UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000026332
Receipt number R000030227
Scientific Title The placebo controlled randomized double blind multicenter study to investigate effectiveness and safety of combination use of melatonin receptor agonist for dose reduction or interruptions of BZD and non-BZD hypnotics on chronic insomnia.
Date of disclosure of the study information 2017/02/28
Last modified on 2020/08/31 13:26:52

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Basic information

Public title

The placebo controlled randomized double blind multicenter study to investigate effectiveness and safety of combination use of melatonin receptor agonist for dose reduction or interruptions of BZD and non-BZD hypnotics on chronic insomnia.

Acronym

The study of combination use of melatonin receptor agonist for dose reduction or interruptions of BZD and non-BZD hypnotics on chronic insomnia

Scientific Title

The placebo controlled randomized double blind multicenter study to investigate effectiveness and safety of combination use of melatonin receptor agonist for dose reduction or interruptions of BZD and non-BZD hypnotics on chronic insomnia.

Scientific Title:Acronym

The study of combination use of melatonin receptor agonist for dose reduction or interruptions of BZD and non-BZD hypnotics on chronic insomnia

Region

Japan


Condition

Condition

Chronic insomnia

Classification by specialty

Psychiatry

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

To investigate effects on combination use of Ramelteon in the dose reduction or interruption process of (non-)BZD hypnotics during the dose reduction or interruption algorithm.

Basic objectives2

Safety,Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

The achievement ratio of the 50% dose reduction of (non-)BZD hypnotics (Diazepam conversion value) at 12weeks or withdrawal without any deterioration of insomnia symptoms
The rate of subjects who achieved more than 50% dose reduction of (non-)BZD hypnotics (Diazepam conversion value) at 12 weeks or withdrawal since informed consent.

Key secondary outcomes

1) The achievement ratio of the 50% dose reduction (Diazepam conversion value) at 4weeks and 8weeks
2) The average of the dose reduction rate at 4weeks, 8weeks and 12weeks
3) The achievement ratio of the 100% dose reduction at 12weeks or withdrawal
4) The variation in total score of PSQI and AIS at 4weeks, 8weeks and 12weeks
5) The variation in PHQ-9 score at 4weeks, 8weeks and 12weeks
6) CIWA-B score at 4weeks, 8weeks and 12weeks
7) PGI score at 12weeks or withdrawal


Base

Study type

Interventional


Study design

Basic design

Parallel

Randomization

Randomized

Randomization unit

Individual

Blinding

Double blind -all involved are blinded

Control

Placebo

Stratification

YES

Dynamic allocation

YES

Institution consideration

Institution is considered as a block.

Blocking

YES

Concealment

Central registration


Intervention

No. of arms

2

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

Co-administer following medication for 12 weeks since informed consent;
R group: taking capsule of Ramelteon 8mg once daily before sleeping.

Interventions/Control_2

Co-administer following medication for 12 weeks since informed consent;
PL group: taking capsule of Placebo once daily before sleeping.

Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

Subjects meeting Criteria 1 or 2 and Criteria 3 and all subsequent criteria will be included in the study:
1. Patients diagnosed as chronic insomnia having sleep onset disturbance, and with a duration of the disease of at least 6 months
2. Patients diagnosed with chronic insomnia comorbid with mood disorders (depression or bipolar disorder) can be included to this study if they have remission of mood symptoms.

3. Patients taking (non-)BZD hypnotics (including etizolam at bedtime) at a fixed dose in the following patterns since at least 1 month prior to consent (over 90% of drug compliance should be confirmed at the time of medical interview):
* Patients taking 2 drugs at the usual dose (1 unit)
*Patients taking 3 drugs at the usual dose (1 unit)
* Patients taking 4 drugs at the usual dose (1 unit)
* Patients taking a drug at 2-fold of the usual dose (2 units)
* Patients taking a drug at 2-fold of the usual dose (2 units) and a drug at the usual dose (1 unit)
* Patients taking a drug at 2-fold of the usual dose (2 units) and 2 drugs at the usual dose (1 unit)
* Patients taking 2 drugs at 2-fold of the usual dose (2 units)
4. Patients whoes symptoms of insomnia were stabilized, and the investigators determined that the (non-) BZD hypnotics could be reduced or discontinued
5. Patients aged 20 years or older at the time of consent
6. Patients who are willing to comply with algorithm for dose reduction and discontinuation
7. Patients who can understand the content of the study and provide consent to participate in the study in writing on their own will.

