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Trial of AD036 in Obstructive Sleep Apnea

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Apnimed

Status and phase

Completed
Phase 2

Conditions

Obstructive Sleep Apnea

Treatments

Drug: AD036 Dose 3
Drug: Placebo
Drug: AD036 Dose 2
Drug: AD036 Dose 1

Study type

Interventional

Funder types

Industry

Identifiers

NCT03845023
APN-002

Details and patient eligibility

About

This is a randomized, double blind, placebo-controlled, repeat-dose, parallel arm, outpatient and inpatient phase 2 clinical study to examine the efficacy and safety of three dose levels of AD036 versus placebo in patients with obstructive sleep apnea.

Full description

This was a randomized, double-blind, placebo-controlled, repeat-dose, parallel arm, outpatient and inpatient, multicenter, dose-finding study of the combination of atomoxetine and oxybutynin in adults with OSA documented by polysomnography (PSG).

Approximately 140 subjects were to be randomized 1:1:1:1 to receive 1 of 3 different fixed-dose combinations of oxybutynin and atomoxetine or matching placebo.

For all subjects, the study consisted of:

  • A screening and baseline period in which subjects' eligibility was determined

  • An initial 2-night, at-home blinded baseline period in which all subjects received placebo

  • A 3-night, run-in period in which subjects received:

    • Low-dose combination for subjects randomized to one of the 3 study treatment arms
    • Placebo for subjects randomized to the placebo treatment arm
  • A 7-night treatment period in which subjects received the treatment to which they were randomized, i.e., 1 of the 3 different fixed-dose combinations of drugs, or placebo

  • An end of study visit

Enrollment

140 patients

Sex

All

Ages

25 to 70 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Male participants between 25 to 65 years of age or female participants between 25 to 70 years of age.

Key Inclusion Criteria:

  • AHI ≥ 20 based on screening polysomnography
  • Epworth Sleepiness Scale (ESS) score ≥ 4 for participants not using CPAP
  • Previous surgical treatment for OSA is allowed if ≥ 1 year prior to enrollment

Key Exclusion Criteria:

  • Clinically significant craniofacial malformation.
  • Clinically significant cardiac disease (e.g., rhythm disturbances, coronary artery disease or cardiac failure) or hypertension requiring more than 2 medications for control.
  • Clinically significant neurological disorder, including epilepsy/convulsions.
  • Positive screen for drugs of abuse or substance use disorder as defined in DSM-V within 24 months prior to Screening Visit.
  • A significant illness or infection requiring medical treatment in the past 30 days.
  • Women who are pregnant or nursing.
  • History of using oral or nasal devices for the treatment of OSA may enroll as long as the devices are not used during participation in the study.
  • History of using devices to affect participant sleeping position for the treatment of OSA, e.g. to discourage supine sleeping position, may enroll as long as the devices are not used during participation in the study.
  • Treatment with strong cytochrome P450 3A4 (CYP3A4) inhibitors, strong cytochrome P450 2D6 (CYP2D6) inhibitors, or monoamine oxidase inhibitors (MAOI) within 14 days of the start of treatment, or concomitant with treatment.
  • Use of another investigational agent within 90 days or 5 half-lives, whichever is longer, prior to dosing.
  • ESS total score > 18.
  • Central apnea index > 5/hour on baseline PSG.
  • Periodic limb movement arousal index >15/hour on baseline PSG.
  • Hepatic transaminases >3X the upper limit of normal (ULN), total bilirubin >2X ULN (unless confirmed Gilbert syndrome), serum creatinine >2X ULN.
  • <6 hours typical sleep duration.
  • Night- or shift-work sleep schedule.
  • Employment as a commercial driver or operator of heavy or hazardous equipment.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Quadruple Blind

140 participants in 4 patient groups, including a placebo group

2-Night at Home
Placebo Comparator group
Description:
An initial 2-night, at-home blinded baseline period in which all subjects received placebo
Treatment:
Drug: Placebo
3-Night Run In
Experimental group
Description:
AD036 Dose 1 (Low Dose: 25/5) or Placebo
Treatment:
Drug: AD036 Dose 1
Drug: Placebo
7-Night
Experimental group
Description:
A 7-night treatment period in which subjects received the treatment to which they were randomized, i.e., 1 of the 3 different fixed-dose combinations of drugs, or placebo
Treatment:
Drug: AD036 Dose 1
Drug: Placebo
Drug: AD036 Dose 2
Drug: AD036 Dose 3
End of Study
No Intervention group
Description:
End of Study Visit

Trial documents
2

Trial contacts and locations

12

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Data sourced from clinicaltrials.gov

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