Study of the Efficacy and Safety of Lemborexant in Subjects 55 Years and Older With Insomnia Disorder (SUNRISE 1)

NCT ID: NCT02783729

Last Updated: 2024-11-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1006 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-31

Study Completion Date

2018-01-30

Brief Summary

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This study will be conducted to demonstrate, using polysomnography, that lemborexant 10 milligrams (mg) and 5 mg is superior to placebo on objective sleep onset as assessed by latency to persistent to sleep (LPS) after the last 2 nights of 1 month of treatment in participants 55 years and older with insomnia disorder.

Detailed Description

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The study is a multicenter, randomized, double-blind, placebo-controlled, active comparator, parallel-group study of 2 dose levels of lemborexant for 30 nights in approximately 950 participants, 55 years or older with insomnia disorder. Participants will be males 65 years or older or females 55 years or older. Approximately 60% of the participants will be age 65 years or older. The study will have 2 phases: The Prerandomization Phase and the Randomization Phase. Including both phases, the study will last for a minimum of 65 and a maximum of 81 days per participant.

Conditions

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Insomnia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Lemborexant 5 milligrams (mg)

Participants will receive one lemborexant 5 mg tablet and one zolpidem-matched placebo tablet each night

Group Type EXPERIMENTAL

Lemborexant

Intervention Type DRUG

Lemborexant 5 mg will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Zolpidem-matched placebo

Intervention Type DRUG

Zolpidem-matched placebo will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Lemborexant 10 mg

Participants will receive one lemborexant 10 mg tablet and one zolpidem-matched placebo tablet each night

Group Type EXPERIMENTAL

Lemborexant

Intervention Type DRUG

Lemborexant 10 mg will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Zolpidem-matched placebo

Intervention Type DRUG

Zolpidem-matched placebo will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Zolpidem tartrate

Participants will receive one zolpidem 6.25 mg tablet and one lemborexant-matched placebo tablet each night

Group Type ACTIVE_COMPARATOR

Lemborexant-matched placebo

Intervention Type DRUG

Lemborexant-matched placebo be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Zolpidem tartrate

Intervention Type DRUG

Zolpidem tartrate extended release 6.25 mg will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Placebo

Participants will receive one zolpidem-matched placebo tablet and one lemborexant-matched placebo tablet each night

Group Type PLACEBO_COMPARATOR

Lemborexant-matched placebo

Intervention Type DRUG

Lemborexant-matched placebo be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Zolpidem-matched placebo

Intervention Type DRUG

Zolpidem-matched placebo will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Interventions

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Lemborexant

Lemborexant 5 mg will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Intervention Type DRUG

Lemborexant

Lemborexant 10 mg will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Intervention Type DRUG

Lemborexant-matched placebo

Lemborexant-matched placebo be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Intervention Type DRUG

Zolpidem tartrate

Zolpidem tartrate extended release 6.25 mg will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Intervention Type DRUG

Zolpidem-matched placebo

Zolpidem-matched placebo will be administered orally in tablet form at home each night, immediately before the time the participant intends to try to sleep.

Intervention Type DRUG

Other Intervention Names

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E2006 E2006 Ambien CR

Eligibility Criteria

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Inclusion Criteria

1. Male age 65 years or older or female age 55 years or older at the time of informed consent
2. Meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for Insomnia Disorder, as follows:

* Complains of dissatisfaction with nighttime sleep, in the form of difficulty staying asleep and/or awakening earlier in the morning than desired despite adequate opportunity for sleep (Note that if the complaint is limited to difficulty initiating sleep, the participant is not eligible)
* Frequency of complaint ≥ 3 times per week
* Duration of complaint ≥ 3 months
* Associated with complaint of daytime impairment
3. History of subjective wake after sleep onset (sWASO) typically ≥ 60 minutes on at least 3 nights per week in the previous 4 weeks
4. Reports regular time spent in bed, either sleeping or trying to sleep, between 7 and 9 hours
5. Reports habitual bedtime, defined as the time the participant attempts to sleep, between 21:00 and 24:00 and habitual waketime between 05:00 and 09:00
6. Insomnia Severity Index (ISI) score ≥ 13
7. Confirmation of current insomnia symptoms as determined from responses on the Sleep Diary before the second screening visit
8. Confirmation of regular bedtime and waketime as determined from responses on the Sleep Diary
9. Confirmation of sufficient duration of time spent in bed, as determined from responses on the Sleep Diary
10. Objective (polysomnography \[PSG\]) evidence of insomnia as follows:

a) Wake after sleep onset (WASO) average ≥ 60 minutes on the 2 consecutive PSGs, with neither night \< 45 minutes
11. Willing and able to comply with all aspects of the protocol, including staying in bed for at least 7 hours each night
12. Willing not to start a behavioral or other treatment program for the treatment of insomnia during the participant's participation in the study

