RESTORA 1: Almorexant (ACT 078573) in Adult Subjects With Chronic Primary Insomnia

Sponsor
Midnight Pharma, LLC (Industry)
Overall Status
Completed
CT.gov ID
NCT00608985
Collaborator
(none)
709
91
4
20
7.8
0.4

Study Details

Study Description

Brief Summary

A polysomnography study to evaluate the effect, safety and tolerability of oral administration of almorexant (ACT 078573) in adult subjects with primary insomnia.

Condition or Disease Intervention/Treatment Phase
Phase 3

Study Design

Study Type:
Interventional
Actual Enrollment :
709 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
Multi-center, Double-blind, Randomized, Placebo-controlled, Active Reference, Parallel-group Polysomnography Study to Assess the Efficacy and Safety of a 16-day Oral Administration of ACT-078573 in Adult Subjects With Chronic Primary Insomnia
Study Start Date :
Mar 1, 2008
Actual Primary Completion Date :
Sep 1, 2009
Actual Study Completion Date :
Nov 1, 2009

Arms and Interventions

Arm Intervention/Treatment
Experimental: 1

almorexant 200 mg

Drug: almorexant
2 100 mg almorexant tablets and 1 placebo matching over-encapsulated zolpidem

Experimental: 2

almorexant 100 mg

Drug: almorexant
1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem

Placebo Comparator: 3

Placebo

Drug: Placebo
2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem

Active Comparator: 4

zolpidem 10 mg

Drug: zolpidem
2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated

Outcome Measures

Primary Outcome Measures

  1. Change From Baseline to Day 1&2 in Wake After Sleep Onset (WASO) [From baseline to Day 1&2]

    WASO was defined as the time spent in epochs scored as wake after onset of persistent sleep as determined by polysomnography (PSG) until lights on. For WASO assessed at the study center, the mean of the 2 PSG nights at each of Visits 3 and 4 was used for Day 1&2 and Day 15&16

  2. Change From Baseline to Day 15&16 in WASO [From baseline to Day 15&16]

    WASO was defined as the time spent in epochs scored as wake after onset of persistent sleep as determined by polysomnography (PSG) until lights on. For WASO assessed at the study center, the mean of the 2 PSG nights at each of Visits 3 and 4 was used for Day 1&2 and Day 15&16

  3. Change From Baseline to Week 1&2 in the Self-reported WASO (sWASO) [From baseline to Week 1&2]

    sWASO was the self-reported time spent awake after sleep onset as reported in the sleep diary. For sWASO assessed at home, the mean of all available data collected between Visits 3 and 4 (i.e., after the second morning of Visit 3 and before the first evening of Visit 4) was used for Week 1&2

Secondary Outcome Measures

  1. Change From Baseline to Day 1&2 in Latency to Persistent Sleep (LPS) [From baseline to Day 1&2]

    LPS was defined as the time from the start of the PSG recording to the beginning of the first continuous 20 epochs (i.e., 10 minutes) scored as non-wake (i.e., either sleep stage 1 (S1), sleep stage 2 (S2), slow-wave sleep (SWS), or rapid eye movement sleep(REM)) as determined by PSG

  2. Change From Baseline to Day 15&16 in LPS [From baseline to Day 15&16]

    LPS was defined as the time from the start of the PSG recording to the beginning of the first continuous 20 epochs (i.e., 10 minutes) scored as non-wake (i.e., either sleep stage 1 (S1), sleep stage 2 (S2), slow-wave sleep (SWS), or rapid eye movement sleep(REM)) as determined by PSG

  3. Change From Baseline to Week 1&2 in Subjective Latency to Sleep Onset (sLSO) [From baseline to Week 1&2]

    sLSO was the self-reported time to fall asleep as reported in the sleep diary

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 64 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Adult subjects (18-64 years) with a diagnosis of primary insomnia.
Exclusion Criteria:
  • History of any sleep disorder, or any Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) axis I disorder other than primary insomnia.