Key exclusion criteria

Subjects meeting any of the following criteria will not be included in the study:
1. Patients with secondary insomnia
2. Patients taking (non-)BZD hypnotics at a dose exceeding 2-fold of the usual dose
3. Patients taking barbiturate and non-barbiturate hypnotics and Suvorexant.
4. Patients taking hypnotics other than medicinal pharmaceuticals (including OTC, supplements believed to be effective for insomnia and melatonin)
5. Patients taking mianserin hydrochloride, mirtazapine, and trazodone hydrochloride
6. Patients taking antipsychotics
7. Patients taking anxiolytic or clonazepam at bedtime
*Patient taking anxiolytic and/or clonazepam at times except for bed-time will be included in the study. However, dosage and timing of administration can not be changed during the study period.
8. Patients who took ramelteon within 1 month prior to the informed consent
9. Patients in whom the dose of psychotropics except for the items 2-7 were changed within 1 month prior to the informed consent
10. Patients who are comorbid with depression or bipolar disordeand and in whom depressive symptoms have not remitted
11. Patients in whom frequency in Q9 of PHQ "thoughts that you would be better off dead or thoughts of hurting yourself in some way" is "more than half the days (in the past 2 weeks)" or the total score is 10 or higher
12. Patients with dementia, schizophrenia, drug dependence and alcoholic
13. Patients with liver/kidney disorder, female subjects who are pregnant or in breast-feeding, and malignant neoplasm
14. Night workers
15. Patients meeting contraindications for ramelteon
16. Other patients judged ineligible for participation in the study by the investigator

Target sample size

130


Research contact person

Name of lead principal investigator

1st name Yuichi
Middle name
Last name Inoue

Organization

Yoyogi Sleep Disorder Clinic
Foundation of Sleep and Health Science

Division name

No

Zip code

151-0053

Address

5-10-10, Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan

TEL

03-6300-5401

Email

inoue@somnology.com


Public contact

Name of contact person

1st name Mina
Middle name
Last name Kobayashi

Organization

Yoyogi Sleep Disorder Clinic

Division name

No

Zip code

151-0053

Address

5-10-10, Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan

TEL

03-6300-5401

Homepage URL


Email

kobayashi@somnology.com


Sponsor or person

Institute

Yoyogi Sleep Disorder Clinic
Foundation of Sleep and Health Science

Institute

Department

Personal name



Funding Source

Organization

Takeda Pharmaceutical Company Limited

Organization

Division

Category of Funding Organization

Profit organization

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

National Center of Neurology and Psychiatry Clinical Research Review Board

Address

4-1-1 Ogawa-Higashi, Kodaira,Tokyo 187-8551, Japan

Tel

042-341-2711

Email

rinri-jimu@ncnp.go.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2017 Year 02 Month 28 Day


Related information

URL releasing protocol


Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled

17

Results


Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2016 Year 12 Month 18 Day

Date of IRB

2016 Year 12 Month 22 Day

Anticipated trial start date

2018 Year 01 Month 04 Day

Last follow-up date

2019 Year 07 Month 31 Day

Date of closure to data entry


Date trial data considered complete

2019 Year 11 Month 30 Day

Date analysis concluded

2019 Year 12 Month 27 Day


Other

Other related information



Management information

Registered date

2017 Year 02 Month 28 Day

Last modified on

2020 Year 08 Month 31 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000030227


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name