Trial Outcomes & Findings for Study to Evaluate the Respiratory Safety of Lemborexant in Adult and Elderly Healthy Subjects and Adult and Elderly Subjects With Mild Obstructive Sleep Apnea (NCT NCT03471871)

NCT ID: NCT03471871

Last Updated: 2020-02-17

Results Overview

SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry. TST was defined as the total time asleep in minutes using polysomnography (PSG).

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

146 participants

Primary outcome timeframe

Day 1

Results posted on

2020-02-17

Participant Flow

Participants took part in the study at 8 investigative sites in the United States from February 21, 2018 to August 3, 2018.

In healthy volunteer (HV) cohort, 39 participants were screened and enrolled, of which 22 were screen failures, 17 were randomized to receive treatment. In obstructive sleep apnea (OSA) cohort, 107 participants were screened and enrolled, of which 68 were screen failures, 39 were randomized to receive treatment. Total participants enrolled=146

Participant milestones

Participant milestones
Measure
HV Cohort,Sequence A:Placebo,Lemborexant 10mg,Lemborexant 25mg
Eligible healthy adult and elderly participants received lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 1, followed by lemborexant 10 mg (milligram) (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 2, and then lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 3. A washout period of 14 days was maintained between each treatment period.
HV Cohort,Sequence B:Lemborexant 10mg,Lemborexant 25mg,Placebo
Eligible healthy adult and elderly participants received lemborexant 10 mg (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 1, followed by lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 2, and then lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 3. A washout period of 14 days was maintained between each treatment period.
HV Cohort,Sequence C:Lemborexant 25mg,Placebo,Lemborexant 10mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 1, followed by lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 2, and then lemborexant 10 mg (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 3. A washout period of 14 days was maintained between each treatment period.
OSA Cohort, Sequence D: Placebo, Lemborexant 10mg
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 of Treatment Period 1, followed by one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 of Treatment Period 2. A washout period of 14 days was maintained between each treatment period.
OSA Cohort, Sequence E: Lemborexant 10mg, Placebo
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once in the evening of Day 1 through Day 8 of Treatment Period 1, followed by one lemborexant-matched placebo, tablet, orally, once, in the evening of Day 1 through Day 8 of Treatment Period 2. A washout period of 14 days was maintained between each treatment period.
Treatment Period 1(HV:1 Day, OSA:8 Days)
STARTED
6
5
6
19
20
Treatment Period 1(HV:1 Day, OSA:8 Days)
Treated
6
5
6
18
20
Treatment Period 1(HV:1 Day, OSA:8 Days)
COMPLETED
6
5
5
18
19
Treatment Period 1(HV:1 Day, OSA:8 Days)
NOT COMPLETED
0
0
1
1
1
Washout Period 1 (14 Days)
STARTED
6
5
5
18
19
Washout Period 1 (14 Days)
COMPLETED
6
5
5
18
19
Washout Period 1 (14 Days)
NOT COMPLETED
0
0
0
0
0
Treatment Period 2(HV:1 Day, OSA:8 Days)
STARTED
6
5
5
18
19
Treatment Period 2(HV:1 Day, OSA:8 Days)
COMPLETED
6
5
5
18
18
Treatment Period 2(HV:1 Day, OSA:8 Days)
NOT COMPLETED
0
0
0
0
1
Washout Period 2 (14 Days)
STARTED
6
5
5
0
0
Washout Period 2 (14 Days)
COMPLETED
6
5
5
0
0
Washout Period 2 (14 Days)
NOT COMPLETED
0
0
0
0
0
Treatment Period 3: ( HV:1 Day)
STARTED
6
5
5
0
0
Treatment Period 3: ( HV:1 Day)
COMPLETED
6
5
5
0
0
Treatment Period 3: ( HV:1 Day)
NOT COMPLETED
0
0
0
0
0
Follow Up (14 Days for Both HV and OSA)
STARTED
6
5
5
18
18
Follow Up (14 Days for Both HV and OSA)
COMPLETED
6
5
5
17
17
Follow Up (14 Days for Both HV and OSA)
NOT COMPLETED
0
0
0
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
HV Cohort,Sequence A:Placebo,Lemborexant 10mg,Lemborexant 25mg
Eligible healthy adult and elderly participants received lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 1, followed by lemborexant 10 mg (milligram) (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 2, and then lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 3. A washout period of 14 days was maintained between each treatment period.
HV Cohort,Sequence B:Lemborexant 10mg,Lemborexant 25mg,Placebo
Eligible healthy adult and elderly participants received lemborexant 10 mg (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 1, followed by lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 2, and then lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 3. A washout period of 14 days was maintained between each treatment period.
HV Cohort,Sequence C:Lemborexant 25mg,Placebo,Lemborexant 10mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 1, followed by lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 2, and then lemborexant 10 mg (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 of Treatment Period 3. A washout period of 14 days was maintained between each treatment period.
OSA Cohort, Sequence D: Placebo, Lemborexant 10mg
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 of Treatment Period 1, followed by one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 of Treatment Period 2. A washout period of 14 days was maintained between each treatment period.
OSA Cohort, Sequence E: Lemborexant 10mg, Placebo
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once in the evening of Day 1 through Day 8 of Treatment Period 1, followed by one lemborexant-matched placebo, tablet, orally, once, in the evening of Day 1 through Day 8 of Treatment Period 2. A washout period of 14 days was maintained between each treatment period.
Treatment Period 1(HV:1 Day, OSA:8 Days)
Work Demand: Return to work
0
0
1
0
0
Treatment Period 1(HV:1 Day, OSA:8 Days)
Protocol deviation
0
0
0
1
1
Treatment Period 2(HV:1 Day, OSA:8 Days)
Other
0
0
0
0
1
Follow Up (14 Days for Both HV and OSA)
Protocol Deviation
0
0
0
0
1
Follow Up (14 Days for Both HV and OSA)
Did Return to Clinic
0
0
0
1
0

