E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Delayed Sleep-Wake Phase Disorder (DSWPD) |
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E.1.1.1 | Medical condition in easily understood language |
Delayed Sleep-Wake Phase Disorder (DSWPD) |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10041013 |
E.1.2 | Term | Sleep-wake schedule disorder |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 effects of a daily single oral dose of 20 mg tasimelteon compared to placebo on Sleep Onset (change from baseline) in participants over a 28-day period, as measured by sleep diary. |
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E.2.2 | Secondary objectives of the trial |
To assess the effects of 20 mg tasimelteon compared to placebo on Sleep Onset (change from baseline) during the treatment phase, as measured by actigraphy.
To assess the effects of 20 mg tasimelteon compared to placebo on nighttime subjective sleep parameters such as LPS, wake time, midpoint of sleep, and total sleep time (change from baseline), as measured by sleep diary.
To assess the effects of 20 mg tasimelteon compared to placebo on nighttime objective sleep parameters such as LPS, wake time, midpoint of sleep, and total sleep time (change from baseline), as measured by actigraphy.
To assess the effects of 20 mg tasimelteon compared to placebo on subjective sleep-related impairments and subjective sleep disturbances, as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Ability and acceptance to provide written informed consent. 2. A confirmed clinical diagnosis of Delayed Sleep-Wake Phase Disorder (DSWPD), as per ICSD-3. 3. Males or females between 18 – 75 years, inclusive. 4. Body Mass Index (BMI) of ≥ 18 and ≤ 35 kg/m2 (BMI = weight (kg)/[height (m)]2). 5. Males, non-fecund females (i.e., surgically sterilized, if procedure was done 6 months before screening or participant is postmenopausal for at least 2 years), or females of childbearing potential using an acceptable method of birth control (abstinence, the use of 2 independent barrier methods, hormonal contraception plus 1 barrier method, or surgically sterilized partner) for a period of 35 days before the first dosing, and agree to continue using these methods during the study, and for one month after the last dose. WOCBP must also have a negative pregnancy test at V1, V2, and V3. 6. In good health as determined by a medical history, physical examination, ECG, serum chemistry and hematology, and urinalysis. 7. Willing to comply with study procedures and restrictions with fixed sleep time during the study and to attend regularly scheduled clinic visits as specified in this protocol. 8. Must have a desired bedtime at least 2 hours earlier than the habitual sleep onset (determined by the DSPD Screening Questionnaire). There must be at least a 2 hour difference between the reported sleep onset, by daily sleep diary, and the desired bedtime (determined by the DSPD Screening Questionnaire), on at least 5 of the 7 days per screening week. 9. Must have a sleep onset of 00:00 or later (determined by the DSPD Screening Questionnaire). 10. Must have a reported sleep onset of 00:00 or later by daily sleep diary, on at least 5 of the 7 days per screening week. 11. Must have 80% compliance for daily sleep diary completion, throughout screening. 12. Must maintain a reported desired bedtime (± 15 minutes) by daily sleep diary, on at least 5 of the 7 days during the run-in phase. 13. Must have a reported sleep onset of ≥ 2 hours from the desired bedtime by daily sleep diary, on at least 5 of the 7 days during the run-in phase. |
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E.4 | Principal exclusion criteria |
1. Current clinically significant cardiovascular, respiratory, neurologic, hepatic, hematopoietic, renal, gastrointestinal, or metabolic dysfunction unless currently controlled and stable. 2. Acute exacerbation of an existing psychiatric comorbid condition that requires change in treatment or intervention in the 3 months prior to the screening visit. 3. History of intolerance and/or hypersensitivity to melatonin or melatonin agonists. 4. Indication of impaired liver function (values for enzymes aspartate transaminase (AST) and alanine transaminase (ALT) or bilirubin > 2 times the Upper Limit of Normal). 5. Clinically significant deviation from normal in clinical laboratory results, vital sign measurements, or physical examination findings as determined by the Investigator. 6. Major surgery, trauma (including broken pelvis/legs), illness (i.e., sepsis, stroke), general anesthesia, or immobility for 3 or more days within 30 days of the screening visit. 7. Current tobacco user or quit using tobacco within 30 days of the screening visit. 8. Active cancer or cancer treatment within 6 months of the screening visit. 9. Central venous catheter in place or within 30 days of the screening visit. 