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Efficacy and Safety of Suvorexant (MK-4305) for Reducing Incidence of Delirium in Japanese Participants at High Risk of Delirium (MK-4305-085)

Phase 3
Completed
Conditions
Delirium
Interventions
Drug: Placebo
Registration Number
NCT04571944
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

The goal of this study is to evaluate the efficacy and safety of suvorexant (MK-4305) for reducing the incidence of delirium in Japanese participants who are at high risk of delirium. The primary hypothesis is that suvorexant reduces the proportion of participants with delirium compared with placebo as assessed by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
207
Inclusion Criteria
  • Is hospitalized for (1) acute disease with severe disease state or decreased daily living function or (2) elective surgery requiring general anesthesia scheduled on the day after or 2 days after admission/Day 1
  • Has (1) mild cognitive impairment or mild dementia and/or (2) a history of delirium in any prior hospitalization
  • Requires hospitalization for 6 days for acute disease, with treatment starting on day of admission; or 7 days, with treatment starting the day after admission OR
  • Requires hospitalization for 6 days for elective surgery scheduled on the day after admission; or for 7 days for elective surgery scheduled 2 days after admission
  • Is able to take study medications orally
Exclusion Criteria
  • Has moderate or severe dementia
  • Has a history of epilepsy or Parkinson's disease
  • Currently uses psychotropic agents or has a mental condition including schizophrenia, other mental disorders, bipolar disorder and major depression
  • Has a history of drug or alcohol abuse in the 5 years prior to start of study or has alcoholic disease such as alcoholic liver disease or gastritis alcoholic
  • Has a history of narcolepsy or cataplexy
  • Has used hypnotics, antipsychotics, mood stabilizers, antidepressants, anxiolytics, psychostimulants, anticonvulsants or tiapride within 2 weeks prior to randomization
  • Has delirium as assessed by DSM-5 or DRS-R-98 (total score ≥14.5) before the first dose of study medication

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants will receive suvorexant-matching placebo orally QD for 5 to 7 days.
SuvorexantSuvorexantParticipants will receive 15 mg of suvorexant orally once daily (QD) for 5 to 7 days.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Delirium as Assessed by Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) CriteriaUp to ~8 days

The DSM-5 is the gold standard for the diagnosis of delirium. DSM-5 criteria were used for clinician assessment of delirium. The percentage of participants with delirium per DSM-5 criteria is presented.

Number of Participants Who Discontinued Study Treatment Due to an AEUp to ~7 days

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinued study treatment due to an AE is presented.

Number of Participants Who Experienced One or More Adverse Events (AEs)Up to ~21 days

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experienced one or more AEs is presented.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Delirium as Assessed by DRS-R-98Up to ~8 days

DRS-R-98 is a diagnostic and assessment tool used for the evaluation of delirium. It is a 16-item clinician-rated scale with 13 items measuring delirium severity and 3 diagnostic items. The total DRS-R-98 score can range from 0 (lowest) to 46 (highest). Higher scores indicate worsening or more severe delirium. Optimized cutoff score for delirium diagnosis in Japanese-translated DRS-R-98 has been determined as ≥14.5. The percentage of participants with delirium as assessed by DRS-R-98, defined as the percentage of participants with total score ≥14.5 per DRS-R-98, is presented.

Maximum Daily Total Score on Delirium Rating Scale-Revised-98 (DRS-R-98)Up to ~8 days

DRS-R-98 is a diagnostic and assessment tool used for evaluation of delirium. It is a 16-item clinician-rated scale with 13 items measuring delirium severity and 3 diagnostic items. The total DRS-R-98 score can range from 0 (lowest) to 46 (highest). Higher scores indicate worsening or more severe delirium. The maximum daily total score on DRS-R-98 is presented.

Trial Locations

Locations (50)

Kanazawa Medical University Hospital ( Site 8514)

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Kahoku-gun, Ishikawa, Japan

Nippon Medical School Musashi Kosugi Hospital ( Site 8502)

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Kawasaki, Kanagawa, Japan

Tonan Hospital ( Site 8512)

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Sapporo, Hokkaido, Japan

National Hospital Organization Maizuru Medical Center ( Site 8535)

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Maizuru-shi, Kyoto, Japan

Niigata City General Hospital ( Site 8544)

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Niigata, Japan

Nippon Life Hospital ( Site 8552)

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Osaka, Japan

National Hospital Organization Tokyo Medical Center ( Site 8529)

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Tokyo, Japan

Tokyo Women's Medical University Hospital ( Site 8527)

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Tokyo, Japan

Maebashi Red Cross Hospital ( Site 8548)

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Maebashi, Gunma, Japan

Fukuyama City Hospital ( Site 8528)

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Fukuyama, Hiroshima, Japan

Kansai Rosai Hospital ( Site 8550)

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Amagasaki, Hyogo, Japan

Kagawa University Hospital ( Site 8519)

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Kita-gun, Kagawa, Japan

Kamitsuga General Hospital ( Site 8546)

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Kanuma, Tochigi, Japan

Jichi Medical University Hospital ( Site 8525)

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Shimotsuke, Tochigi, Japan

National Hospital Organization Kumamoto Medical Center ( Site 8511)

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Kumamoto, Japan

Okayama University Hospital ( Site 8510)

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Okayama, Japan

Osaka City General Hospital ( Site 8518)

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Osaka, Japan

National Hospital Organization Osaka National Hospital ( Site 8536)

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Osaka, Japan

Osaka General Medical Center ( Site 8538)

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Osaka, Japan

Tokushima Prefectural Central Hospital ( Site 8509)

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Tokushima, Japan

National Cancer Center Hospital ( Site 8520)

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Tokyo, Japan

Kyoto Katsura Hospital ( Site 8539)

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Kyoto, Japan

Saiseikai Yokohamashi Nanbu Hospital ( Site 8541)

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Yokohama, Kanagawa, Japan

Miyazaki Prefectural Miyazaki Hospital ( Site 8543)

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Miyazaki, Japan

Okayama Saiseikai General Hospital ( Site 8549)

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Okayama, Japan

Tokyo Medical and Dental University Hospital ( Site 8503)

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Tokyo, Japan

Iizuka Hospital ( Site 8540)

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Iizuka, Fukuoka, Japan

Showa University Northern Yokohama Hospital ( Site 8534)

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Yokohama, Kanagawa, Japan

Yokohama City University Hospital ( Site 8515)

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Yokohama, Kanagawa, Japan

Toyonaka Municipal Hospital ( Site 8521)

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Toyonaka, Osaka, Japan

Gifu Municipal Hospital ( Site 8555)

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Gifu, Japan

Juntendo University Nerima Hospital ( Site 8501)

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Tokyo, Japan

Kohnodai Hospital, National Center for Global Health and Medicine ( Site 8522)

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Ichikawa, Chiba, Japan

Yokohama City University Medical Center ( Site 8516)

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Yokohama, Kanagawa, Japan

Aizawa Hospital ( Site 8542)

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Matsumoto, Nagano, Japan

Matsushita Memorial Hospital ( Site 8556)

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Moriguchi, Osaka, Japan

Yamaguchi University Hospital ( Site 8517)

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Ube, Yamaguchi, Japan

National Hospital Organization Kyushu Medical Center ( Site 8532)

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Fukuoka, Japan

National Hospital Organization Kanazawa Medical Center ( Site 8554)

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Kanazawa, Ishikawa, Japan

Osaka University Hospital ( Site 8524)

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Suita, Osaka, Japan

SANO KOSEI GENERAL HOSPITAL ( Site 8551)

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Sano, Tochigi, Japan

Hiroshima City Hiroshima Citizens Hospital ( Site 8505)

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Hiroshima, Japan

Japanese Red Cross Kyoto Daini Hospital ( Site 8533)

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Kyoto, Japan

Saga-Ken Medical Centre Koseikan ( Site 8526)

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Saga, Japan

Kokura Memorial Hospital ( Site 8537)

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Kitakyushu, Fukuoka, Japan

TAKAMATSU Red Cross Hospital ( Site 8547)

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Takamatsu, Kagawa, Japan

National Hospital Organization Yokohama Medical Center ( Site 8531)

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Yokohama, Kanagawa, Japan

Shimane Prefectural Central Hospital ( Site 8530)

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Izumo, Shimane, Japan

Japanese Red Cross Osaka Hospital ( Site 8523)

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Osaka, Japan

Japan Community Health care Organization Osaka Hospital ( Site 8545)

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Osaka, Japan

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