MedPath

Efficacy and Tolerability of Armodafinil in Adults With Excessive Sleepiness Associated With Shift Work Disorder

Phase 4
Completed
Conditions
Excessive Sleepiness
Interventions
Drug: Matching Placebo
Registration Number
NCT01080807
Lead Sponsor
Cephalon
Brief Summary

The primary objective of the study is to determine whether armodafinil treatment is more effective than placebo treatment in patients with excessive sleepiness associated with shift work disorder (SWD) by measuring improved clinical condition late in the shift, including the commute home.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
385
Inclusion Criteria
  1. The patient currently meets the criteria for Shift Work Disorder (SWD) for duration of at least 1 month.
  2. The patient has the presence of excessive sleepiness late in the shift, including the commute home if applicable, with a Clinical Global Impression of Severity of Illness (CGI-S) rating of 4 or more at screening.
  3. The patient has clinically significant difficulty in social or occupational functioning, with a Global Assessment of Function (GAF) score less than 70 (on clinician interview) at screening.
  4. The patient has a Karolinska Sleepiness Scale (KSS) score of 6 or more at screening (visit 1) that is confirmed at baseline (visit 2).
  5. The patient works at least 5 night shifts per month, of which at least 3 nights are consecutive, and plans to maintain this schedule.
  6. The patient works night shifts or rotating shifts that include at least 6 hours between 2200 and 0800 (including the time period 0400 to 0800), and shifts are no longer than 12 hours in duration.
  7. The patient is in good health, as judged by the investigator.
  8. The patient is able to complete self-rating scales.
  9. Women of childbearing potential (not surgically sterile or 2 years postmenopausal), must use a medically accepted method of contraception, and must continue use of 1 of these methods for the duration of the study (and for 30 days after participation in the study). Acceptable methods of contraception include: abstinence, barrier method with spermicide, steroidal contraceptive (oral, transdermal, implanted, and injected) in conjunction with a barrier method, or intrauterine device (IUD).
  10. The patient is willing and able to comply with study restrictions and to attend regularly scheduled clinic visits as specified in this protocol
Exclusion Criteria
  1. The patient has mild or more severe obstructive sleep apnea (OSA) defined as an apnea/hypopnea index more than 5 as determined by daytime polysomnography (PSG).
  2. The patient has a medical or psychiatric disorder causing clinically significant functional impairment or contributing to the patient's excessive sleepiness.
  3. The patient is currently taking a medication or substance that is causing clinically significant functional impairment or contributing to the patient's excessive sleepiness.
  4. The patient has a clinically significant treated or untreated medical condition.
  5. The patient has a history of clinically significant suicidal ideation in the judgment of the principal investigator or is currently suicidal based on medical and psychiatric history.
  6. The patient has a known hypersensitivity to armodafinil, racemic modafinil, or any component of the study drug tablets.
  7. The patient has a history of any clinically significant cutaneous drug reaction, or a history of clinically significant hypersensitivity reaction, including multiple allergies or drug reactions.
  8. The patient consumes caffeine including coffee, tea and/or other caffeine containing beverages or food averaging more than 600 mg of caffeine per day within 7 days of the baseline visit.
  9. The patient uses any prescription or over-the-counter (OTC) drugs disallowed by the protocol within 30 days of the baseline visit.
  10. The patient has been in a prior armodafinil study.
  11. The patient has a history of alcohol, narcotic, or any other drug abuse.
  12. The patient has a positive urine drug screen (UDS) without medical explanation at the screening visit.
  13. The patient has a clinically significant deviation from normal on physical examination.
  14. The patient is a pregnant or lactating woman.
  15. The patient has used an investigational drug within 1 month of the screening visit.
  16. The patient has a disorder that could interfere with the absorption, distribution, metabolism, or excretion of the investigational product.
  17. The patient needs to use any of the excluded medications in this protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
150 mg/day armodafinilArmodafinil-
Matching placeboMatching Placebo-
Primary Outcome Measures
NameTimeMethod
Percentage of Patients With at Least Minimal Improvement From Baseline in the Clinical Global Impression of Change (CGI-C) Rating as Related to Late Shift Sleepiness at EndpointBaseline and week 6 (or last observation after baseline)

