Safety, Tolerability and Efficacy Study of V117957 in Subjects With Insomnia Associated With Alcohol Cessation

Insomnia Clinical Trial

Official title:

A Phase 2, Randomized, Double-Blind, Multi-Center, Placebo-Controlled, Parallel-Group Study to Evaluate the Safety, Tolerability, and Efficacy of V117957 in Subjects With an Alcohol Use Disorder Who Are Experiencing Insomnia Associated With Alcohol Cessation

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04035200
• Other study ID #: OAG2002
• Status: Completed
• Phase: Phase 2
• Start date: September 23, 2019
• Est. completion date: November 6, 2020

Study information

• Verified date: September 2023
• Source: Imbrium Therapeutics
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the safety, tolerability and efficacy of V117957 in subjects with alcohol use disorder (AUD) who experience insomnia associated with alcohol cessation, compared to placebo.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 114
• Est. completion date: November 6, 2020
• Est. primary completion date: November 6, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 64 Years

Eligibility

Key Inclusion Criteria include:

• Male or female, 18-64 years of age with a body weight of 50-100 kg (110-220 lbs) and a body mass index (BMI) of 18-32 kg/m2.

• Otherwise healthy as determined by medical evaluation that includes: medical history, physical examination, neurological exam, laboratory tests, vital signs, and cardiac monitoring.

• History of moderate or severe alcohol use disorder (AUD) categorized based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria, as follows:

• Moderate as defined by presence of 4-5 of the 11 criteria

• Severe as defined by the presence of = 6 of the 11 criteria.

• At least 3 weeks and not more than 6 months since last alcoholic beverage intake at the time of study screening. Any subject who completed an alcohol detoxification program must be at least 7 days from completion of the program at the time of screening.

• Persistent insomnia that emerged or worsened during AUD period, or during or after alcohol cessation characterized by a study-specific sleep diary.

• A female participant is eligible to participate if she is not pregnant and not breastfeeding. Both females of childbearing potential and nonsurgically sterilized males with a sexual partner of childbearing potential must be willing to use adequate and reliable contraception throughout the study.

• Willing to refrain from a behavioral or other treatment program for insomnia during participation in the study.

Key Exclusion Criteria include:

• Current diagnosis of a sleep-related breathing disorder including obstructive sleep apnea (with or without continuous positive airway pressure (CPAP) treatment), periodic limb movement disorder, restless legs syndrome, circadian rhythm sleep disorder or narcolepsy.

• An apnea-hypopnea index (AHI) score of >10 or a periodic limb movement arousal index (PLMAI) score of > 15 recorded during the screening period PSG.

• Documented history of insomnia prior to onset of the alcohol use disorder (AUD), which did not worsen during the AUD period or during or after alcohol cessation.

• Comorbid conditions which interfere with normal sleep pattern or the evaluation of next day residual effects.

• Any lifetime history of suicidal ideation or behavior.

• History of or any current conditions that might interfere with drug absorption, distribution, metabolism, or excretion (including any surgical interventions for weight loss).

• Any history of seizures (except related to alcohol withdrawal) or head trauma with sequelae.

• Known history of testing positive for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) or hepatitis C antibody (anti-HCV).

• History of diagnosed, active liver disease or elevated liver enzymes/bilirubin.

• History of kidney stones or renal insufficiency or abnormal kidney function at screening.

• Uncontrolled hypertension (> 140 mm Hg systolic / 90 mm Hg diastolic).

• Use of any medication that affects sleep and/or wake function during the week before starting the screening period.

• Subjects currently undergoing treatment of other addictions in addition to alcohol.

• Excessive caffeine consumption.

• Positive urine drug screen for prohibited substances, except for cannabis on a case-by-case basis.

• History of drug use disorder over the past year, other than alcohol/nicotine/caffeine/cannabis.

• Plans to travel across more than 3 time zones in the 2 weeks before screening, or during study participation.

• Night or rotating shift worker.

• Any history and/or current evidence of other medical (eg, cardiac, respiratory, gastrointestinal, renal, malignancy other than basal cell carcinoma), neurological, or psychiatric conditions that, in the opinion of the investigator, could affect the subject's safety or interfere with the study.

Other protocol-specific inclusion/exclusion criteria may apply.

Related Conditions & MeSH terms

• Insomnia
• Sleep Initiation and Maintenance Disorders

Intervention

Drug:
• V117957 tablets
V117957 tablets taken orally at bedtime
• Placebo
Tablets to match V117957

Locations

Country	Name	City	State
United States	NeuroTrials Research Inc	Atlanta	Georgia
United States	SPRI Clinical Trials	Brooklyn	New York
United States	Investigational Site	Chevy Chase	Maryland
United States	CTI Clinical Research Center	Cincinnati	Ohio
United States	St. Francis Medical Institute	Clearwater	Florida
United States	Advanced Medical Trials	Georgetown	Texas
United States	Sleep Disorders Centers of the Mid Atlantic	Glen Burnie	Maryland
United States	California Clinical Trials Medical Group	Glendale	California
United States	Research Centers of America	Hollywood	Florida
United States	Wake Research - Clinical Research Center of Nevada, LLC	Las Vegas	Nevada
United States	Research Centers of America, LLC	Miami	Florida
United States	Innovative Clinical Research, Inc.	Miami Lakes	Florida
United States	Clinilabs Drug Development Corporation	New York	New York
United States	Artemis Institute for Clinical Research	Riverside	California
United States	Artemis Institute for Clinical Research	San Diego	California
United States	CITrials	Santa Ana	California
United States	SDS Clinical Trials, Inc.	Santa Ana	California