  • Sleep apnea, or restless legs syndrome.

  • Daytime napping of more than 1 hour per day.

  • Important caffeine consumption, heavy tobacco use, alcohol or drug abuse within 2 years prior to the screening visit.

  • Unwillingness to refrain from drugs, over-the-counter or herbal medication having an effect on sleep or behavior.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Sleep Disorders Laboratory, Royal Adelaide Hospital Adelaide South Australia Australia 5000
2 Monash Adult Sleep Center, Monash Medical Centre Clayton Victoria Australia 3168
3 Western Hospitpal, Private Bag Footscray Victoria Australia 3011
4 Institute for Breathing and Sleep (IBAS) Heidelburg Victoria Australia 3084
5 The Woolcock Institute of Medical Research Glebe Australia 2050
6 Australian Clinical Research Organisation Kippa Ring Australia 4021
7 Melbourne Sleep Disorder Centre Melbourne Australia
8 Burnside Hospital Clinical Trials Centre Toorak Gardens Australia 5065
9 Westmead Hospital, Department of Respiratory Westmead Australia 2145
10 Medical University of Innsbruck, Department of Neurology Innsbruck Austria
11 Rudolfinerhaus Vienna Austria A-1090
12 University of Vienna - Department of Neurology Vienna Austria A-1090
13 Cliniques Universitaires Saint Luc Brussels Belgium
14 CH Jolimont / Sleep Disorders Center, Hospital de Jolimont Haine Saint Paul Belgium
15 Clinique Andre Vesale Montigny le Tilleuil Belgium
16 Hospital St. Naum, Paediatr. Neurology Sofia Bulgaria
17 MHAT 'St. Marina' Varna Bulgaria
18 Oddeleni nasledne pece, Nemocnice Ceske Budejovice Ceske Budejovice Czech Republic
19 Centrum pro poruchy spanku a bdeni, Neurologicka klinika Katerinska Czech Republic
20 Fakultni nemocnice Ostrava/Klinika detske neurologie SLEEP LABORATORY Ostava-Poruba Czech Republic
21 Poradna pro porchy spanku a spankova, Laborator Unimeds s.r.o. Prague Czech Republic
22 Somnocentrum Trutnov-spankova laborator, Oddeleni neurologie Trutnov Czech Republic
23 Scansleep Aps, Sovnlaegecentret Arhus Denmark
24 Sovnlagecentret - Scan Sleep Copenhagen Denmark 1364
25 Scan Sleep ApS, Sovnlaegecentret Copenhagen Denmark
26 Tutkimuskeskus Vitalmed Helsinki Finland
27 Unesta Research Center Tampere Finland
28 University of Turku, Sleep Research Unit Turku Finland
29 Hopital Pellegrin Bordeaux France
30 Hopital Raymond Poincare Garches France
31 Service de Neurologie B, Hopital Gui de Chauliac Montpellier France
32 Hopital Pitie-Salpetriere Paris France 75651
33 Centre du Sommeil et de la Vigilance, Hopital Hotel Dieu de Paris Paris France
34 Federation des Pathologies du Sommeil Paris France
35 Advanced Sleep Research GmbH Berlin Germany
36 Charite Campus Benjamin Franklin, Klinik und Hochschulambulanz fur Psychiatrie und Psychotherapie Berlin Germany
37 ClinPharm International GmbH Berlin Berlin Germany
38 Klinische Forschung Berlin GmbH Berlin Germany
39 St. Hedwig-Krnkenhaus Berlin Germany
40 ClinPharm International GmbH Bochum Bochum Germany
41 ClinPharm International GmbH Chemnitz Chemnitz Germany
42 ClinPharm International GmbH Dresden Dresden Germany
43 ClinPharm International GmbH Frankfurt Frankfurt Germany
44 Department of Psychiatry and Psychotherapy of the University Hospital of Freiburg Freiburg Germany
45 ClinPharm International GmbH Gorlitz Gorlitz Germany
46 Klinische Forschung Hamburg Germany
47 ClinPharm International GmbH Leipzig Leipzig Germany