The Clinical Global Impression of Change (CGI-C) is an assessment performed by the clinician, evaluating the change in the patient's symptoms over time. The clinician categorizes the change as: very much improved, much improved, minimally improved, no change, minimally worse, much worse, or very much worse. The data presented here represents the percentage of patients whose condition showed at least minimal improvement in the CGI-C rating as related to late shift sleepiness (defined as the period 0400-0800, including the commute home).

Secondary Outcome Measures
NameTimeMethod
Change From Baseline to Endpoint in Global Assessment of Function (GAF) ScoreBaseline and week 6 (or last observation after baseline)

The Global Assessment of Functioning (GAF) is a numeric scale (0 through 100) used by the clinician to rate the social, occupational, and psychological functioning of the patient. A higher score indicates superior functioning and fewer symptoms. The data presented here represents the mean change from baseline to endpoint in the GAF scores of each group.

Change From Baseline to Week 3 in Global Assessment of FunctioningBaseline and Week 3

The Global Assessment of Functioning (GAF) is a numeric scale (0 through 100) used by the clinician to rate the social, occupational, and psychological functioning of the patient. A higher score indicates superior functioning and fewer symptoms. The data presented here represents the mean change from baseline in the GAF scores of each group.

Change From Baseline to Week 6 in Global Assessment of FunctioningBaseline and Week 6

The Global Assessment of Functioning (GAF) is a numeric scale (0 through 100) used by the clinician to rate the social, occupational, and psychological functioning of the patient. A higher score indicates superior functioning and fewer symptoms. The data presented here represents the mean change from baseline in the GAF scores of each group.

Change From Baseline to Endpoint in the Mean Karolinska Sleepiness Scale (KSS) ScoreBaseline and week 6 (or last observation after baseline)

The Karolinska sleepiness scale is a 10-point scale, on which the participant has to mark his sleepiness during the previous 10 minutes. The scale ranges from 1, which indicates "extremely alert", to 10, which indicates "extremely sleepy, can't stay awake". The KSS was performed by the participant at the baseline visit, week 3, and week 6 (or early termination visit). The score recorded is the average of 3 assessments within ±15 minutes at 0400, 0600, and 0800. The data presented here represents the mean change from baseline in the KSS scores of each group.

Change From Baseline to Week 3 in the Mean Karolinska Sleepiness Scale (KSS) ScoreBaseline and week 3

The Karolinska sleepiness scale is a 10-point scale, on which the participant has to mark his sleepiness during the previous 10 minutes. The scale ranges from 1, which indicates "extremely alert", to 10, which indicates "extremely sleepy, can't stay awake". The KSS was performed by the participant at the baseline visit, week 3, and week 6 (or early termination visit). The score recorded is the average of 3 assessments within ±15 minutes at 0400, 0600, and 0800. The data presented here represents the mean change from baseline in the KSS scores of each group.

Change From Baseline to Week 6 in the Mean Karolinska Sleepiness Scale (KSS) ScoreBaseline and week 6

The Karolinska sleepiness scale is a 10-point scale, on which the participant has to mark his sleepiness during the previous 10 minutes. The scale ranges from 1, which indicates "extremely alert", to 10, which indicates "extremely sleepy, can't stay awake". The KSS was performed by the participant at the baseline visit, week 3, and week 6 (or early termination visit). The score recorded is the average of 3 assessments within ±15 minutes at 0400, 0600, and 0800. The data presented here represents the mean change from baseline in the KSS scores of each group.

Percentage of Patients With at Least Minimal Improvement From Baseline in the Clinical Global Impression of Change (CGI-C) Rating as Related to Late Shift Sleepiness at Week 3Baseline and week 3

The Clinical Global Impression of Change (CGI-C) is an assessment performed by the clinician, evaluating the change in the patient's symptoms over time. The clinician categorizes the change as: very much improved, much improved, minimally improved, no change, minimally worse, much worse, or very much worse. The data presented here represents the percentage of patients whose condition showed at least minimal improvement in the CGI-C rating as related to late shift sleepiness (defined as the period 0400-0800, including the commute home).

Percentage of Patients With at Least Minimal Improvement From Baseline in the Clinical Global Impression of Change (CGI-C) Rating as Related to Late Shift Sleepiness at Week 6Baseline and week 6

The Clinical Global Impression of Change (CGI-C) is an assessment performed by the clinician, evaluating the change in the patient's symptoms over time. The clinician categorizes the change as: very much improved, much improved, minimally improved, no change, minimally worse, much worse, or very much worse. The data presented here represents the percentage of patients whose condition showed at least minimal improvement in the CGI-C rating as related to late shift sleepiness (defined as the period 0400-0800, including the commute home).

Change From Baseline to Endpoint in the Modified Sheehan Disability Scale (MSDS) Composite ScoreBaseline and week 6 (or last observation after baseline)

Mental-health related disability was assessed with the Modified Sheehan Disability Scale (MSDS). The MSDS has three 11-point items, and the participant is asked to rate, on a numerical scale, the extent to which emotional problems have disrupted her/his work, social life, and family life/home responsibilities over the last month. Each item is rated from 0, indicating "not at all", to 10, indicating "extremely". Scores for the items are summed for a possible score of 0 to 30. The MSDS was performed by the patient at the baseline visit, at Week 3, and at Week 6.

Change From Baseline to Endpoint in the Modified Sheehan Disability Scale (MSDS) Work Item ScoreBaseline and week 6 (or last observation after baseline)

Mental-health related disability was assessed with the Modified Sheehan Disability Scale (MSDS). The MSDS has three 11-point items, and the participant is asked to rate, on a numerical scale, the extent to which emotional problems have disrupted her/his work, social life, and family life/home responsibilities over the last month. Each item is rated from 0, indicating "not at all", to 10, indicating "extremely". Scores for the items are summed for a possible score of 0 to 30. The MSDS was performed by the patient at the baseline visit, at Week 3, and at Week 6.

Change From Baseline to Endpoint in the Modified Sheehan Disability Scale (MSDS) Social Life Item ScoreBaseline and week 6 (or last observation (or last observation after baseline))

Mental-health related disability was assessed with the Modified Sheehan Disability Scale (MSDS). The MSDS has three 11-point items, and the participant is asked to rate, on a numerical scale, the extent to which emotional problems have disrupted her/his work, social life, and family life/home responsibilities over the last month. Each item is rated from 0, indicating "not at all", to 10, indicating "extremely". Scores for the items are summed for a possible score of 0 to 30. The MSDS was performed by the patient at the baseline visit, at Week 3, and at Week 6.

Change From Baseline to Endpoint in the Modified Sheehan Disability Scale (MSDS) Family Life Item ScoreBaseline and week 6 (or last observation after baseline)

Mental-health related disability was assessed with the Modified Sheehan Disability Scale (MSDS). The MSDS has three 11-point items, and the participant is asked to rate, on a numerical scale, the extent to which emotional problems have disrupted her/his work, social life, and family life/home responsibilities over the last month. Each item is rated from 0, indicating "not at all", to 10, indicating "extremely". Scores for the items are summed for a possible score of 0 to 30. The MSDS was performed by the patient at the baseline visit, at Week 3, and at Week 6.

