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| Name | Class |
|---|---|
| Clinilabs, Inc. | OTHER |
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The purpose of this study is to evaluate the effect of a combination drug product containing diphenhydramine, zolpidem and lorazepam on total sleep time. Participants will be adults who sometimes have difficulty falling asleep or staying asleep, but who do not have chronic insomnia. The study involves 3 one-night stays in a sleep center in New York City.
The purpose of this study is to evaluate the effect of a combination drug product containing 50 mg diphenhydramine, 5 mg zolpidem and 0.5 mg lorazepam on total sleep time, and to determine the contribution of diphenhydramine to the combination, using a 5-hour Phase Advance model of sleep challenge. This is a 3-arm cross-over study; each participant will receive 3 single-dose treatments on consecutive visits. The 3 arms are: investigational combination product, placebo, and a 2-drug comparator containing the zolpidem and lorazepam components but not diphenhydramine. Participants will be adults who sometimes have difficulty falling asleep or staying asleep, but who are generally healthy and do not have chronic insomnia or sleep apnea.
A total of 39 subjects are being recruited. Subjects who qualify for participation will be asked to keep a sleep diary to document their sleep times leading up to and during the study, and will be asked to spend 7-8 hours in bed at a regular bedtime during the study. Qualifying participants also will not anticipate significant disruptions in their sleep schedules, for example by traveling across timezones or changing shifts at work, during the study. The study requires 3 one-night stays in a sleep center in New York City, for administration of the study treatments and EEG measurements. Qualifying subjects will anticipate being able to return to the sleep center, located in Manhattan, for a total of 4 visits, including initial screening and 3 treatment times.
During each sleep center visit, subjects will be given their study treatment and be put to bed 5 hours before their usual bedtime, and sleep time will be monitored for 8 hours. Each subject will receive all 3 treatments, although the sequence of the 3 treatments will be randomized. Both subjects and study personnel monitoring the subjects will be blinded to the identity of the treatment administered at each visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental | SM-1 |
|
| Comparator | Active Comparator | 2-drug combination |
|
| Placebo | Placebo Comparator | Placebo |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SM-1 | Drug | 3-drug combination product containing 50 mg diphenhydramine, 5 mg zolpidem and 0.5 mg lorazepam |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total Sleep Time | 8 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Latency to Persistent Sleep | Time it takes to fall asleep | 8 hours |
| Awakenings | 8 hours | |
| Latency to REM Sleep Onset |
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Inclusion Criteria:
Body mass index (BMI) between 19 and 32 kg/m2, inclusive;
Report occasional difficulty falling asleep or staying asleep;
Report a regular, habitual bedtime between 21:00 and 24:00, routinely spend at least 7.5 and no more than 9.0 hours in bed each night and observe a bedtime that does not vary by more than 2 hours over the course of the week. Subjects will be required to complete at least 5 days of sleep information in a diary provided at the screening visit and returned to study personnel no later than 24 hours prior to check-in for the first overnight visit.
Be in good general health as determined by a thorough medical history and physical examination including vital signs and clinical laboratory tests;
Females of childbearing potential must be using an acceptable method of contraception, have a negative serum pregnancy test at screening and have a negative urine pregnancy test before randomization and prior to each Treatment Period. Acceptable methods of contraception include oral, intrauterine and injectable contraceptives or double barrier methods. After screening, subjects using oral contraceptives must agree to add a double barrier method until 30 days following the last dose of study medication. Female subjects relying on oral contraceptives must have been using them for at least one month prior to screening;
Female subjects who have been surgically sterilized are eligible if they have a negative serum pregnancy test at screening and negative urine pregnancy test at check-in for Visits 2 and 3, or are post-menopausal as defined by the cessation of menses for a period of at least 2 years prior to screening or have had a complete hysterectomy;
Male subjects must use an acceptable method of contraception during the course of the study and for the 30 days following the last dose of study medication. Acceptable methods of contraception include:
i. Vasectomy for more than 6 months. ii. Female partner who meets one of the following conditions:
Be able to read, understand, and provide written/dated informed consent before enrolling in the study and must be willing to comply with all study procedures;
Be willing and able to be confined to the clinical research site for one night in each of 3 treatment periods as required by the protocol.
Refrain from alcohol on PSG days;
On the days of check-in for each of the study's two treatment periods, refrain from the use of alcohol and from napping, defined as any sleep episode occurring outside of the subject's main sleep episode of the day;
Report a recent history of napping of no more than once per week.