Exclusion Criteria

1. A current diagnosis of 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, or an exclusionary score on screening instruments to rule out individuals with symptoms of certain sleep disorders other than insomnia as follows:

1. STOPBang score ≥5
2. International Restless Legs Scale score ≥16
3. Epworth Sleepiness Scale score \>15 (scores of 11 to 15 require excessive daytime sleepiness to be recorded in participant's Medical History)
2. Reports symptoms potentially related to narcolepsy, that in the clinical opinion of the investigator indicates the need for referral for a diagnostic evaluation for the presence of narcolepsy
3. On the Munich Parasomnia Scale (MUPS), endorsed the item that corresponds to a history of sleep-eating or reports a history of sleep-related violent behavior, sleep-driving, or symptoms of another parasomnia that in the investigator's opinion make the participant unsuitable for the study
4. Apnea-Hypopnea Index \> 15 or Periodic Limb Movement with Arousal Index \>15 as measured on the PSG at the second screening visit
5. Beck Depression Inventory - II (BDI-II) score \>19 at Screening
6. Beck Anxiety Index (BAI) score \>15 at Screening
7. Habitually naps during the day more than 3 times per week
8. Is a female of childbearing potential Note: All females will be considered to be of childbearing potential unless they are postmenopausal (defined as amenorrheic for at least 12 consecutive months, and are postmenopausal without other known or suspected cause), or have been sterilized surgically (i.e., bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at least 1 month before dosing).
9. Excessive caffeine use that in the opinion of the investigator contributes to the participant's insomnia, or habitually consumes caffeine-containing beverages after 18:00 and is unwilling to forego caffeine after 18:00 for the duration of his/her participation in the study.
10. History of drug or alcohol dependency or abuse within approximately the previous 2 years
11. Reports habitually consuming more than 14 drinks containing alcohol per week (females) or more than 21 drinks containing alcohol per week (males), or unwilling to limit alcohol intake to no more than 2 drinks per day or forego having alcohol within the 3 hours before bedtime for the duration of his/her participation in the study
12. Known to be positive for human immunodeficiency virus
13. Active viral hepatitis (B or C) as demonstrated by positive serology at Screening
14. A prolonged QT/QTcF interval (QTcF \>450 milliseconds \[ms\]) as demonstrated by a repeated electrocardiogram (ECG) at Screening (repeated only if initial ECG indicates a QTcF interval \>450 ms)
15. Current evidence of clinically significant disease (e.g., cardiac; respiratory including chronic obstructive pulmonary disease, acute and/or severe respiratory depression; gastrointestinal; severe hepatic impairment; renal including severe renal impairment; neurological including myasthenia gravis; psychiatric disease; or malignancy within the past 5 years other than adequately treated basal cell carcinoma) or chronic pain that in the opinion of the investigator(s) could affect the participant's safety or interfere with the study assessments, including the ability to perform tasks on the cognitive performance assessment battery (PAB). Participants for whom a sedating drug would be contraindicated for safety reasons because of the participant's occupation or activities are also excluded.
16. Comorbid nocturia resulting in frequent need to get out of bed to use the bathroom during the night
17. Any history of a medical or psychiatric condition that in the opinion of the investigator(s) could affect the participant's safety or interfere with the study assessment, including the ability to perform the PAB.
18. Any suicidal ideation with intent with or without a plan, at the time of or within 6 months before the electronic Columbia-Suicide Severity Rating Scale (eC-SSRS) administration during the Prerandomization Phase (i.e., answering "Yes" to questions 4 or 5 on the Suicidal Ideation section of the eC-SSRS)
19. Any suicidal behavior in the past 10 years (per the Suicidal Behavior section of the eC-SSRS)
20. Scheduled for surgery during the study
21. Used any prohibited prescription or over-the-counter concomitant medications within 1 week or 5 half lives, whichever is longer, before the first dose of study medication (Run-in Period).
22. Used any modality of treatment for insomnia, including cognitive behavioral therapy or marijuana within 1 week or 5 half-lives, whichever is longer, before the first dose of study medication (Run-in Period)
23. Failed treatment with suvorexant (Belsomra®) (efficacy and/or safety) following treatment with an appropriate dose and of adequate duration in the opinion of the investigator
24. Transmeridian travel across more than 3 time zones in the 2 weeks before Screening, or between Screening and Baseline, or plans to travel across more than 3 time zones during the study
25. A positive drug test at Screening, Run-In, or Baseline, or unwilling to refrain from use of recreational drugs during the study
26. Hypersensitivity to lemborexant or zolpidem or to their excipients
27. Currently enrolled in another clinical trial or used any investigational drug or device within 30 days or 5× the half-life, whichever is longer preceding informed consent
28. Previously participated in any clinical trial of lemborexant
Minimum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eisai Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Jasper Summit Research LLC