Baseline Characteristics

Study to Evaluate the Respiratory Safety of Lemborexant in Adult and Elderly Healthy Subjects and Adult and Elderly Subjects With Mild Obstructive Sleep Apnea

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
HV Cohort
n=17 Participants
Eligible healthy adult and elderly participants received lemborexant-matched placebo (3 placebo tablets), lemborexant 10 mg (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]) or lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3. A washout period of 14 days was maintained between each treatment period.
OSA Cohort
n=39 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo or one lemborexant 10 mg, tablets, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2. A washout period of 14 days was maintained between each treatment period.
Total
n=56 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
10 Participants
n=93 Participants
26 Participants
n=4 Participants
36 Participants
n=27 Participants
Age, Categorical
>=65 years
7 Participants
n=93 Participants
13 Participants
n=4 Participants
20 Participants
n=27 Participants
Sex: Female, Male
Female
12 Participants
n=93 Participants
24 Participants
n=4 Participants
36 Participants
n=27 Participants
Sex: Female, Male
Male
5 Participants
n=93 Participants
15 Participants
n=4 Participants
20 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=93 Participants
16 Participants
n=4 Participants
17 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
16 Participants
n=93 Participants
23 Participants
n=4 Participants
39 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
8 Participants
n=93 Participants
3 Participants
n=4 Participants
11 Participants
n=27 Participants
Race (NIH/OMB)
White
9 Participants
n=93 Participants
35 Participants
n=4 Participants
44 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants

PRIMARY outcome

Timeframe: Day 1

Population: Pharmacodynamic (PD) analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter.

SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry. TST was defined as the total time asleep in minutes using polysomnography (PSG).

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
n=16 Participants
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
HV Cohort: Peripheral Oxygen Saturation (SpO2) During Total Sleep Time (TST) on Day 1 of Treatment
95.34 percentage of oxygen saturation
Standard Deviation 0.900
95.00 percentage of oxygen saturation
Standard Deviation 1.283
95.07 percentage of oxygen saturation
Standard Deviation 1.311

PRIMARY outcome

Timeframe: Day 8

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter. Here, overall number of participants analyzed signifies participants who were evaluable for this outcome measure.

The AHI is the number of apneas and hypopneas per hour of sleep. AHI less than 5 is considered normal. An AHI from 5 to 14 denotes mild sleep apnea, 15 to 30 is moderate, while a greater than 30 AHI is considered severe.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=35 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
OSA Cohort: Apnea-Hypopnea Index (AHI) on Day 8 of Treatment
10.03 events (apnea plus hyponea) per hour
Standard Deviation 6.799
9.99 events (apnea plus hyponea) per hour
Standard Deviation 5.878

SECONDARY outcome

Timeframe: Day 1

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter.