An Epworth Sleepiness Scale score ≤8 at screening.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Thomas Dahl, PhD | Sequential Medicine Ltd | Study Director |
| Maha Ahamad, MD | Clinilabs, Inc. | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31837050 | Derived | Dahl T, Chen LB, Zammit G, Ahmad M, Roth T. Efficacy of SM-1 in a transient insomnia model. Hum Psychopharmacol. 2019 Nov;34(6):e2713. doi: 10.1002/hup.2713. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Experimental: SM-1 Then Comparator Then Placebo | Subjects received a single dose of SM-1 followed by a 5-16 day washout. They the received a single dose of Comparator followed by a 5-16 day washout. They then received a single dose of Placebo. |
| FG001 | Experimental: Comparator Then Placebo Then SM-1 | Subjects received a single dose of Comparator followed by a 5-16 day washout. They the received a single dose of Placebo followed by a 5-16 day washout. They then received a single dose of SM-1. |
| FG002 | Experimental: Placebo Then SM-1 Then Comparator | Subjects received a single dose of Placebo followed by a 5-16 day washout. They the received a single dose of SM-1 followed by a 5-16 day washout. They then received a single dose of Comparator. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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|
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| ID | Title | Description |
|---|---|---|
| BG000 | All Study Participants | All study participants regardless of randomization sequence. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Total Sleep Time | Posted | Mean | Standard Deviation | minutes | 8 hours |
|
Entire study, up to 7 days after the last treatment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Treatment | SM-1 SM-1: 3-drug combination product containing 50 mg diphenhydramine, 5 mg zolpidem and 0.5 mg lorazepam |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | MedDRA 18.1 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Head of Product Development | Sequential Medicine Ltd | 617-818-2735 | tadahl@outlook.com |
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| ID | Term |
|---|---|
| D020447 | Parasomnias |
| ID | Term |
|---|---|
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D001523 | Mental Disorders |
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| Comparator | Drug | 2-drug combination comprised of 5 mg zolpidem and 0.5 mg lorazepam |
|
| Placebo | Drug | Placebo |
|
Time required to achieve REM sleep |
| 8 hours |
| Adverse Events | Safety and tolerability assessed in terms of the incidence of AEs | 8 hours |
| Safety and Tolerability in Terms of Residual Sleepiness | Karolinska Sleepiness Scale. This is a 9-point scale with values ranging from 1 (extremely alert) to 9 (extremely sleepy). Lower scores indicate less residual sleepiness. | 8 hours |
| Safety and Tolerability in Terms of Residual Sleepiness | Digit Symbol Substitution Test. The test score is number of correct answers in 90 seconds. Higher scores indicate favorable response (i.e., less residual sleepiness). The duration of the challenge is the 90 second time limit; there is no theoretical maximum score to attain. | 8 hours |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|---|
| Participants |
|
|
| Secondary | Latency to Persistent Sleep | Time it takes to fall asleep | Posted | Mean | Standard Deviation | minutes | 8 hours |
|
|
|
| Secondary | Awakenings | Posted | Mean | Standard Deviation | Awakenings | 8 hours |
|
|
|
| Secondary | Latency to REM Sleep Onset | Time required to achieve REM sleep | Posted | Mean | Standard Deviation | minutes | 8 hours |
|
|
|
| Secondary | Adverse Events | Safety and tolerability assessed in terms of the incidence of AEs | Posted | Number | Number of Events | 8 hours |
|
|
|
| Secondary | Safety and Tolerability in Terms of Residual Sleepiness | Karolinska Sleepiness Scale. This is a 9-point scale with values ranging from 1 (extremely alert) to 9 (extremely sleepy). Lower scores indicate less residual sleepiness. | Posted | Mean | Standard Deviation | Units on a scale | 8 hours |
|
|
|
| Secondary | Safety and Tolerability in Terms of Residual Sleepiness | Digit Symbol Substitution Test. The test score is number of correct answers in 90 seconds. Higher scores indicate favorable response (i.e., less residual sleepiness). The duration of the challenge is the 90 second time limit; there is no theoretical maximum score to attain. | Posted | Mean | Standard Deviation | Correct answers | 8 hours |
|
|
|
| 0 |
| 39 |
| 0 |
| 39 |
| 2 |
| 39 |
| EG001 | Comparator | 2-drug combination Comparator: 2-drug combination comprised of 5 mg zolpidem and 0.5 mg lorazepam | 0 | 39 | 0 | 39 | 3 | 39 |
| EG002 | Placebo | Placebo Placebo: Placebo | 0 | 39 | 0 | 39 | 3 | 39 |
| Initial Insomnia | Psychiatric disorders | MedDRA 18.1 | Non-systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA 18.1 | Non-systematic Assessment |
|
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