Jasper, Alabama, United States

Site Status

PACT

Glendale, Arizona, United States

Site Status

Preferred Research Partners

Little Rock, Arkansas, United States

Site Status

Carlsbad, California, United States

Site Status

Southern California Research

Fountain Valley, California, United States

Site Status

Pacific Sleep Medicine Services

Oceanside, California, United States

Site Status

Research Center of Southern California

Oceanside, California, United States

Site Status

Orange County Neuropsychiatric Research Center, LLC

Orange, California, United States

Site Status

SDS Clinical Trials, Inc.

Orange, California, United States

Site Status

Artemis Institute For Clinical Research LLC

San Diego, California, United States

Site Status

Pacific Research Network Inc

San Diego, California, United States

Site Status

Artemis Institute For Clinical Research

San Marcos, California, United States

Site Status

Santa Monica Clinical Trials

Santa Monica, California, United States

Site Status

Empire Clinical Research

Upland, California, United States

Site Status

PAB Clinical Research

Brandon, Florida, United States

Site Status

Saint Francis Sleep Allergy and Lung Institute

Clearwater, Florida, United States

Site Status

Fleming Island Center For Clinical Research

Fleming Island, Florida, United States

Site Status

Sarkis Clinical Trials

Gainesville, Florida, United States

Site Status

MD Clinical

Hallandale, Florida, United States

Site Status

QPS MRA

Hollywood, Florida, United States

Site Status

Quest Pharmaceutical Services-Miami Research Associates, LLC (QPS MRA)

Miami, Florida, United States

Site Status

Research Centers of America

Oakland Park, Florida, United States

Site Status

Compass Research LLC

Orlando, Florida, United States

Site Status

NeuroMedical Research Institute

Panama City, Florida, United States

Site Status

Clinical Research Group of St Petersburg Inc

St. Petersburg, Florida, United States

Site Status

NeuroTrials Research Inc.

Atlanta, Georgia, United States

Site Status

SleepCare Research Institute Inc

Stockbridge, Georgia, United States

Site Status

Northwestern University

Chicago, Illinois, United States

Site Status

Chicago Research Center Inc

Chicago, Illinois, United States

Site Status

Helene A Emsellem MD PC

Chevy Chase, Maryland, United States

Site Status

Sleep Disorders Center of the Mid-Atlantic

Glen Burnie, Maryland, United States

Site Status

Neurocare Inc

Newton, Massachusetts, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Henry Ford Hospital

Novi, Michigan, United States

Site Status

Clinical Neurophysiology Services

Sterling Heights, Michigan, United States

Site Status

St. Louis Clinical Trials

St Louis, Missouri, United States

Site Status

Clayton Sleep Institute

St Louis, Missouri, United States

Site Status

Clinical Research Center of Nevada

Las Vegas, Nevada, United States

Site Status

Hassman Research Institute

Berlin, New Jersey, United States

Site Status

CLINiLABS, Inc.

