E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
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 |
To characterize the dose-response relationship of daridorexant on objective total sleep time (TST) using polysomnography (PSG) in pediatric subjects with insomnia disorder. |
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E.2.2 | Secondary objectives of the trial |
To assess the safety and tolerability of daridorexant in pediatric subjects with insomnia disorder. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
An optional PK sub-study will be available at all participating sites. The objective of the sub-study is to characterize the PK profile of daridorexant in pediatric subjects with insomnia disorder over a 24-hour period.
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E.3 | Principal inclusion criteria |
Inclusion Criteria applicable to all subjects: - Signed and dated informed consent form (ICF) from the caregiver, i.e., parent/legal guardian prior to any study mandated procedure, or as per local regulation. - Written assent must be obtained from subjects of the appropriate age who can give assent, as determined by the caregiver and local regulation or institutional review boards (IRBs) / independent ethics committees (IECs). - Male or female subjects aged ≥ 10 and < 18 years at the time of signing the ICF. - Chronic insomnia disorder in accordance with International Classification of Sleep Disorders (ICSD), 3rd edition or insomnia disorder in accordance with DSM-5 criteria at Screening, as supported by statements from the child and/or the caregiver: 1) Difficulty initiating or maintaining sleep, or early morning awakening with inability to return to sleep, 2) Sleep difficulty has been present for at least 3 months prior to Screening, 3) Sleep difficulty occurs at least 3 nights per week, 4) Persistence of sleep difficulty, despite adequate sleep hygiene or non-pharmacological therapy, 5) The sleep problem occurs despite adequate age appropriate time and opportunity for sleep, 6) The sleep problem is not due to the direct pharmacological effects of any concomitant medication (e.g., amphetamines, selective serotonin reuptake inhibitors) as per investigator judgment, 7) Self-report or caregiver report of poor sleep quality and/or quantity impacting the daytime performance of the subject, - Sleep Disturbance Scale for Children (SDSC) score > 16 on the Difficulty Initiating or Maintaining Sleep domain at Screening. - Adolescent of Child-Bearing Potential (AoCBP): 1) Negative serum pregnancy test at Screening and a negative urine pregnancy test at Randomization. 2) Agreement to undertake urine pregnancy tests during the study, as per the schedule of activities and up to 5 days after study treatment discontinuation. 3) Agreement to use an acceptable effective method of contraception from Screening up to 5 days after study treatment discontinuation.
Inclusion criteria applicable only to a subset of children with insomnia and comorbid neurodevelopmental disorder: - Must have a documented history of NDD (including ASD or ADHD) according to DSM-5 criteria, as confirmed by review of medical records, at Screening. Use of CNS stimulants is allowed if started at least 4 weeks prior to Screening, stable and expected to remain stable during the study until EOT. CNS stimulants are recommended to be taken in the morning. |
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E.4 | Principal exclusion criteria |
- Body weight < 25 kg. - Daytime napping ≥ 1 h per day on at least 3 weekdays per week during the 3 months prior to Screening. - Any lifetime history of sleep-related breathing disorders such as obstructive sleep apnea, based on the subject’s medical records. Note: a subject whose breathing disorder has been treated by tonsillectomy/ adenoidectomy remains eligible. - Any other diagnosed sleep-wake disorder as defined in DSM-5 or ICSD-3 (e.g., restless legs syndrome, circadian rhythm sleep wake disorder, parasomnias, narcolepsy) at Screening. - Any of the following conditions related to suicidality: 1) Any suicidal ideation with intent, with or without a plan at Screening, i.e., answering “Yes” to questions 4 or 5 on the suicidal ideation section of the lifetime (Visit 1) and visit (Visit 2) version of the C-SSRS©. Participants who answer “yes” to any of these questions must be referred to the investigator for follow-up evaluation. 2) History of suicide attempt on the suicidal behavior section of the lifetime version of the C-SSRS© at Visit 1. - Any acute or unstable significant medical condition (e.g., seizure disorder, bipolar disorder, schizophrenia), hematology/biochemistry test results, ECG results deviating from the normal ranges to a clinically relevant extent that would preclude participation in the study or could prevent the subject from complying with study requirements, as per investigator judgement. - Cognitive behavior therapy (CBT) for any indication is allowed only if it has been started at least 1 month prior to Visit 2 and is kept stable throughout the study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from baseline to Day 1 in TST (in min) as measured by polysomnography (PSG). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Baseline is defined as the mean of the 2 PSG nights during the screening period. PSG will be performed on 2 nights during the screening period and on Day 1 of the treatment period (total duration: 3 days). |
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E.5.2 | Secondary end point(s) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
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 | 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.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 4 |
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 | 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 |
United States |
Belgium |
Bulgaria |
Germany |
Italy |
Spain |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 1 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |