Safety and Efficacy of Ramelteon in Elderly Subjects With Chronic Insomnia - Full Text View

Sponsor:	Takeda Global Research & Development Center, Inc.
Information provided by:	Takeda Global Research & Development Center, Inc.
ClinicalTrials.gov Identifier:	NCT00671255

Purpose

This purpose of this study is to evaluate the safety and effectiveness of Ramelteon, once daily (QD), in elderly participants with chronic insomnia.

Condition	Intervention	Phase
Chronic Insomnia	Drug: Ramelteon Drug: Placebo	Phase III

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	A Phase III, Randomized, Double-Blind, Placebo-Controlled, Outpatient, Safety and Efficacy Study of TAK-375 in Elderly Subjects With Chronic Insomnia

Resource links provided by NLM:

Drug Information available for: Ramelteon

U.S. FDA Resources

Further study details as provided by Takeda Global Research & Development Center, Inc.:

Primary Outcome Measures:

Mean Subjective Sleep Latency per subject diary, from Nights 1 through 7 of double-blind Treatment [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Subjective Total Sleep Time. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Subjective Number of Awakenings. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Subjective Ease of Falling Back to Sleep after Awakening. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Subjective Sleep Quality. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Clinical Global Impression Change of Condition. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Clinical Global Impression Severity of Illness. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Clinical Global Impression Therapeutic Effect. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Clinical Global Impression Side Effects. [ Time Frame: Weeks 1, 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]
Average Subjective Sleep Latency over the week preceding the Day 15, Day 22, Day 29, and Day 36 Visits. [ Time Frame: Weeks 2, 3, 4 and 5 or Final Visit. ] [ Designated as safety issue: No ]

Enrollment:	829
Study Start Date:	December 2002
Study Completion Date:	January 2004
Primary Completion Date:	January 2004 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Ramelteon 4 mg QD	Drug: Ramelteon Ramelteon 4 mg, tablets, orally, once daily for up to 5 weeks. Other Names: Rozerem™ ramelteon TAK-375
Experimental: Ramelteon 8 mg QD	Drug: Ramelteon Ramelteon 8 mg, tablets, orally, once daily for up to 5 weeks. Other Names: Rozerem™ ramelteon TAK-375
Placebo Comparator: Placebo	Drug: Placebo Ramelteon placebo-matching, tablets, orally, each night for up to 35 consecutive days.

Detailed Description:

Insomnia is characterized by a complaint of initiating and maintaining sleep or complaints of nonrestorative and non-refreshing sleep. Transient insomnia affects approximately one-third to one-half of the US population, based on the results of 2 surveys of representative samples of the adult US population conducted by the Gallup Organization in which respondents were asked if they had "ever had difficulty sleeping." Based on reports of "regular" or "frequent" sleep difficulty, results from the same studies suggest that approximately one-tenth of the US population experiences chronic insomnia. The ideal treatment for insomnia would reduce the latency to onset of sleep and increase total sleep time, without a negative impact on sleep architecture and without safety concerns or next-day effects.

Ramelteon is a selective melatonin-1 receptor agonist under development by Takeda Chemical Industries, Ltd., for the treatment of transient and chronic insomnia and for the treatment of Circadian Rhythm Sleep Disorders.

Ramelteon is the first candidate in a novel class of drugs based on this mechanism. Based on non-clinical and clinical studies completed to date, TAK-375 has the potential to offer unique advantages relative to approved hypnotics in terms of its pharmacological profile and its selectivity to the melatonin-1 receptor.

This study is designed to determine the safety and efficacy of 35-day treatment of chronic insomnia with ramelteon. Participation in this study is anticipated to be approximately 2 months.