48 ClinPharm International GmbH Magdeburg Magdeburg Germany
49 Interdisziplinäres Schlafmedizinisches Zentrum, Universitätsklinikum Giesen und Marburg GmbH Marburg Germany
50 ClinPharm International GmbH Potsdam Potsdam Germany
51 Klinik und Poliklinik fur Psychiatre Regensburg Germany
52 Klinische Forschung Schwerin GmbH Schwerin Germany
53 SOMNIBENE Institut fur Medizinische Schwerin Germany
54 Sleep Disorder Centre, State Health Centre Budapest Hungary H-1134
55 Department of Neurology , University of Debrecen Debrecen Hungary
56 Dept of Neurology, University of Pecs Pecs Hungary
57 Sleep Laboratory, Ilnd Hospital Szeged Hungary J-6725
58 Soroka University Medical Center, Unit for Sleep Research Beer Sheva Israel 84101
59 Technion Sleep Medicine Center, Rambam Medical Center Haifa Israel 31096
60 IRCCS Neurologico Casimiro Mondino, Centro Multidisciplinare di Medicina del Sonno, Servizio di Neurofisiopatologia Bologna Italy IT-27100
61 IRCCS Fondazione San Raffaele del Monte Tabor, Centro per i Disturbi del Sonno Milan Italy 20127
62 Centro del Sonno, Dipartimento di Neuroscienze, Clinica Neuroligica, Università di Pisa Pisa Italy IT-56126
63 Klinika Chorob Psychicznych i Zaburzen Nerwicowych ACK, Szpital AMG Gdansk Poland 890-952
64 Laboratorium Diagnostyka Snu, Pro-Medica Krakow Poland 30-002
65 Osrodek Diagnostyki i Leczenia Zaburzen Snu i Chorob Ukladu Lodz Poland 92-215
66 Instytut Psychiatrii i Neurologii, Zaklad Neurofizjologii Klinicznej Warsaw Poland 02957
67 Laboratorium Diagnostyka Snu, Pro-Medica Warszawa Poland 04-730
68 EMC Instytut Medyczny S.A Wroclaw Poland 50-220
69 I. Neurologická klinika FNsP Bratislava Nemocnica Staré Mesto Bratislava Slovakia 81369
70 Neurologicka klinika, FN L. Pasteura Kosice Kosice Slovakia 04066
71 BenMed Park Clinic Benoni Johannesburg South Africa
72 WITS Sleep Laboratory School of Physiology Parktown Johannesburg South Africa
73 Gatesville Medical Centre Gatesville Western Cape South Africa
74 Little Company of Mary Hospital Pretoria South Africa
75 Somerset West Trial Centre Somerset West South Africa
76 Hospital de la Santa Creu i Sant Pau, Unidad Framacologia Clinica Barcelona Spain E-08025
77 Instituto de Investigaciones del Sueno Madrid Spain 28036
78 Hospital Son Dureta, Unidad de Psicologia Palma de Mallorca Spain 07014
79 Hospital La Fe, Unidad de Neurofisiologi Valencia Spain 46009
80 Hospital MAZ, Unidad de Neurofisiologia y Sueno Zaragoza Spain 50015
81 Carlanderska Sömnlaboratoriet Goteborg Sweden SE-144 35
82 Örebro University Hospital, Neurology department Sleep Unit Orebro Sweden
83 Aleris Fysiologlab Stockholm Sweden
84 Psychiatric University Clinics (UPK) Basel, Sleep Medicine and Neurophysiology Basel Switzerland CH-4025
85 Centre pour l'Etude et le Traitement des Troubles du Sommeil Hopital Bell Idee Chene-Bourg Switzerland CH-1225
86 KSM Luzern Klinik fur Schlafmedizin, c/o Klinik St. Anna Lucerne Switzerland CH-6006
87 University Hospital Zurich (USZ) Neurology Polyclinic, Center for Sleep Medicine Zurich Switzerland CH-8091
88 KSM Zurzach Klinik fur Schlafmedizin Zurzach Switzerland CH-5330
89 National Medical University n.a. O.O. BohomoletsChair of Diseases of Nervous System, City Clinical Hospital No.4, Neurological Departments I and II Kiev Ukraine
90 The Edinburgh Sleep Centre Edinburgh United Kingdom
91 The London Sleep Centre London United Kingdom

