Trial Outcomes & Findings for Efficacy and Safety of Circadin® 2 mg in the Treatment of Primary Insomnia Patients (NCT NCT00397189)

NCT ID: NCT00397189

Last Updated: 2018-05-01

Results Overview

Sleep latency (SL) after 3 weeks of treatment was assessed by Patient Daily Sleep Diary (National sleep foundation sleep diary). The patients reported subjectively of their SL. The Sleep Diary question 3 (SL) was summarised at baseline (end of the two-week run-in period) and after three weeks double-blind treatment (actual and change from baseline) for each treatment group using descriptive statistics. At each visit, the mean of the seven days prior to the visit were used. For each treatment group, the mean score at visit 3 was compared, adjusting for the visit 2 score. An ANCOVA model was used. Lower score indicates reduction in sleep latency and thus considered improvement

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

930 participants

Primary outcome timeframe

Baseline and 3 weeks

Results posted on

2018-05-01

Participant Flow

The first patient entered the study on 24 October 2006 and the last patient completed the study (safety follow up) on 2 December 2008 (last patient completed the last visit on 24 October 2008).

930 patients were enrolled into the study and entered the run-in period; 139 of these patients were discontinued during the run-in period. The main reasons for discontinuation from the run-in were unwillingness to continue and ineligible to continue. Treatment periods were 3 weeks double-blind (DB) (1:1) and extension period 26 weeks DB (3:1)

Participant milestones

Participant milestones
Measure
Circadin
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
3 Weeks Period
STARTED
394
395
3 Weeks Period
COMPLETED
373
373
3 Weeks Period
NOT COMPLETED
21
22
Extension Period
STARTED
534
177
Extension Period
COMPLETED
421
134
Extension Period
NOT COMPLETED
113
43

Reasons for withdrawal

Reasons for withdrawal
Measure
Circadin
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
3 Weeks Period
Lost to Follow-up
5
4
3 Weeks Period
Adverse Event
3
2
3 Weeks Period
Withdrawal by Subject
13
9
3 Weeks Period
Physician Decision
0
2
3 Weeks Period
Protocol Violation
0
3
3 Weeks Period
Other
0
2

Baseline Characteristics

Efficacy and Safety of Circadin® 2 mg in the Treatment of Primary Insomnia Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Circadin
n=360 Participants
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
n=362 Participants
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
Total
n=722 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
223 Participants
n=5 Participants
218 Participants
n=7 Participants
441 Participants
n=5 Participants
Age, Categorical
>=65 years
137 Participants
n=5 Participants
144 Participants
n=7 Participants
281 Participants
n=5 Participants
Age, Continuous
61.9 years
STANDARD_DEVIATION 10 • n=5 Participants
61.5 years
STANDARD_DEVIATION 10.5 • n=7 Participants
61.7 years
STANDARD_DEVIATION 10.2 • n=5 Participants
Sex: Female, Male
Female
253 Participants
n=5 Participants
244 Participants
n=7 Participants
497 Participants
n=5 Participants
Sex: Female, Male
Male
107 Participants
n=5 Participants
118 Participants
n=7 Participants
225 Participants
n=5 Participants
Region of Enrollment
United Kingdom
360 participants
n=5 Participants
362 participants
n=7 Participants
722 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and 3 weeks

Population: Pre-planned analysis on ITT population age 65-80

Sleep latency (SL) after 3 weeks of treatment was assessed by Patient Daily Sleep Diary (National sleep foundation sleep diary). The patients reported subjectively of their SL. The Sleep Diary question 3 (SL) was summarised at baseline (end of the two-week run-in period) and after three weeks double-blind treatment (actual and change from baseline) for each treatment group using descriptive statistics. At each visit, the mean of the seven days prior to the visit were used. For each treatment group, the mean score at visit 3 was compared, adjusting for the visit 2 score. An ANCOVA model was used. Lower score indicates reduction in sleep latency and thus considered improvement

Outcome measures

Outcome measures
Measure
Circadin
n=137 Participants
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
n=144 Participants
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
The Change From Baseline in Subjective Sleep Latency.
-19.1 minutes
Standard Deviation 47.3
-1.7 minutes
Standard Deviation 47.8

SECONDARY outcome

Timeframe: 3 weeks

Sleep maintenance as measured by number of awakening (NOA) after 3 weeks of treatment was assessed by Patient Daily Sleep Diary (National sleep foundation sleep diary). The patients reported subjectively of their NOA. The Sleep Diary question 4 (NOA) was summarized at baseline (end of the two-week run-in period) and after three weeks double-blind treatment (actual and change from baseline) for each treatment group using descriptive statistics. At each visit, the mean of the seven days prior to the visit were used. For each treatment group, the mean score at visit 3 was compared, adjusting for the visit 2 score. An ANCOVA model was used. Lower score indicates less awakenings and thus considered improvement.

Outcome measures

Outcome measures
Measure
Circadin
n=137 Participants
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
n=144 Participants
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
The Change From Baseline in Subjective Sleep Maintenance.
-0.24 Awakenings
Interval -0.33 to 0.0
-0.09 Awakenings
Interval -0.33 to 0.0

Adverse Events

Circadin

Serious events: 1 serious events
Other events: 32 other events
Deaths: 0 deaths

Placebo

Serious events: 3 serious events
Other events: 42 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Circadin
n=394 participants at risk
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
n=395 participants at risk
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
Infections and infestations
cellulitis
0.25%
1/394 • Number of events 1 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
0.00%
0/395 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
General disorders
chest pain
0.00%
0/394 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
0.25%
1/395 • Number of events 1 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
Infections and infestations
upper respiratory tract infection
0.00%
0/394 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
0.25%
1/395 • Number of events 1 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
uterine cancer
0.00%
0/394 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
0.25%
1/395 • Number of events 1 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator

Other adverse events

Other adverse events
Measure
Circadin
n=394 participants at risk
Prolonged release melatonin 2 mg. Tablets should be taken 1-2 hours before going to bed.
Placebo
n=395 participants at risk
Identical tablets to Circadin. Tablets should be taken 1-2 hours before going to bed.
Infections and infestations
nasopharyngitis
3.3%
13/394 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
4.1%
16/395 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
Infections and infestations
upper respiratory tract infection
2.0%
8/394 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
2.0%
8/395 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
Nervous system disorders
headache
2.8%
11/394 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator
4.6%
18/395 • 37 weeks (2 weeks baseline, 3 weeks double-blind, 26 weeks double-blind extension period and 2 weeks run-out,AEs were to be reported for up to 30 days after stopping study medication )
The safety variables were assessed at each visit and included spontaneously reported adverse events (AEs); unusual events and AEs recorded by the investigator

Additional Information

VP clinical and regulatory affairs

Neurim Pharmaceuticals

Phone: +972-3-6499340

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60