Sponsors (2)

Lead Sponsor	Collaborator
Imbrium Therapeutics	Purdue Pharma LP

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change From Baseline of Wakefulness After Sleep Onset (WASO) Measured by Polysomnography (PSG)	Wakefulness After Sleep Onset, as measured by PSG, was defined as wake time after persistent sleep (wake time during sleep plus wake time after sleep, expressed in minutes). Nights 1 / 2 is the average of the PSG measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the PSG measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Mean Sleep Efficiency (SE)	Sleep efficiency, as measured by PSG, is defined as Total Sleep Time (TST), divided by total recording time, multiplied by 100.; Nights 1 / 2 is the average of the PSG measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the PSG measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Mean Latency to Persistent Sleep (LPS)	Latency to onset of persistent sleep (LPS), as measured by PSG, is defined as time from lights-off to the first of 20 consecutive periods of non-wake sleep stages. Latency to persistent sleep is reported in minutes.; Nights 1 / 2 is the average of the PSG measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the PSG measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Mean Total Sleep Time (TST)	Total sleep time, as measured by PSG, is the duration of rapid eye movement (REM) plus NREM (stages N1 + N2 + N3) during time in bed.; Nights 1 / 2 is the average of the PSG measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the PSG measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Mean Number of Awakenings (NAW)	Sleep component as measured by PSG. Number of awakenings is determined from persistent sleep to lights-on. An awakening is defined as a PSG recording of at least 2 consecutive wake periods.; Nights 1 / 2 is the average of the PSG measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the PSG measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Sleep Quality (sSleep)	Self-reported sleep outcome measured by subject diary data. Scores have a range of 1 to 5, with 1 being equal to "Very Poor" and 5 being equal to "'Very Good."; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Total Sleep Time (sTST)	Self-reported sleep outcome measured by subject diary data. Total sleep time is reported in minutes.; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Wakefulness After Sleep Onset (sWASO)	Self-reported sleep outcome measured by subject diary data. WASO is defined as wake time after persistent sleep (wake time during sleep plus wake time after sleep, expressed in minutes).; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Sleep Onset Latency (sSOL)	Self-reported sleep outcome measured by subject diary data. Sleep onset latency (SOL) is the time it takes to fall asleep after turning the lights out.; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Sleep Efficiency (sSE)	Self-reported sleep outcome measured by subject diary data. Sleep efficiency (SE) is calculated by dividing the time asleep by the total time in bed multiplied by 100 (SE is reported as percent).; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Number of Awakenings (sNAW)	Self-reported sleep outcome measured by subject diary data. The subject recorded the number of awakenings in the diary.; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Change From Baseline in Subjective Morning Sleepiness on Awakening	Self-reported sleep outcome measured by subject diary data. Individual scores have a range of 1 to 5, with 1 being equal to "Not at All Rested" and 5 being equal to "Very Well Rested." Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Baseline, Nights 1 / 2, Nights 20 / 21
Secondary	Proportion of Responders to V117957 1 mg and 2 mg Compared to Placebo	The proportion of responders is based on subjects meeting or exceeding WASO (wakefulness after sleep onset) 15 minute threshold as derived from polysomnography (PSG).; Nights 1 / 2 is the average of the measurements taken during the first two nights of study drug exposure. Nights 20 / 21 is the average of the measurements taken during nights 20 and 21 of study drug exposure.	Nights 1 / 2, Nights 20 / 21
Secondary	Occurrence of Rebound Insomnia During the Washout/Follow-up Period	Rebound insomnia is defined as a worsening of sleep compared with pretreatment. The comparison is based on the Wakefulness After Sleep Onset (WASO) measured by PSG of the Washout/Follow-up Period versus Baseline. If the LS means for WASO for the Washout/Follow-up Period is lower than Baseline, then no rebound insomnia was suggested. Nights 22 / 23 is the average of the measurements taken during nights 22 and 23 (Washout Period).	Baseline Compared to Washout/Follow-up Period (Nights 22 / 23)
Secondary	Next Day Residual Effects as Determined by Digit Symbol Substitution Test (DSST).	The DSST explores attention and psychomotor speed by measuring total correct responses. The maximum score is 165. Higher scores represent better outcome/improvement.	Baseline, Night 2, Night 21
Secondary	Next Day Residual Effects as Determined by Karolinska Sleepiness Scale (KSS)	The KSS is a 9-point Likert scale (range: 1 = "extremely alert" to 9 = "very sleepy") that measures level of sleepiness.	Baseline, Night 2 (9- and 10-hours postdose), Night 21 (9- and 10-hours postdose)
Secondary	Next Day Residual Effects as Determined by Profile of Mood States (POMS) - Brief	The POMS-Brief contains 30 questions that assess mood states. Scores for each question range 0 = not at all to 4 = extremely. Total mood disturbance assessment is the total of the subject's subscales scores on anger/hostility, confusion/bewilderment, depression/dejection, fatigue/inertia, tension/anxiety, and vigor/activity. Total scores range from 0-120 and a higher total score indicates more mood disturbance.	Baseline, Night 2, Night 21