Sponsors and Collaborators

  • Midnight Pharma, LLC

Investigators

  • Study Chair: Raymond Cluydts, Dr., Cognitive and Biological Psychology, University of Brussels

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Midnight Pharma, LLC
ClinicalTrials.gov Identifier:
NCT00608985
Other Study ID Numbers:
  • AC-057A301
First Posted:
Feb 6, 2008
Last Update Posted:
Mar 14, 2016
Last Verified:
Feb 1, 2016
Keywords provided by Midnight Pharma, LLC
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details First subject, first visit was on 28 April 2008. The last subject, last visit (safety follow-up) was on 30 September 2009.
Pre-assignment Detail There was a screening period of 14 to 28 days. Two randomized subjects (one in each almorexant (ACT-078573) dose group) did not receive double-blind study treatment. The 'Started population' was defined as those participants who were randomized and treated.
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Period Title: Overall Study
STARTED 177 186 176 168
Completed Double-blind Treatment 163 174 171 161
COMPLETED 161 173 170 159
NOT COMPLETED 16 13 6 9

Baseline Characteristics

Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg Total
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated Total of all reporting groups
Overall Participants 177 186 176 168 707
Age (Count of Participants)
<=18 years
0
0%
0
0%
0
0%
0
0%
0
0%
Between 18 and 65 years
177
100%
186
100%
176
100%
168
100%
707
100%
>=65 years
0
0%
0
0%
0
0%
0
0%
0
0%
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
46.2
(11.69)
44.1
(12.44)
46.1
(11.83)
45.1
(12.11)
45.4
(12.03)
Sex: Female, Male (Count of Participants)
Female
111
62.7%
113
60.8%
106
60.2%
106
63.1%
436
61.7%
Male
66
37.3%
73
39.2%
70
39.8%
62
36.9%
271
38.3%
Region of Enrollment (participants) [Number]
Australia
13
7.3%
15
8.1%
12
6.8%
14
8.3%
54
7.6%
Austria
3
1.7%
5
2.7%
2
1.1%
4
2.4%
14
2%
Belgium
0
0%
1
0.5%
1
0.6%
0
0%
2
0.3%
Bulgaria
1
0.6%
0
0%
1
0.6%
0
0%
2
0.3%
Czech Republic
2
1.1%
2
1.1%
1
0.6%
1
0.6%
6
0.8%
Denmark
6
3.4%
5
2.7%
5
2.8%
4
2.4%
20
2.8%
Finland
13
7.3%
14
7.5%
13
7.4%
14
8.3%
54
7.6%
France
3
1.7%
2
1.1%
3
1.7%
2
1.2%
10
1.4%
Germany
83
46.9%
86
46.2%
87
49.4%
81
48.2%
337
47.7%
Hungary
12
6.8%
11
5.9%
11
6.3%
13
7.7%
47
6.6%
Israel
5
2.8%
5
2.7%
6
3.4%
5
3%
21
3%
Italy
3
1.7%
3
1.6%
2
1.1%
2
1.2%
10
1.4%
Poland
3
1.7%
3
1.6%
3
1.7%
3
1.8%
12
1.7%
South Africa
15
8.5%
13
7%
13
7.4%
12
7.1%
53
7.5%
Spain
4
2.3%
6
3.2%
5
2.8%
3
1.8%
18
2.5%
Sweden
6
3.4%
8
4.3%
5
2.8%
6
3.6%
25
3.5%
Switzerland
1
0.6%
4
2.2%
4
2.3%
1
0.6%
10
1.4%
United Kingdom
4
2.3%
3
1.6%
2
1.1%
3
1.8%
12
1.7%