10. History of pulmonary embolism/deep vein thrombosis (DVT) or short-term blood thinner treatment as an outpatient (i.e., Coumadin, Lovenox, Heparin). 11. History or family history of thrombosis or hypercoagulable state (i.e., Factor V Leiden, Factor VIII deficiency, Protein C & S deficiency). 12. Pregnancy, recent pregnancy (within 6 weeks of the screening visit), or females who are breastfeeding. 13. History of restless leg syndrome, sleep apnea, or periodic limb movement disorder and/or have current diagnosis as confirmed by the screening visit. 14. History or evidence of sleep apnea as determined by a high-risk score in any two of the three categories in TBQ, unless ruled out by a recent sleep study for sleep apnea. 15. History of drug or alcohol abuse as defined in DSM-V, Diagnostic Criteria for Drug and Alcohol Abuse, within the 12 months prior to screening and/or regular consumption of alcoholic drinks (> 2 drinks/day or > 14 drinks/week). 16. A positive test for substances of abuse at the screening visit, V2, or V3. 17. Traveled more than 3 time zones 2 weeks prior to the screening visit. 18. Traveled outside the origination time zone within 1 week before the screening period and until the end of the treatment period. 19. Worked regular night shifts in the 2 months leading up to the screening visit. 20. Randomization in a previous tasimelteon (VEC-162 or BMS-214778) trial. 21. Use of any investigational drug, including placebo, central nervous system medication, or any other prescription or over-the-counter (OTC) medication that affects the sleep-wake cycle within 3 weeks or 5 half-lives (whichever is longer) of the screening visit. 22. Participant is at risk of suicide, in the opinion of the Investigator. Evidence of suicide risk could include any suicide attempt or any other suicidal behavior within 12 months of the screening visit or any suicidal ideation of type 4 or 5 on the C-SSRS at V1, V2, or V3. 23. Unwilling or unable to follow the medication restrictions, or unwilling or unable to sufficiently washout from use of a restricted medication. 24. Use of melatonin or melatonin agonist within 3 weeks of the screening visit. 25. Have a reported change of ≥ 2 hours from the average reported sleep onset from screening by daily sleep diary, during the run-in phase. 26. Any other sound medical reason as determined by the Investigator. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Sleep onset (change from baseline), as measured by sleep diary. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
• To assess the effects of 20 mg tasimelteon compared to placebo on Sleep Onset (change from baseline) during the treatment phase, as measured by actigraphy.
• To assess the effects of 20 mg tasimelteon compared to placebo on nighttime subjective sleep parameters such as latency to persistent sleep (LPS), wake time, midpoint of sleep, and total sleep time (change from baseline), as measured by sleep diary.
• To assess the effects of 20 mg tasimelteon compared to placebo on nighttime objective sleep parameters such as LPS, wake time, midpoint of sleep, and total sleep time (change from baseline), as measured by actigraphy.
• To assess the effects of 20 mg tasimelteon compared to placebo on subjective sleeprelated impairments and subjective sleep disturbances, as measured by the Patient- Reported Outcomes Measurement Information System (PROMIS).
• To assess the effects of 20 mg tasimelteon compared to placebo on global improvement and severity, as measured by Clinical Global Impression of Change (CGI-C), Patient Global Impression of Change (PGI-C), and Patient Global Impression of Severity (PGIS).
• To assess the effects of 20 mg tasimelteon compared to placebo on the change in circadian phase from baseline to post-treatment, as measured by salivary DLMO.
• To assess the effects of 20 mg tasimelteon on Sleep Onset (change from baseline) in participants with delayed DLMO compared to participants with non-delayed DLMO, as measured by sleep diary.
• To assess the effects of 20 mg tasimelteon on Sleep Onset (change from baseline) in participants with PER3 rs57875989 (specifically genotype 4/4 and 4/4+4/5), as measured by sleep diary.
• To assess the safety and tolerability of a daily single oral dose of 20 mg tasimelteon. |
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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 | 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 | Yes |
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 | 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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 8 |
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 |
Australia |
United States |
Germany |
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E.8.7 | Trial has a data monitoring committee | No |
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 | 2 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 4 |