Clinical trial • Phase III • Neurology

TASIMELTEON for Delayed Sleep-Wake Phase Disorder (DSWPD)

Phase III trial of TASIMELTEON for Delayed Sleep-Wake Phase Disorder (DSWPD).

Overview

Trial Therapeutic Area
Neurology
Trial Disease
Delayed Sleep-Wake Phase Disorder (DSWPD)
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
17-10-2024
First CTIS Authorization Date
13-11-2024

Trial design

Randomised, open-label, placebo (matching tasimelteon in size and appearance), administered orally once daily (matching schedule to tasimelteon: single oral dose given 60 minutes (±5 min) prior to bedtime); randomized 1:1 versus 20 mg tasimelteon.-controlled Phase III trial in Germany, Austria.

Randomised
Yes
Open Label
Yes
Comparator
Placebo (matching tasimelteon in size and appearance), administered orally once daily (matching schedule to tasimelteon: single oral dose given 60 minutes (±5 min) prior to bedtime); randomized 1:1 versus 20 mg tasimelteon.
Target Sample Size
42
Trial Duration For Participant
56

Eligibility

Recruits 42 Vulnerable population selected (isVulnerablePopulationSelected = true). Participants must have the ability and acceptance to provide written informed consent. Age inclusion is 18–75 years inclusive (no minors); subject information and informed consent forms are provided (documents titled L1_SIS and ICF Main available in English and German). No assent procedures for minors are described (only adult participants included)..

Pregnancy Exclusion
Pregnancy, recent pregnancy (within 6 weeks of the screening visit), or females who are breastfeeding.
Vulnerable Population
Vulnerable population selected (isVulnerablePopulationSelected = true). Participants must have the ability and acceptance to provide written informed consent. Age inclusion is 18–75 years inclusive (no minors); subject information and informed consent forms are provided (documents titled L1_SIS and ICF Main available in English and German). No assent procedures for minors are described (only adult participants included).

Inclusion criteria

  • {"criterion_text":"- Ability and acceptance to provide written informed consent.\n- Must have a reported sleep onset of 00:00 or later by daily sleep diary, on at least 5 of the 7 days per screening week.\n- Must have 80% compliance for daily sleep diary completion, throughout screening.\n- Must maintain an actual bedtime ± 15 minutes from the desired bedtime by daily sleep diary, on at least 5 of the 7 days during the run-in.\n- Must have a reported sleep onset of ≥ 2 hours from the desired bedtime by daily sleep diary, on at least 5 of the 7 days during the run-in.\n- A confirmed clinical diagnosis of DSWPD, as per International Classification of Sleep Disorders-3 (ICSD-3).\n- Males or females between 18 – 75 years, inclusive.\n- Body Mass Index (BMI) of ≥ 18 and ≤ 35 kg/m2 (BMI = weight (kg)/[height (m)]2).\n- Males, non-fecund females (i.e., surgically sterilized, if procedure was done 6 months before screening or participant is postmenopausal for at least 2 years), or females of childbearing potential using an acceptable method of birth control (abstinence, the use of 2 independent barrier methods, hormonal contraception plus 1 barrier method, or surgically sterilized partner) for a period of 35 days before the first dosing, and agree to continue using these methods during the study, and for one month after the last dose. Women of Childbearing Potential (WOCBP) must also have a negative pregnancy test at V1, V2, and V3.\n- In good health as determined by a medical history, physical examination, electrocardiogram (ECG), serum chemistry and hematology, and urinalysis.\n- Willing to comply with study procedures and restrictions with fixed sleep time during the study and to attend regularly scheduled clinic visits as specified in the protocol.\n- Must have a desired bedtime at least 2 hours earlier than the habitual sleep onset (determined by the DSPD Screening Questionnaire). There must be at least a 2 hour difference between the reported sleep onset, by daily sleep diary, and the desired bedtime (determined by the DSPD Screening Questionnaire), on at least 5 of the 7 days per screening week.\n- Must have a sleep onset of 00:00 or later (determined by the DSPD Screening Questionnaire)."}