Outcome Measures

1. Primary Outcome
Title Change From Baseline to Day 1&2 in Wake After Sleep Onset (WASO)
Description WASO was defined as the time spent in epochs scored as wake after onset of persistent sleep as determined by polysomnography (PSG) until lights on. For WASO assessed at the study center, the mean of the 2 PSG nights at each of Visits 3 and 4 was used for Day 1&2 and Day 15&16
Time Frame From baseline to Day 1&2

Outcome Measure Data

Analysis Population Description
All treated patients
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Measure Participants 177 186 176 168
Baseline
85.0
(39.81)
86.6
(39.17)
92.3
(35.92)
76.5
(36.95)
Day 1&2
72.8
(42.63)
54.5
(37.65)
46.4
(28.85)
54.6
(36.05)
Change from baseline to day 1&2
-11.8
(38.73)
-29.0
(31.50)
-40.4
(31.70)
-17.9
(29.19)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 100mg
Comments Change from baseline to day 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -15.0
Confidence Interval (2-Sided) 95%
-21.8 to -8.8
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 200mg
Comments Change from baseline to day 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -26.8
Confidence Interval (2-Sided) 95%
-34.3 to -19.5
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Zolpidem 10mg
Comments Change from baseline to day 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0376
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -6.8
Confidence Interval (2-Sided) 95%
-13.5 to -0.3
Parameter Dispersion Type:
Value:
Estimation Comments
2. Primary Outcome
Title Change From Baseline to Day 15&16 in WASO
Description WASO was defined as the time spent in epochs scored as wake after onset of persistent sleep as determined by polysomnography (PSG) until lights on. For WASO assessed at the study center, the mean of the 2 PSG nights at each of Visits 3 and 4 was used for Day 1&2 and Day 15&16
Time Frame From baseline to Day 15&16

Outcome Measure Data

Analysis Population Description
All treated patients
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Measure Participants 177 186 176 168
Baseline
85.0
(39.81)
86.6
(39.17)
92.3
(35.92)
76.5
(36.95)
Day 15&16
65.0
(45.90)
55.8
(35.07)
51.8
(31.31)
63.0
(42.31)
Change from baseline to Day 15&16
-18.3
(43.40)
-29.6
(33.12)
-36.3
(35.20)
-15.1
(36.61)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 100mg
Comments Change from baseline to day 15&16 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0001
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -13.5
Confidence Interval (2-Sided) 95%
-20.3 to -6.5
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 200mg
Comments Change from baseline to day 15&16 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -19.5
Confidence Interval (2-Sided) 95%
-27.3 to -12.3
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Zolpidem 10mg
Comments Change from baseline to day 15&16 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.3358
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value 3.5
Confidence Interval (2-Sided) 95%
-3.8 to 11.0
Parameter Dispersion Type:
Value:
Estimation Comments
3. Primary Outcome
Title Change From Baseline to Week 1&2 in the Self-reported WASO (sWASO)
Description sWASO was the self-reported time spent awake after sleep onset as reported in the sleep diary. For sWASO assessed at home, the mean of all available data collected between Visits 3 and 4 (i.e., after the second morning of Visit 3 and before the first evening of Visit 4) was used for Week 1&2
Time Frame From baseline to Week 1&2

