Sodium Oxybate in Idiopathic Hypersomnia

NCT ID: NCT03597555

Last Updated: 2023-09-28

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 48 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-10-18
• Study Completion Date: 2023-04-12

Brief Summary

this study evaluates of the efficacy of sodium oxybate on excessive daytime sleepiness using Epworth sleepiness scale over 8 weeks compared to placebo

Detailed Description

Bicentric, randomized, double-blind controlled study Outpatients aged from 18 to 60 years, suffering from current idiopathic hypersomnia (ICSD-3), recruited via medical consultations in the investigation centers Randomization in Xyrem or placebo arms after the inclusion visit,

1.Screening Period (up to 15 days), 2.Titration Period (up to 45 days), 3.Maintenance Period (minimum 15 days), 4.Safety Follow-Up Period (14 days)

Conditions

Idiopathic Hypersomnia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Xyrem

Xyrem (Sodium Oxybate), oral solution 500mg/mL First night after V1: Dose prescribed at 4.5 g per night (2.25 g x 2) for 2 weeks First night after V2: Dose increased to 6 g per night (3 g x 2) for 2 weeks, according to investigator's opinion, tolerance of drug and CGI-S First night after V3: Dose either maintained stable at 6 g or increased to 9 g per night (4.5 g x 2) with dose increments of 1.5 g per night (0.75 g x 2) every week, based on benefit-risk ratio, for 2 weeks.

First night after V4: Dose maintained at 9 g or reduced at 6 g per night according to benefit-risk ratio for 2 weeks. No dose adjustment during the Maintenance period.

First night after V5: Taper period. Dose decrease by 2.25 g x 2 every two days until complete withdrawal

Group Type: EXPERIMENTAL

Sodium Oxybate Oral Solution 500 MG/ML

Intervention Type: DRUG

First night after V1: Dose prescribed at 4.5 g per night (2.25 g x 2) for 2 weeks First night after V2: Dose increased to 6 g per night (3 g x 2) for 2 weeks, according to investigator's opinion, tolerance of drug and CGI-S First night after V3: Dose either maintained stable at 6 g or increased to 9 g per night (4.5 g x 2) with dose increments of 1.5 g per night (0.75 g x 2) every week, based on benefit-risk ratio, for 2 weeks.

First night after V4: Dose maintained at 9 g or reduced at 6 g per night according to benefit-risk ratio for 2 weeks. No dose adjustment during the Maintenance period.

First night after V5: Taper period. Dose decrease by 2.25 g x 2 every two days until complete withdrawal

Placebos

Xyrem Placebo: sodium citrate solution in equimolar concentration of sodium in the 500 mg/mL Xyrem oral solution, PH adjusted with malic acid

Group Type: PLACEBO_COMPARATOR

Placebos

Intervention Type: DRUG

Xyrem Placebo: sodium citrate solution in equimolar concentration of sodium in the 500 mg/mL Xyrem oral solution, PH adjusted with malic acid

Interventions

Sodium Oxybate Oral Solution 500 MG/ML

First night after V1: Dose prescribed at 4.5 g per night (2.25 g x 2) for 2 weeks First night after V2: Dose increased to 6 g per night (3 g x 2) for 2 weeks, according to investigator's opinion, tolerance of drug and CGI-S First night after V3: Dose either maintained stable at 6 g or increased to 9 g per night (4.5 g x 2) with dose increments of 1.5 g per night (0.75 g x 2) every week, based on benefit-risk ratio, for 2 weeks.

First night after V4: Dose maintained at 9 g or reduced at 6 g per night according to benefit-risk ratio for 2 weeks. No dose adjustment during the Maintenance period.

First night after V5: Taper period. Dose decrease by 2.25 g x 2 every two days until complete withdrawal

Intervention Type: DRUG

Placebos

Xyrem Placebo: sodium citrate solution in equimolar concentration of sodium in the 500 mg/mL Xyrem oral solution, PH adjusted with malic acid

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Diagnostic of idiopathic hypersomnia (ICSD-3 criteria)
• Age between 18 and 60 years-old
• BMI between 18 and 35 kg/m2
• MSLT: mean sleep latency (MSL) ≤8 minutes and < 2 SOREMPs, AND/OR total sleep time > 11h/24h on 24-hours long-term polysomnography
• Polysomnography recording: sleep efficiency > 85%, total sleep time ≥6 hours, AHI <10/hour, micro-arousals index <15/hour, PLM index associated with micro-arousals <10/hour.
• Absence of sleep deprivation, assessed by actigraphy or sleep logs
• ESS score ≥14 points
• Written informed consent
• National health insurance cover

Exclusion Criteria

• Current alcohol intake or treatment with modafinil, amphetamine, methylphenidate, mazindol, pitolisant, neuroleptics, sedative hypnotics, barbiturates, general anesthetics, myorelaxants, other CNS depressants, antidepressants*, anxiolytic drugs, anticonvulsive therapy, topiramate, inhibitors of GHB dehydrogenase (i.e. valproate, ethosuximide, phenytoin), budipine, dopamine antagonist antiemetics (except domperidone), opioids, benzodiazepines, Z-drugs, MAO inhibitors, COMT inhibitors, or sedative antihistamines. If patient has received such therapy, a washout-period of at least 15 days, or equivalent to 5 half-lives of the drug, prior to the inclusion in the study is required before starting treatment in this study.

*30 days for antidepressants

• Previous intake of sodium oxybate
• Succinic semialdehyde dehydrogenase deficiency, porphyria
• Other central nervous system diseases: neurodegenerative diseases, seizure disorders or history of head trauma associated with loss of consciousness
• Lifetime history of suicide attempt or suicidal ideation in the past 6 months, prior history of psychotic episodes, current or recent history of a major depressive disorder (DSM-V), Beck depression inventory (BDI) > 16 and/or item G> 0
• History of chronic alcohol or drug abuse within the prior 12 months
• Malignant neoplastic disease requiring therapy within 12 months prior to Visit 1 or clinically relevant
• Heart failure, severe hypertension or other cardiovascular disease compromising the patient's wellbeing or ability to participate in this study
• Renal or hepatic impairment Compromised respiratory function
• Sleep-related breathing disorders (AHI ≥ 10/h)
• No regular sleep at night: shift work or other continuous non-disease-related life conditions
• Participation in another study of an investigational drug within the 28 days prior to Visit 1 or currently
• Hypersensitivity to any of the components of the study medication
• Pregnancy (βHCG positive) and breast-feeding

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University Hospital, Montpellier

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Yves DAUVILLIERS

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Montpellier

Locations

University Hospital of Montpellier

Montpellier, , France

Countries

France

References

Dauvilliers Y, Chenini S, Thobois O, Rassu AL, Denis C, Guiraud L, Jaussent I, Barateau L. Efficacy and Safety of Sodium Oxybate in Adults With Idiopathic Hypersomnia: A Randomized Controlled Trial. Neurology. 2025 Jun 10;104(11):e213690. doi: 10.1212/WNL.0000000000213690. Epub 2025 May 13.

Reference Type: DERIVED

PMID: 40359459 (View on PubMed)

Other Identifiers

RECHMPL17_0375

Identifier Type: -

Identifier Source: org_study_id