Exclusion criteria

  • {"criterion_text":"- Current clinically significant cardiovascular, respiratory, neurologic, hepatic, hematopoietic, renal, gastrointestinal, or metabolic dysfunction unless currently controlled and stable.\n- Recent history of pulmonary embolism/deep vein thrombosis (DVT) or short-term blood thinner treatment as an outpatient (i.e., Coumadin, Lovenox, Heparin), one year prior to the screening visit.\n- Recent history or family history of thrombosis or hypercoagulable state (i.e., Factor V Leiden, Factor VIII deficiency, Protein C & S deficiency), one year prior to the screening visit.\n- Pregnancy, recent pregnancy (within 6 weeks of the screening visit), or females who are breastfeeding.\n- History of restless leg syndrome, sleep apnea, or periodic limb movement disorder and/or have current diagnosis as confirmed by the screening visit.\n- History or evidence of sleep apnea as determined by a high-risk score in any two of the three categories in The Berlin Questionnaire (TBQ), unless ruled out by a recent sleep study for sleep apnea.\n- History of drug or alcohol abuse as defined in DSM-V, Diagnostic Criteria for Drug and Alcohol Abuse, within the 12 months prior to screening and/or regular consumption of alcoholic drinks (> 2 drinks/day or > 14 drinks/week).\n- A positive test for substances of abuse at the screening visit, V2, or V3.\n- Traveled more than 3 time zones 2 weeks prior to the screening visit.\n- Traveled outside the origination time zone within 1 week before the screening period and until the end of the treatment period.\n- Worked regular night shifts in the 2 months leading up to the screening visit.\n- Acute exacerbation of an existing psychiatric comorbid condition that requires change in treatment or intervention in the 3 months prior to the screening visit.\n- Randomization in a previous tasimelteon (VEC-162 or BMS-214778) trial.\n- Use of any investigational drug, including placebo, any central nervous system medication (unless on a chronic, stable dose of the medication), or any other prescription or over-the-counter (OTC) medication that affects the sleep-wake cycle within 3 weeks or 5 half-lives (whichever is longer) of the screening visit.\n- Participant is at risk of suicide, in the opinion of the Investigator. Evidence of suicide risk could include any suicide attempt or any other suicidal behavior within 12 months of the screening visit or any suicidal ideation of type 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) at V1, V2, or V3.\n- Unwilling or unable to follow the medication restrictions, or unwilling or unable to sufficiently washout from use of a restricted medication.\n- Use of melatonin or melatonin agonist within 3 weeks of the screening visit.\n- Have a reported change of ≥ 2 hours from the average reported sleep onset from screening by daily sleep diary, during the run-in.\n- Any other sound medical reason as determined by the Investigator.\n- History of intolerance and/or hypersensitivity to melatonin or melatonin agonists.\n- Indication of impaired liver function (values for enzymes aspartate transaminase (AST) and alanine transaminase (ALT) or bilirubin > 2 times the Upper Limit of Normal).\n- Clinically significant deviation from normal in clinical laboratory results, vital sign measurements, or physical examination findings as determined by the Investigator.\n- Major surgery, trauma (including broken pelvis/legs), illness (i.e., sepsis, stroke), general anesthesia, or immobility for 3 or more days within 30 days of the screening visit.\n- Current tobacco user or quit using tobacco within 30 days of the screening visit.\n- Active cancer or cancer treatment within 6 months of the screening visit.\n- Central venous catheter in place or within 30 days of the screening visit."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- To assess the effects of a daily single oral dose of 20 mg tasimelteon compared to placebo on Sleep Onset (change from baseline) in participants over a 28-day period, as measured by sleep diary.","definition_or_measurement_approach":"Change from baseline in Sleep Onset over a 28-day period, measured by sleep diary."}

Secondary endpoints

  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon compared to placebo on Sleep Onset (change from baseline) during the treatment phase, as measured by actigraphy.","definition_or_measurement_approach":"Change from baseline in Sleep Onset during the treatment phase, measured by actigraphy."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon compared to placebo on nighttime subjective sleep parameters such as SOL, wake time, midpoint of sleep, and total sleep time (change from baseline), as measured by sleep diary.","definition_or_measurement_approach":"Change from baseline in subjective nighttime sleep parameters (SOL, wake time, midpoint of sleep, total sleep time), measured by sleep diary."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon compared to placebo on nighttime objective sleep parameters such as SOL, wake time, midpoint of sleep, and total sleep time (change from baseline), as measured by actigraphy.","definition_or_measurement_approach":"Change from baseline in objective nighttime sleep parameters (SOL, wake time, midpoint of sleep, total sleep time), measured by actigraphy."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon compared to placebo on subjective sleep-related impairments and subjective sleep disturbances, as measured by PROMIS.","definition_or_measurement_approach":"Subjective sleep-related impairments and disturbances measured using PROMIS instruments."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon compared to placebo on global improvement and severity, as measured by CGI-C, PGI-C, and PGI-S.","definition_or_measurement_approach":"Global improvement and severity measured by CGI-C, PGI-C, and PGI-S scales."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon compared to placebo on the change in circadian phase from baseline to post-treatment, as measured by salivary DLMO.","definition_or_measurement_approach":"Change in circadian phase from baseline to post-treatment measured by salivary Dim Light Melatonin Onset (DLMO)."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon on Sleep Onset (change from baseline) in participants with delayed DLMO compared to participants with non-delayed DLMO, as measured by sleep diary.","definition_or_measurement_approach":"Subgroup comparison of change from baseline in Sleep Onset between participants with delayed vs non-delayed DLMO, measured by sleep diary."}
  • {"endpoint_text":"- To assess the effects of 20 mg tasimelteon on Sleep Onset (change from baseline) in participants with PER3 rs57875989 (specifically genotype 4/4 and 4/4+4/5), as measured by sleep diary.","definition_or_measurement_approach":"Subgroup analysis of change from baseline in Sleep Onset in participants with specified PER3 rs57875989 genotypes, measured by sleep diary."}
  • {"endpoint_text":"- To assess the safety and tolerability of a daily single oral dose of 20 mg tasimelteon.","definition_or_measurement_approach":"Safety and tolerability assessments per protocol (adverse events, labs, vitals, ECGs) during treatment."}