Eatontown, New Jersey, United States

Site Status

Winthrop University Hospital

Garden City, New York, United States

Site Status

Clinical Research Unit

New York, New York, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

Richmond Behavioral Associates

Staten Island, New York, United States

Site Status

Sleep Medicine Centers of Western New York

West Seneca, New York, United States

Site Status

Wake Research Associates, LLC

Raleigh, North Carolina, United States

Site Status

Wilmington Health Associates

Wilmington, North Carolina, United States

Site Status

Cincinnati, Ohio, United States

Site Status

Intrepid Research

Cincinnati, Ohio, United States

Site Status

CTI Clinical Research Center

Cincinnati, Ohio, United States

Site Status

Ohio Sleep Medicine Institute

Dublin, Ohio, United States

Site Status

Cleveland Sleep Research Center

Middleburg Heights, Ohio, United States

Site Status

Lynn Health Science Institute

Oklahoma City, Oklahoma, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Medical University of South Carolina - PPDS

Charleston, South Carolina, United States

Site Status

Sleepmed of South Carolina

Columbia, South Carolina, United States

Site Status

Pioneer Research Solutions

Houston, Texas, United States

Site Status

Sleep Disorders Center of the Mid-Atlantic

Vienna, Virginia, United States

Site Status

Seattle, Washington, United States

Site Status

Swedish Medical Center

Seattle, Washington, United States

Site Status

Sleep and Fatigue Institute

Calgary, Alberta, Canada

Site Status

Medical Arts Health Research Group

Kelowna, British Columbia, Canada

Site Status

Markham, Ontario, Canada

Site Status

Somni Research Inc.

Markham, Ontario, Canada

Site Status

Tri Hospital Sleep West

Mississauga, Ontario, Canada

Site Status

Sleep Wake Disorders Clinic

Scarborough Village, Ontario, Canada

Site Status

Toronto, Ontario, Canada

Site Status

Toronto Sleep Institute

Toronto, Ontario, Canada

Site Status

Centre Hospitalier Universitaire de Bordeaux, Hopital Pellegrin

Bordeaux, , France

Site Status

Hopital Gabriel Montpied

Clermont-Ferrand, , France

Site Status

CHU Dijon Bourgogne

Dijon, , France

Site Status

Hôtel Dieu de Paris Hospital

Paris, , France

Site Status

Hopital Civil

Strasbourg, , France

Site Status

Zentralinstitut für Seelische Gesundheit

Mannheim, Baden-Wurttemberg, Germany

Site Status

Universitätsklinikum Schleswig-Holstein

Lübeck, Schleswig-Holstein, Germany

Site Status

Advanced Sleep Research GmbH

Berlin, , Germany

Site Status

Emovis GmbH

Berlin, , Germany

Site Status

Studienzentrum Wilhelmshöhe

Kassel, , Germany

Site Status

Klinikum rechts der Isar der Technischen Universität München

München, , Germany

Site Status

Universitätsklinikum Münster

Münster, , Germany

Site Status

Somni Bene Institut für Medizinische Forschung und Schlafmedizin Schwerin GmbH

Schwerin, , Germany

Site Status

Ospedale Bellaria

Bologna, Emilia-Romagna, Italy

Site Status

Ospedale San Raffaele S.r.l. - PPDS

Milan, Lombardy, Italy

Site Status

Azienda Ospedaliero Universitaria di Parma

Parma, , Italy

Site Status

ASST di Pavia - Fondazione Istituto Neurologico Mondino IRCCS

Pavia, , Italy

Site Status

Azienda Ospedaliero Universitaria Pisana

Pisa, , Italy

Site Status

Fondazione PTV Policlinico Tor Vergata

Roma, , Italy

Site Status

Azienda Ospedaliera Città della Salute e della Scienza di Torino

Torino, , Italy

Site Status

Clinica Universidad de Navarra

Pamplona, Navarre, Spain

Site Status

Hospital San Rafael

A Coruña, , Spain

Site Status

Hospital Clinic de Barcelona

Badalona, , Spain

Site Status

Barcelona, , Spain

Site Status

Clinica del Son Estivill

Barcelona, , Spain

Site Status

Hospital de La Santa Creu i Sant Pau

Barcelona, , Spain

Site Status

Hospital Universitario Fundacion Jimenez Diaz

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Instituto de Investigaciones del Sueño