Outcome Measure Data

Analysis Population Description
All treated patients with available data
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Measure Participants 175 179 173 168
Baseline
64.0
(51.32)
65.0
(60.49)
69.0
(46.68)
61.6
(48.29)
Week 1&2
52.9
(48.33)
40.5
(50.87)
42.9
(42.06)
30.5
(42.26)
Change from baseline to week 1&2
-14.1
(31.84)
-19.5
(36.93)
-21.8
(32.5)
-23.4
(33.22)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 100mg
Comments Change from baseline to week 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0186
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -7.3
Confidence Interval (2-Sided) 95%
-13.3 to -1.3
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 200mg
Comments Change from baseline to week 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0006
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -10.4
Confidence Interval (2-Sided) 95%
-16.4 to -4.6
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Zolpidem 10mg
Comments Change from baseline to week 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -12.7
Confidence Interval (2-Sided) 95%
-18.8 to -6.6
Parameter Dispersion Type:
Value:
Estimation Comments
4. Secondary Outcome
Title Change From Baseline to Day 1&2 in Latency to Persistent Sleep (LPS)
Description LPS was defined as the time from the start of the PSG recording to the beginning of the first continuous 20 epochs (i.e., 10 minutes) scored as non-wake (i.e., either sleep stage 1 (S1), sleep stage 2 (S2), slow-wave sleep (SWS), or rapid eye movement sleep(REM)) as determined by PSG
Time Frame From baseline to Day 1&2

Outcome Measure Data

Analysis Population Description
All treated patients
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Measure Participants 177 186 176 168
Baseline
57.3
(41.81)
57.4
(37.03)
54.1
(32.89)
56.5
(34.60)
Day 1&2
37.5
(34.64)
28.8
(30.13)
25.0
(21.97)
22.5
(27.25)
Change from baseline to day 1&2
-15.8
(40.21)
-24.8
(37.00)
-22.5
(30.83)
-29.4
(34.63)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 100mg
Comments Change from baseline to day 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0035
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -9.3
Confidence Interval (2-Sided) 95%
-15.3 to -3.0
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 200mg
Comments Change from baseline to day 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0006
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -9.5
Confidence Interval (2-Sided) 95%
-15.0 to -4.3
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Zolpidem 10mg
Comments Change from baseline to day 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -16.0
Confidence Interval (2-Sided) 95%
-22.0 to -9.8
Parameter Dispersion Type:
Value:
Estimation Comments
5. Secondary Outcome
Title Change From Baseline to Day 15&16 in LPS
Description LPS was defined as the time from the start of the PSG recording to the beginning of the first continuous 20 epochs (i.e., 10 minutes) scored as non-wake (i.e., either sleep stage 1 (S1), sleep stage 2 (S2), slow-wave sleep (SWS), or rapid eye movement sleep(REM)) as determined by PSG
Time Frame From baseline to Day 15&16

Outcome Measure Data

Analysis Population Description
All treated patients
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Measure Participants 177 186 176 168
Baseline
57.3
(41.81)
57.4
(37.03)
54.1
(32.89)
56.5
(34.60)
Day 15&16
30.0
(35.33)
29.3
(28.51)
24.1
(22.48)
24.6
(25.62)
Change from baseline to day 15&16
-20.0
(46.10)
-23.5
(35.90)
-26.5
(31.10)
-32.3
(34.19)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 100mg
Comments Change from baseline to day 15&16 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.2237
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -4.0
Confidence Interval (2-Sided) 95%
-11.0 to 2.5
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 200mg
Comments Change from baseline to day 15&16 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0607
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -6.0
Confidence Interval (2-Sided) 95%
-12.3 to 0.3
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Zolpidem 10mg
Comments Change from baseline to day 15&16 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0017
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -10.5
Confidence Interval (2-Sided) 95%
-17.3 to -4.0
Parameter Dispersion Type:
Value:
Estimation Comments
6. Secondary Outcome
Title Change From Baseline to Week 1&2 in Subjective Latency to Sleep Onset (sLSO)
Description sLSO was the self-reported time to fall asleep as reported in the sleep diary
Time Frame From baseline to Week 1&2