Recruitment

Digital Remote Recruitment
Yes
Planned Sample Size
42
Recruitment Window Months
42
Consent Approach
Written informed consent is required from each participant (principal inclusion criterion: ability and acceptance to provide written informed consent). Subject information and informed consent forms (L1_SIS and ICF Main) are provided; versions exist in English and German and country-specific ICFs are present for Austria and Germany. Participants are adults (18–75); no assent procedures for minors are described.

Methods

  • Website landing page / recruitment webpage (documents: K2_Recruitment material_DE_307_DSWPD Landing Page_DE; K2_Recruitment material_DE 307_DSWPD Landing Page Short_DE) — Germany.
  • Website advertisement / advertisement text for website (document: K2_Recruitment material_DE_304 Lederer_Adverstisement_text_website_DE) — Germany.
  • General Practitioner letter (documents: K2_Recruitment material_DE_General Practitioner Letter_DE; K2_Recruitment material_AT_General Practitioner Letter_DE) — used for outreach to physicians in Germany and Austria.
  • Patient letter and patient-facing materials (documents: K2_Recruitment material_DE_307_DSWPD Patient Letter_DE; various patient-facing PDFs) — Germany.
  • Printed materials/flyers and advertisements (documents: K2_Recruitment material_DE_306_Benes_Anzeige DSPS_DE; K2_Recruitment material_DE 307_DSWPD Flyer Short_DE) — Germany.
  • Recruitment arrangements documents (K1_Recruitment Arrangements_DE_EN and K1_Recruitment Arrangements_AT) describing country-specific recruitment approaches for Germany and Austria.

Geography

Total Number Of Sites
6
Total Number Of Participants
28

Germany

Earliest CTIS Part Ii Submission Date
04-11-2024
Latest Decision Or Authorization Date
09-02-2026
Processing Time Days
462
Number Of Sites
4
Number Of Participants
20

Sites

Site Name
Universitaetsklinikum Giessen und Marburg GmbH
Department Name
Klinik für Innere Medizin mit Schwerpunkt Pneumologie, Schlafmedizinisches Zentrum
Contact Person Name
Christian Viniol
Site Name
Advanced Sleep Research GmbH
Department Name
Not applicable
Contact Person Name
Katharina Lederer
Site Name
Klinische Forschung Hamburg GmbH
Department Name
Not applicable
Contact Person Name
Christian Deckert
Contact Person Email
deckert@kfgn.de
Site Name
Somni bene Institut fuer medizinische Forschung und Schlafmedizin Schwerin GmbH
Department Name
Not applicable
Contact Person Name
Heike Beneš
Contact Person Email
heike.benes@somnibene.de

Austria

Earliest CTIS Part Ii Submission Date
04-11-2024
Latest Decision Or Authorization Date
16-02-2026
Processing Time Days
469
Number Of Sites
2
Number Of Participants
8

Sites

Site Name
Universitaet Wien
Department Name
Department of Neurology
Contact Person Name
Karin Trimmel
Contact Person Email
karin.trimmel@meduniwien.ac.at
Site Name
Medizinische Universitaet Innsbruck
Department Name
Department of Neurology
Contact Person Name
Birgit Högl
Contact Person Email
birgit.ho@i-med.ac.at

Sponsor

Primary sponsor

Full Name
Vanda Pharmaceuticals Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
QPS LLC
Responsibilities
Sponsor duties listed with codes 1,12,5,8; contact Kevin.Vernarec@qps.com

Third parties

  • {"country":"United States","full_name":"QPS LLC","duties_or_roles":"Codes: 1,12,5,8 (as listed in sponsorDuties)","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
HETLIOZ 20 mg hard capsules
Active Substance
TASIMELTEON
Modality
Small molecule
Routes Of Administration
Oral
Route
Oral
Authorisation Status
Marketing authorisation EU/1/15/1008/001
Starting Dose
20 mg
Dose Levels
20 mg
Frequency
Once daily (single oral dose daily, 60 minutes (±5 min) prior to bedtime)
Maximum Dose
20 mg (max daily dose)
Investigational Product Name
Placebo will be provided in size and appearance identical to those containing tasimelteon and will be administered orally.
Modality
Other
Routes Of Administration
Oral
Route
Oral
Frequency
Once daily (matching tasimelteon schedule)

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