dose administration
please see protocol for more details |
|
E.5.2 | Secondary end point(s) |
The secondary objectives of the study are as follows:
• to characterize the safety of armodafinil following single- and multiple-dose administration in
children and adolescents with excessive sleepiness associated with narcolepsy as assessed by:
― occurrence of adverse events (including protocol-defined expedited adverse events) throughout
the study
― clinical laboratory test results at the final assessment or early withdrawal
― vital signs measurements throughout the study
― resting 12-lead electrocardiogram (ECG) findings at the final assessment or early withdrawal
― physical examination findings throughout the study
― body weight measurements throughout the study
― body temperature measurements throughout the study
― skin examinations throughout the study
― suicidality assessments throughout the study
― concomitant medication usage throughout the study
• to explore the pharmacodynamics of armodafinil following single- and multiple-dose administration
in children and adolescents with excessive sleepiness associated with narcolepsy as assessed by the
multiple sleep latency test (MSLT) and the Clinical Global Impression of Change (CGI-C) ratings |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
throughout study:occurrence of adverse events, vital signs measurements, physical examination findings, body weight measurements, body temperature measurements, skin examinations, suicidality assessments, concomitant medication usage.
at final assessment or early withdrawal:
-clinical laboratory test results
-resting 12-lead electrocardiogram findings
explore pharmacodynamics of armodafinil following single and multiple dose administration in children and adolescents with excessive sleepiness associated with narcolepsy as assessed by multiple sleep latency test and Clinical Global Impression of Change ratingsin children and adolescents with excessive sleepiness associated with narcolepsy as assessed by multiple sleep latency test and Clinical Global Impression of Change ratings |
|
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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
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) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
characterization of Pharmacokinetics, Pharmacodynamics and Safety in Children and Adolescents |
|
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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 | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
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 | No |
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 |
|
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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |