Primary ObjectiveTo evaluate the effect of JNJ-42847922 on sleep latency (latency to persistent sleep [LPS]) in MDD subjects, stably treated with an SSRI/SNRI, who suffer from insomnia.Secondary Objectives* To investigate the safety, tolerability,…
ID
Source
Brief title
Condition
- Mood disorders and disturbances NEC
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
- Latency to persistent sleep (minutes)
- Total sleep time (minutes)
- Time spent awake (minutes)
- Sleep efficiency (%)
- Total time spent in Deep sleep (duration of slow wave sleep) (minutes)
Secondary outcome
- PSG secondary endpoints
Time in bed (minutes)
Sleep onset latency (minutes)
Number of awakenings (#)
Time to REM sleep onset (minutes)
Duration of REM sleep (minutes)
Duration of Stage 1 Sleep (minutes)
Duration of stage 2 Sleep (minutes)
Number of REM blocks (#)
- Safety
ECG
Vital signs
Clinical chemistry / hematology
- Depressive symptoms
IDS-SR30
- Suicidal ideation
C-SSRS
- Next day residual effects
VAS Sleepiness
VAS Bond and Lader
Saccadic eye movements
Body Sway
- Cortisol level in saliva
Background summary
Patients with MDD frequently experience sleep disturbances. JNJ-42847922 is an
orexin-2 (ORX2) antagonist that is hypothesized to improve sleep quality
(decrease sleep latency, decrease wake after sleep onset, and increase NREM
sleep) that may have additional benefits on depressive symptoms.
Study objective
Primary Objective
To evaluate the effect of JNJ-42847922 on sleep latency (latency to persistent
sleep [LPS]) in MDD subjects, stably treated with an SSRI/SNRI, who suffer from
insomnia.
Secondary Objectives
* To investigate the safety, tolerability, and pharmacokinetics of JNJ-42847922
in this population
* To explore the effect of JNJ-42847922 on suicidal ideation/behavior
* To evaluate the effect of JNJ-42847922 on other elements of sleep
architecture including total sleep time and sleep efficiency
* To investigate the presence of next-day residual effects of JNJ-42847922
* To explore the effect of JNJ-42847922 on depressive symptoms
* To explore the effect of JNJ-42847922 on the saliva concentrations of
cortisol, a biomarker for stress.
Primair doel
Het evalueren van het effect van JNJ-42847922 op slaaplatentie in patienten met
een depressieve stoornis, die stabiel behandeld worden met een SSR/SNRI en die
lijden aan slapeloosheid.
Secundaire doelen
Study design
This is a 4-way crossover, single dose, double-blind, placebo-controlled study.
Intervention
10, 20, 40 mg JNJ-42847922 or placebo
Study burden and risks
JNJ-42847922 has been administered to humans before in a single ascending dose
study in healthy volunteers. However, this will be the first study in a patient
population. Three single doses of between 10 and 40 mg and placebo will be
tested. Single doses up to 80 mg have proven to be well tolerated (study
42847922EDI1001) in healthy subjects. Latent sedation may occur and the
potential for residual effects will be tested. Subjects will be under constant
supervision while in the clinic. Also, the sponsor will monitor the study site
and records to ensure compliance with the protocol, current ICH guidelines on
Good Clinical Practice (GCP), and applicable regulatory requirements.
Turnhoutseweg 30
Beerse 2340
BE
Turnhoutseweg 30
Beerse 2340
BE
Listed location countries
Age
Inclusion criteria
1. Subjects must be men or women, 18 to 64 years of age, inclusive.
2. Body Mass Index (BMI) between 18 and 30 kg/m2 inclusive (BMI=weight/height2)
3. Subjects must be healthy / medically stable on the basis of clinical laboratory tests
performed at screening. If the results of the serum chemistry panel, hematology, or urinalysis are outside the normal reference ranges, retesting of an abnormal lab value(s) that may lead to exclusion will be allowed once during the screening phase.
-The subject may be included only if the investigator judges the abnormalities or deviations from normal to be not clinically significant or to be appropriate and reasonable for the population under study. This determination must be recorded in the subject's source documents and initialed by the investigator.
4. Population specific:
• Subjects with a current/recurrent or past episode of MDD as established per Mini International Neuropsychiatric Interview (M.I.N.I.) at screening or otherwise specified by the treating physician.
• HAMD17 <= 21 (i.e., subjects with more than moderate depression will be excluded from study participation).
• Stably treated with SSRI/SNRI monotherapy, with no change in dose in the last 30 days before screening.
• Insomnia per PSG (latency to sleep onset > 20 minutes). Sleep onset latency measurements twice obtained during the screening period should be both > 20 min.
5. Before randomization, a woman must be either:
• Not of childbearing potential: postmenopausal (>45 years of age with amenorrhea for at least 12 months, or any age with amenorrhea for at least 6 months and a serum follicle stimulating hormone (FSH) level >40 IU/L); permanently sterilized (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy); or otherwise be incapable of pregnancy
• Of childbearing potential and practicing a highly effective method of birth control consistent with local regulations regarding the use of birth control methods for subjects participating in clinical studies (i.e. one that results in a less than 1% per year failure rate when used consistently and correctly): e.g., established use of oral, injected or implanted hormonal methods of contraception; placement of an intrauterine device (IUD) or intrauterine system (IUS); barrier methods: condom with spermicidal foam/gel/film/cream/suppository or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository; male partner sterilization (the vasectomized partner should be the sole partner for that subject); true abstinence (when this is in line with the preferred and usual lifestyle of the subject). Women must agree to continue using these methods of contraception throughout the study and for at least 3 months after receiving the last dose of study medication.
Note: If the childbearing potential changes after start of the study (e.g., woman who is not heterosexually active becomes active) a woman must begin a highly effective method of birth control, as described above.
6. A woman of childbearing potential must have a negative urine pregnancy test at Screening and predose on Day 1 of each study period.
7. A woman must agree not to donate eggs (ova, oocytes) for the purposes of assisted reproduction during the study and for at least 3 months after receiving the last dose of study drug.
8. A man who is sexually active with a woman of childbearing potential and has not had a vasectomy must agree to use a barrier method of birth control e.g., either condom with spermicidal foam/gel/film/cream/suppository or partner with occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository, and all men must also not donate sperm during the study and for 3 months after receiving the last dose of study drug.
9. Subject must be willing and able to adhere to the prohibitions and restrictions specified in this protocol
10. Each subject must sign an ICF indicating that he or she understands the purpose of and procedures required for the study and are willing to participate in the study. Participation in the pharmacogenomic part of the study is mandatory.
Exclusion criteria
1. Subject has current signs/symptoms of, liver or renal insufficiency; hypothyroidism or hyperthyroidism (a normal thyroid-stimulating hormone [TSH] is required at screening; subjects with hypo- or hyperthyroidism who are on stable treatment with normal TSH may participate), significant cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic, or metabolic disturbances. Subjects with non-insulin dependent diabetes mellitus who are adequately controlled (not on insulin) may participate in the study.
2. Has uncontrolled hypertension (SBP >= 160 mmHg or DBP >= 90 mmHg despite diet, exercise or a stable dose of an allowed anti-hypertensive treatment) at Screening and Day 1 prior to randomization; or any past history of hypertensive crisis.
3. Subject has a history of malignancy within 5 years before screening (exceptions are squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix, or malignancy that in the opinion of the investigator, with concurrence with the sponsor's medical monitor, is considered cured with minimal risk of recurrence).
4. Has a primary Diagnostic and Statistical Manual of Mental Disorders (4th edition) DSM-IV diagnosis of current (active) GAD, panic disorder, OCD, posttraumatic stress disorder (PTSD), anorexia nervosa, or bulimia nervosa. Subjects with primary depression with comorbid anxiety disorder, GAD, or PTSD are not excluded.
5. Has a current diagnosis of a psychotic disorder, MDD with psychosis, bipolar disorder, mental retardation, or cluster B personality disorder (e.g., borderline personality disorders, antisocial personality disorder).
6. Has suicidal ideation with some intent to act, or has homicidal ideation/intent, per Principal Investigator*s clinical judgment.
7. Abnormal day/night rhythm, e.g., nightshift worker, or normal bed time past midnight.
8. Subject has been diagnosed with sleep-related breathing disorder.
9. Subject has received an investigational drug (including investigational vaccines) or used an invasive investigational medical device within 60 days before the planned first dose of study drug, or has participated in 2 or more clinical studies in the previous 1 year, or is currently enrolled in an investigational study.
10. Subject is a man who plans to father a child while enrolled in this study or within 3 months after the last dose of study drug.
11. Subject has a history of hepatitis B surface antigen (HBsAg) or hepatitis C antibody (anti-HCV) positive, or other clinically active liver disease, or tests positive for HBsAg or anti-HCV at Screening.
12. Subject has a history of human immunodeficiency virus (HIV) antibody positive, or tests positive for HIV at Screening.
13. Subject has a history of drug or alcohol abuse or dependence according to DSM-IV criteria, except nicotine or caffeine, within 6 months before Screening.
14. Subject has positive test result(s) for alcohol or drugs of abuse (including barbiturates, methadone, opiates, cocaine, cannabinoids, amphetamine/methamphetamine, and ecstasy) at Screening.
* Subjects with a positive alcohol or drug screen at Screening may have the test repeated once during the screening phase, based on the investigator's discretion. This determination, and the reason for permitting a repeat test, must be recorded in the subject's source documents and initialed by the investigator. A positive, repeat alcohol screen is exclusionary.
15. Use of long acting benzodiazepines from 1 month prior to the first screening PSG until completion of the study (Day 2, Period 4). Occasional use of short- and intermediate-acting acting benzodiazepines as well as short acting hypnotics, such as zolpidem and zopiclon, will be allowed with the exception of the days of the screening PSGs and from Day 1 (admission) to Day 2 (discharge) of each study period (see Attachment 5).
16. Daily use of tricyclic antidepressant or neuroleptic drugs. Occasional low doses of tricyclic antidepressants, quetiapine, trazodone or antihistaminergic drugs will be allowed with the exception of the day of screening PSGs and from Day 1 (admission) to Day 2 (discharge) of each study period (see Attachment 6).
17. Received a known inhibitor of CYP3A activity (e.g., erythromycin, clarithromycin, ketoconazole, itraconazole) within 14 days or a period less than 5-times the drug*s half-life, whichever is longer, before study drug administration on Day 1 of Period 1.
18. Is unwilling or unable to undergo multiple venipunctures because of poor tolerability or lack of easy access.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2013-004335-80-NL |
CCMO | NL47595.056.13 |