Outcome Measure Data

Analysis Population Description
All treated patients with available data
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
Measure Participants 175 179 173 168
Baseline
58.8
(33.68)
55.0
(50.70)
53.3
(27.93)
50.5
(29.34)
Week 1&2
45.0
(31.61)
36.5
(40.64)
34.5
(21.56)
33.3
(21.50)
Change from baseline to week 1&2
-10.0
(26.89)
-16.2
(34.48)
-16.2
(23.22)
-17.2
(25.67)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 100mg
Comments Change from baseline to week 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.1187
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -4.1
Confidence Interval (2-Sided) 95%
-9.1 to 0.9
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Almorexant 200mg
Comments Change from baseline to week 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0017
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -7.1
Confidence Interval (2-Sided) 95%
-11.5 to -2.7
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Zolpidem 10mg
Comments Change from baseline to week 1&2 compared with placebo
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.0121
Comments
Method Wilcoxon rank-sum
Comments
Method of Estimation Estimation Parameter Median Difference (Net)
Estimated Value -6.1
Confidence Interval (2-Sided) 95%
-10.8 to -1.4
Parameter Dispersion Type:
Value:
Estimation Comments

Adverse Events

Time Frame All adverse events occurring after the start of study treatment and within 24 hours after the last dose of study treatment
Adverse Event Reporting Description
Arm/Group Title Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Arm/Group Description Placebo Placebo : 2 placebo matching almorexant tablets and 1 placebo matching over-encapsulated zolpidem almorexant 100 mg almorexant : 1 100 mg almorexant tablet, 1 placebo matching almorexant tablet, and 1 placebo matching over-encapsulated zolpidem almorexant 200 mg almorexant : 2 100 mg almorexant tablets, and 1 placebo matching over-encapsulated zolpidem zolpidem 10 mg zolpidem : 2 placebo matching almorexant tablets and 1 zolpidem 10 mg over-encapsulated
All Cause Mortality
Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN) / (NaN) / (NaN)
Serious Adverse Events
Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/177 (0%) 2/186 (1.1%) 1/176 (0.6%) 0/168 (0%)
Infections and infestations
ABSCESS LIMB 0/177 (0%) 0 1/186 (0.5%) 1 0/176 (0%) 0 0/168 (0%) 0
Nervous system disorders
MULTIPLE SCLEROSIS 0/177 (0%) 0 1/186 (0.5%) 1 0/176 (0%) 0 0/168 (0%) 0
Renal and urinary disorders
CALCULUS URETERIC 0/177 (0%) 0 0/186 (0%) 0 1/176 (0.6%) 1 0/168 (0%) 0
Other (Not Including Serious) Adverse Events
Placebo Almorexant 100mg Almorexant 200mg Zolpidem 10mg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 64/177 (36.2%) 65/186 (34.9%) 61/176 (34.7%) 72/168 (42.9%)