The AHI is the number of apneas and hypopneas per hour of sleep. AHI less than 5 is considered normal. An AHI from 5 to 14 denotes mild sleep apnea, 15 to 30 is moderate, while a greater than 30 AHI is considered severe.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
n=16 Participants
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
HV Cohort: AHI on Day 1 of Treatment
4.69 events (apnea plus hyponea) per hour
Standard Deviation 8.183
5.29 events (apnea plus hyponea) per hour
Standard Deviation 10.484
3.55 events (apnea plus hyponea) per hour
Standard Deviation 6.585

SECONDARY outcome

Timeframe: Day 1

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter. Here, overall number of participants analyzed signifies participants who were evaluable for this outcome measure.

The AHI is the number of apneas and hypopneas per hour of sleep. AHI less than 5 is considered normal. An AHI from 5 to 14 denotes mild sleep apnea, 15 to 30 is moderate, while a greater than 30 AHI is considered severe.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=36 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
OSA Cohort: AHI on Day 1 of Treatment
10.24 events (apnea plus hyponea) per hour
Standard Deviation 7.094
10.29 events (apnea plus hyponea) per hour
Standard Deviation 6.681

SECONDARY outcome

Timeframe: Day 1

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter.

TST was defined as the total time asleep in minutes using PSG. SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
n=16 Participants
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
HV Cohort: Percentage of TST During Which SpO2 Was Less Than (<) 90 Percent (%), 85 % and 80 % on Day 1 of Treatment
SpO2 <90%
0.037 percentage of TST
Standard Deviation 0.0968
0.224 percentage of TST
Standard Deviation 0.3755
0.287 percentage of TST
Standard Deviation 0.5555
HV Cohort: Percentage of TST During Which SpO2 Was Less Than (<) 90 Percent (%), 85 % and 80 % on Day 1 of Treatment
SpO2 <85%
0 percentage of TST
Standard Deviation 0
0.004 percentage of TST
Standard Deviation 0.0109
0.047 percentage of TST
Standard Deviation 0.1516
HV Cohort: Percentage of TST During Which SpO2 Was Less Than (<) 90 Percent (%), 85 % and 80 % on Day 1 of Treatment
SpO2 <80%
0 percentage of TST
Standard Deviation 0
0.001 percentage of TST
Standard Deviation 0.0034
0.003 percentage of TST
Standard Deviation 0.0077

SECONDARY outcome

Timeframe: Day 1

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter.

SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry. TST was defined as the total time asleep in minutes using PSG.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=16 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
n=16 Participants
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
HV Cohort: Percentage of Participants With at Least One Incident of SpO2 <90% for at Least 30 Seconds During TST on Day 1 of Treatment
31.3 percentage of participant
31.3 percentage of participant
37.5 percentage of participant

SECONDARY outcome

Timeframe: Day 1 and Day 8

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter. Here, 'number analyzed' signifies participants who were evaluable for analysis at the specified timepoints.

SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry. TST was defined as the total time asleep in minutes using PSG.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
OSA Cohort: SpO2 During TST on Day 1 and Day 8 of Treatment
Day 1
94.53 percentage of oxygen saturation
Standard Deviation 1.620
94.54 percentage of oxygen saturation
Standard Deviation 1.470
OSA Cohort: SpO2 During TST on Day 1 and Day 8 of Treatment
Day 8
94.46 percentage of oxygen saturation
Standard Deviation 1.316
94.65 percentage of oxygen saturation
Standard Deviation 1.539

SECONDARY outcome

Timeframe: Day 1 and Day 8

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter. Here, 'number analyzed' signifies participants who were evaluable for analysis at the specified timepoints.

TST was defined as the total time asleep in minutes using PSG. SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
OSA Cohort: Percentage of TST During Which the SpO2 is <90%, 85% and 80 % on Day 1 and Day 8 of Treatment
Day 8: SpO2 <90%
1.011 percentage of TST
Standard Deviation 1.4210
1.102 percentage of TST
Standard Deviation 1.5469
OSA Cohort: Percentage of TST During Which the SpO2 is <90%, 85% and 80 % on Day 1 and Day 8 of Treatment
Day 1: SpO2 <90%
1.044 percentage of TST
Standard Deviation 1.8851
1.362 percentage of TST
Standard Deviation 2.6170
OSA Cohort: Percentage of TST During Which the SpO2 is <90%, 85% and 80 % on Day 1 and Day 8 of Treatment
Day 1: SpO2 <85%
0.104 percentage of TST
Standard Deviation 0.3043
0.170 percentage of TST
Standard Deviation 0.5132
OSA Cohort: Percentage of TST During Which the SpO2 is <90%, 85% and 80 % on Day 1 and Day 8 of Treatment
Day 1: SpO2 <80%
0.012 percentage of TST
Standard Deviation 0.0483
0.014 percentage of TST
Standard Deviation 0.0433
OSA Cohort: Percentage of TST During Which the SpO2 is <90%, 85% and 80 % on Day 1 and Day 8 of Treatment
Day 8: SpO2 <85%
0.109 percentage of TST
Standard Deviation 0.2974
0.162 percentage of TST
Standard Deviation 0.4350
OSA Cohort: Percentage of TST During Which the SpO2 is <90%, 85% and 80 % on Day 1 and Day 8 of Treatment
Day 8: SpO2 <80%
0.009 percentage of TST
Standard Deviation 0.0366
0.015 percentage of TST
Standard Deviation 0.0603