Eligibility

Ages Eligible for Study:	65 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria

Subject is a male or a post-menopausal female.
Primary insomnia as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised for at least 3 months and a history of daytime complaint(s) associated with disturbed sleep.
Subjective sleep latency greater than or equal to 45 minutes and a subjective total sleep time less than or equal to 6.5 hours per night for at least 3 nights during the week of the lead-in period.
Habitual bedtime is between 8:30 PM and 12:00 AM.
Body mass index between 18 and 34, inclusive.

Exclusion Criteria

Known hypersensitivity to ramelteon or related compounds, including melatonin.
Previously participated in a study involving ramelteon.
Participated in any other investigational study, and/or took any investigational drug within 30 days or five half-lives prior to the first day of single-blind study medication, whichever is longer.
Sleep schedule changes required by employment (eg, shift worker) within three months prior to the first day of single-blind study medication, or has flown across greater than three time zones within seven days prior to screening.
Participated in a weight loss program or substantially altered exercise routine within 30 days prior to the first day of single blind study medication.
Has ever had a history of seizures, sleep apnea, chronic obstructive pulmonary disease, restless leg syndrome, schizophrenia, bipolar disorder, mental retardation, or cognitive disorder.
History of psychiatric disorder within the past 12 months.
History of drug addiction or drug abuse within the past 12 months.
History of alcohol abuse within the past 12 months, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Revised and/or regularly consumes 4 or more alcoholic drinks per day.
Current significant neurological, hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, hematologic or metabolic disease, unless currently controlled and stable with protocol-allowed medication.
Uses tobacco products during nightly awakenings.
Any clinically important abnormal finding as determined by a medical history, physical examination, electrocardiogram, or clinical laboratory tests, as determined by the investigator.
Positive hepatitis panel.
Any additional condition(s) that in the Investigator's opinion would:
- affect sleep-wake function
- prohibit the subject from completing the study
- not be in the best interest of the subject.
Is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication, including:
- Anxiolytics
- Hypnotics
- Antidepressants
- Anticonvulsants
- Sedating H1 antihistamines
- Systemic steroids
- Respiratory stimulants
- Decongestants
- Over-the-counter and prescription stimulants
- Over-the-counter and prescription diet aids
- Central nervous system active drugs
- Narcotic analgesics
- All beta blockers
- Melatonin
- St. John's Wort
- Kava-kava
- Gingko biloba

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00671255

Show 115 Study Locations

Sponsors and Collaborators

Takeda Global Research & Development Center, Inc.

Investigators

Study Director:

VP Clinical Science

Takeda Global Research & Development Center, Inc.

More Information

Additional Information:

Rozerem Package Insert This link exits the ClinicalTrials.gov site

FDA Safety Alerts and Recalls This link exits the ClinicalTrials.gov site

Publications:

Mini LJ, Wang-Weigand S, Zhang J. Self-reported efficacy and tolerability of ramelteon 8 mg in older adults experiencing severe sleep-onset difficulty. Am J Geriatr Pharmacother. 2007 Sep;5(3):177-84.

Roth T, Seiden D, Sainati S, Wang-Weigand S, Zhang J, Zee P. Effects of ramelteon on patient-reported sleep latency in older adults with chronic insomnia. Sleep Med. 2006 Jun;7(4):312-8. Epub 2006 May 18.

Responsible Party:	Sr. VP, Clinical Science, Takeda Global Research & Development Center, Inc.
ClinicalTrials.gov Identifier:	NCT00671255 History of Changes
Other Study ID Numbers:	01-02-TL-375-025, U1111-1114-1190
Study First Received:	May 1, 2008
Last Updated:	May 30, 2010
Health Authority:	United States: Food and Drug Administration

Keywords provided by Takeda Global Research & Development Center, Inc.:

Chronic Insomnia
Drug Therapy
Elderly

Additional relevant MeSH terms:

Sleep Initiation and Maintenance Disorders
Sleep Disorders, Intrinsic
Dyssomnias

Sleep Disorders
Nervous System Diseases
Mental Disorders

ClinicalTrials.gov processed this record on February 09, 2012