Cardiac disorders
PALPITATIONS 1/177 (0.6%) 1/186 (0.5%) 1/176 (0.6%) 2/168 (1.2%)
Ear and labyrinth disorders
VERTIGO 0/177 (0%) 1/186 (0.5%) 1/176 (0.6%) 2/168 (1.2%)
Eye disorders
BLEPHAROSPASM 0/177 (0%) 0/186 (0%) 2/176 (1.1%) 0/168 (0%)
VISION BLURRED 3/177 (1.7%) 0/186 (0%) 1/176 (0.6%) 1/168 (0.6%)
Gastrointestinal disorders
NAUSEA 7/177 (4%) 4/186 (2.2%) 6/176 (3.4%) 4/168 (2.4%)
DIARRHOEA 1/177 (0.6%) 6/186 (3.2%) 1/176 (0.6%) 2/168 (1.2%)
ABDOMINAL PAIN UPPER 3/177 (1.7%) 3/186 (1.6%) 2/176 (1.1%) 1/168 (0.6%)
CONSTIPATION 0/177 (0%) 2/186 (1.1%) 0/176 (0%) 0/168 (0%)
DRY MOUTH 1/177 (0.6%) 1/186 (0.5%) 0/176 (0%) 3/168 (1.8%)
DYSPEPSIA 2/177 (1.1%) 0/186 (0%) 1/176 (0.6%) 1/168 (0.6%)
General disorders
FATIGUE 2/177 (1.1%) 9/186 (4.8%) 6/176 (3.4%) 6/168 (3.6%)
ASTHENIA 2/177 (1.1%) 5/186 (2.7%) 3/176 (1.7%) 1/168 (0.6%)
CHEST DISCOMFORT 1/177 (0.6%) 1/186 (0.5%) 1/176 (0.6%) 1/168 (0.6%)
Infections and infestations
NASOPHARYNGITIS 3/177 (1.7%) 5/186 (2.7%) 2/176 (1.1%) 5/168 (3%)
INFLUENZA 0/177 (0%) 2/186 (1.1%) 0/176 (0%) 0/168 (0%)
Investigations
WEIGHT INCREASED 0/177 (0%) 0/186 (0%) 3/176 (1.7%) 1/168 (0.6%)
Metabolism and nutrition disorders
FOOD CRAVING 0/177 (0%) 0/186 (0%) 2/176 (1.1%) 0/168 (0%)
Musculoskeletal and connective tissue disorders
MUSCLE SPASMS 2/177 (1.1%) 1/186 (0.5%) 1/176 (0.6%) 0/168 (0%)
Nervous system disorders
HEADACHE 21/177 (11.9%) 18/186 (9.7%) 26/176 (14.8%) 29/168 (17.3%)
DIZZINESS 10/177 (5.6%) 6/186 (3.2%) 8/176 (4.5%) 3/168 (1.8%)
SOMNOLENCE 4/177 (2.3%) 6/186 (3.2%) 5/176 (2.8%) 4/168 (2.4%)
BALANCE DISORDER 0/177 (0%) 1/186 (0.5%) 2/176 (1.1%) 2/168 (1.2%)
DYSGEUSIA 1/177 (0.6%) 1/186 (0.5%) 1/176 (0.6%) 3/168 (1.8%)
PARAESTHESIA 2/177 (1.1%) 1/186 (0.5%) 1/176 (0.6%) 2/168 (1.2%)
Psychiatric disorders
DEPRESSED MOOD 0/177 (0%) 2/186 (1.1%) 1/176 (0.6%) 3/168 (1.8%)
CONFUSIONAL STATE 1/177 (0.6%) 1/186 (0.5%) 1/176 (0.6%) 2/168 (1.2%)
NIGHTMARE 2/177 (1.1%) 0/186 (0%) 2/176 (1.1%) 1/168 (0.6%)
ANXIETY 0/177 (0%) 1/186 (0.5%) 1/176 (0.6%) 2/168 (1.2%)
RESTLESSNESS 0/177 (0%) 0/186 (0%) 2/176 (1.1%) 0/168 (0%)
Renal and urinary disorders
MICTURITION URGENCY 0/177 (0%) 1/186 (0.5%) 1/176 (0.6%) 0/168 (0%)
Respiratory, thoracic and mediastinal disorders
OROPHARYNGEAL PAIN 1/177 (0.6%) 2/186 (1.1%) 0/176 (0%) 2/168 (1.2%)
COUGH 1/177 (0.6%) 0/186 (0%) 1/176 (0.6%) 2/168 (1.2%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

Results Point of Contact

Name/Title Ouali Berkani/Clinical Trial Leader
Organization Actelion Pharmaceuticals Ltd
Phone +41 61 565 5342
Email
Responsible Party:
Midnight Pharma, LLC
ClinicalTrials.gov Identifier:
NCT00608985
Other Study ID Numbers:
  • AC-057A301
First Posted:
Feb 6, 2008
Last Update Posted:
Mar 14, 2016
Last Verified:
Feb 1, 2016