Madrid, , Spain

Site Status

Hospital Universitario Araba - Txagorritxu

Vitoria-Gasteiz, , Spain

Site Status

Papworth Hospital

Cambridge, Cambridge Shire, United Kingdom

Site Status

University of Surrey

Guildford, Surrey, United Kingdom

Site Status

Guys Hospital

London, , United Kingdom

Site Status

Royal Stoke University Hospital

Stoke-on-Trent, , United Kingdom

Site Status

Countries

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United States Canada France Germany Italy Spain United Kingdom

References

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Kushida CA, Zammit GK, Cheng JY, Kumar D, Moline M. Effect of lemborexant on sleep architecture in participants with insomnia disorder and mild obstructive sleep apnea. Sleep Med. 2025 Mar;127:170-177. doi: 10.1016/j.sleep.2024.12.023. Epub 2024 Dec 17.

Reference Type DERIVED
PMID: 39879708 (View on PubMed)

Gotfried MH, Auerbach SH, Dang-Vu TT, Mishima K, Kumar D, Moline M, Malhotra M. Efficacy and safety of insomnia treatment with lemborexant in older adults: analyses from three clinical trials. Drugs Aging. 2024 Sep;41(9):741-752. doi: 10.1007/s40266-024-01135-8. Epub 2024 Aug 9.

Reference Type DERIVED
PMID: 39120786 (View on PubMed)

Citrome L, Juday TR, Lundwall C. Lemborexant and Daridorexant for the Treatment of Insomnia: An Indirect Comparison Using Number Needed to Treat, Number Needed to Harm, and Likelihood to Be Helped or Harmed. J Clin Psychiatry. 2023 Oct 2;84(6):23m14851. doi: 10.4088/JCP.23m14851.

Reference Type DERIVED
PMID: 37796657 (View on PubMed)

Inoue Y, Nishida M, Kubota N, Koebis M, Taninaga T, Muramoto K, Ishikawa K, Moline M. Comparison of the treatment effectiveness between lemborexant and zolpidem tartrate extended-release for insomnia disorder subtypes defined based on polysomnographic findings. J Clin Sleep Med. 2023 Mar 1;19(3):519-528. doi: 10.5664/jcsm.10378.

Reference Type DERIVED
PMID: 36472134 (View on PubMed)

Chepke C, Jain R, Rosenberg R, Moline M, Yardley J, Pinner K, Kumar D, Perdomo C, Filippov G, Atkins N, Malhotra M. Improvement in fatigue and sleep measures with the dual orexin receptor antagonist lemborexant in adults with insomnia disorder. Postgrad Med. 2022 Apr;134(3):316-325. doi: 10.1080/00325481.2022.2049553. Epub 2022 Mar 20.

Reference Type DERIVED
PMID: 35254948 (View on PubMed)

Citrome L, Juday T, Frech F, Atkins N Jr. Lemborexant for the Treatment of Insomnia: Direct and Indirect Comparisons With Other Hypnotics Using Number Needed to Treat, Number Needed to Harm, and Likelihood to Be Helped or Harmed. J Clin Psychiatry. 2021 Jun 1;82:20m13795. doi: 10.4088/JCP.20m13795.

Reference Type DERIVED
PMID: 34077032 (View on PubMed)

Moline M, Zammit G, Cheng JY, Perdomo C, Kumar D, Mayleben D. Comparison of the effect of lemborexant with placebo and zolpidem tartrate extended release on sleep architecture in older adults with insomnia disorder. J Clin Sleep Med. 2021 Jun 1;17(6):1167-1174. doi: 10.5664/jcsm.9150.

Reference Type DERIVED
PMID: 33590823 (View on PubMed)

Rosenberg R, Murphy P, Zammit G, Mayleben D, Kumar D, Dhadda S, Filippov G, LoPresti A, Moline M. Comparison of Lemborexant With Placebo and Zolpidem Tartrate Extended Release for the Treatment of Older Adults With Insomnia Disorder: A Phase 3 Randomized Clinical Trial. JAMA Netw Open. 2019 Dec 2;2(12):e1918254. doi: 10.1001/jamanetworkopen.2019.18254.

Reference Type DERIVED
PMID: 31880796 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2015-004347-39

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

E2006-G000-304

Identifier Type: -

Identifier Source: org_study_id

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