SECONDARY outcome

Timeframe: Day 1 and Day 8

Population: PD analysis set included group of participants who received at least 1 dose of study drug in each treatment periods and who had sufficient PD data to derive at least 1 primary PD parameter.

SpO2 is an estimate of the amount of oxygen in the blood. It is the percentage of hemoglobin containing oxygen compared to the total amount of hemoglobin in the blood (that is, oxygenated hemoglobin versus oxygenated and non-oxygenated hemoglobin). SpO2 was monitored by noninvasive method known as transmissive pulse oximetry. TST was defined as the total time asleep in minutes using PSG.

Outcome measures

Outcome measures
Measure
OSA Cohort: Placebo
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=37 Participants
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
HV Cohort: Lemborexant 25 mg
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
OSA Cohort: Percentage of Participants With at Least One Incident of SpO2 <90% for at Least 30 Seconds During TST on Day 1 and Day 8 of Treatment
Day 1: SpO2 <90%
67.6 percentage of participant
75.7 percentage of participant
OSA Cohort: Percentage of Participants With at Least One Incident of SpO2 <90% for at Least 30 Seconds During TST on Day 1 and Day 8 of Treatment
Day 8: SpO2 <90%
75.7 percentage of participant
83.8 percentage of participant

Adverse Events

HV Cohort: Placebo

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

HV Cohort: Lemborexant 10 mg

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

HV Cohort: Lemborexant 25 mg

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

OSA Cohort: Placebo

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

OSA Cohort: Lemborexant 10 mg

Serious events: 0 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
HV Cohort: Placebo
n=16 participants at risk
Eligible healthy adult and elderly participants received lemborexant-matched placebo (3 placebo tablets), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
HV Cohort: Lemborexant 10 mg
n=16 participants at risk
Eligible healthy adult and elderly participants received lemborexant 10 mg (1 lemborexant 10 mg tablet and 2 matching placebo tablets \[to maintain blind\]), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
HV Cohort: Lemborexant 25 mg
n=17 participants at risk
Eligible healthy adult and elderly participants received lemborexant 25 mg (2 lemborexant 10 mg tablets and 1 lemborexant 5 mg tablet), orally, once, in the evening (within 5 minutes of lights off) of Day 1 in the respective Treatment Period 1, 2 or 3.
OSA Cohort: Placebo
n=38 participants at risk
Eligible adult and elderly participants with mild OSA received one lemborexant-matched placebo, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
OSA Cohort: Lemborexant 10 mg
n=38 participants at risk
Eligible adult and elderly participants with mild OSA received one lemborexant 10 mg, tablet, orally, once, in the evening (within 5 minutes of lights off) of Day 1 through Day 8 in the respective Treatment Period 1 or 2.
Eye disorders
Photopsia
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.9%
1/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Immune system disorders
Seasonal allergy
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.9%
1/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.9%
1/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Musculoskeletal and connective tissue disorders
Muscular weakness
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.9%
1/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Nervous system disorders
Dizziness
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.9%
1/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Nervous system disorders
Somnolence
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
6.2%
1/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.9%
1/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
5.3%
2/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Respiratory, thoracic and mediastinal disorders
Rhinitis allergic
6.2%
1/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Gastrointestinal disorders
Abdominal pain upper
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Gastrointestinal disorders
Haemorrhoids
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
General disorders
Asthenia
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Infections and infestations
Nasopharyngitis
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Infections and infestations
Vaginal infection
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Nervous system disorders
Headache
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Reproductive system and breast disorders
Endometriosis
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
Vascular disorders
Hypertension
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/16 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/17 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
2.6%
1/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.
0.00%
0/38 • Baseline up to end of follow up visit (up to 67 days)
Safety analysis set included group of participants who received study drug and had at least 1 postdose safety assessment.

Additional Information

Eisai Medical Information

Eisai Inc.

Phone: +1-888-274-2378

Results disclosure agreements

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