Change From Baseline to Endpoint in the Modified Sheehan Disability Scale (MSDS) Score - Days Missed Work or Unable to Carry Out ResponsibilitiesBaseline and week 6 (or last observation after baseline)

Mental-health related disability was assessed with the Modified Sheehan Disability Scale (MSDS). The MSDS has three 11-point items, and the participant is asked to rate, on a numerical scale, the extent to which emotional problems have disrupted her/his work, social life, and family life/home responsibilities over the last month. Each item is rated from 0, indicating "not at all", to 10, indicating "extremely". Scores for the items are summed for a possible score of 0 to 30. The MSDS was performed by the patient at the baseline visit, at Week 3, and at Week 6.

Change From Baseline to Endpoint in the Modified Sheehan Disability Scale (MSDS) Score - Number of Days of Reduced ProductivityBaseline and week 6 (or last observation after baseline)

Mental-health related disability was assessed with the Modified Sheehan Disability Scale (MSDS). The MSDS has three 11-point items, and the participant is asked to rate, on a numerical scale, the extent to which emotional problems have disrupted her/his work, social life, and family life/home responsibilities over the last month. Each item is rated from 0, indicating "not at all", to 10, indicating "extremely". Scores for the items are summed for a possible score of 0 to 30. The MSDS was performed by the patient at the baseline visit, at Week 3, and at Week 6.

Treatment Satisfaction Questionnaire for Medication (TSQM)- Effectiveness Score at EndpointEndpoint

TSQM is a 14 question questionnaire assessing satisfaction with the medication. 4 scales are generated: side effects, effectiveness, convenience, and global satisfaction. Subjects responded to the questionnaire at Week 3, Week 6, and last observation after baseline. Optional responses are: Extremely Dissatisfied, Very Dissatisfied, Dissatisfied, Somewhat Satisfied, Satisfied, Very Satisfied, and Extremely Satisfied. From the responses, a scale score from 0 - 100 is calculated, with a higher score indicating greater satisfaction. Results from the Effectiveness scale are presented here.

Treatment Satisfaction Questionnaire for Medication (TSQM)- Side Effects Score at EndpointEndpoint

TSQM is a 14 question questionnaire assessing satisfaction with the medication. 4 scales are generated: side effects, effectiveness, convenience, and global satisfaction. Subjects responded to the questionnaire at Week 3, Week 6, and last post-baseline observation. Optional responses are: Extremely Dissatisfied, Very Dissatisfied, Dissatisfied, Somewhat Satisfied, Satisfied, Very Satisfied, and Extremely Satisfied. From the responses, a scale score from 0 - 100 is calculated, with a higher score indicating greater satisfaction. Results from the Side Effects scale are presented here.

Treatment Satisfaction Questionnaire for Medication (TSQM)- Convenience Score at EndpointEndpoint

TSQM is a 14 question questionnaire assessing satisfaction with the medication. 4 scales are generated: side effects, effectiveness, convenience, and global satisfaction. Subjects responded to the questionnaire at Week 3, Week 6, and last observation after baseline. Optional responses are: Extremely Dissatisfied, Very Dissatisfied, Dissatisfied, Somewhat Satisfied, Satisfied, Very Satisfied, and Extremely Satisfied. From the responses, a scale score from 0 - 100 is calculated, with a higher score indicating greater satisfaction. Results from the Convenience scale are presented here.

Treatment Satisfaction Questionnaire for Medication (TSQM)- Global Satisfaction Score at EndpointEndpoint

TSQM is a 14 question questionnaire assessing satisfaction with the medication. 4 scales are generated: side effects, effectiveness, convenience, and global satisfaction. Subjects responded to the questionnaire at Week 3, Week 6, and last observation after baseline. Optional responses are: Extremely Dissatisfied, Very Dissatisfied, Dissatisfied, Somewhat Satisfied, Satisfied, Very Satisfied, and Extremely Satisfied. From the responses, a scale score from 0 - 100 is calculated, with a higher score indicating greater satisfaction. Results from the Global Satisfaction scale are presented here.

Change From Baseline to Endpoint in the Functional Outcomes of Sleep Questionnaire (FOSQ-10) Total ScoreBaseline and week 6 (or last observation after baseline)

FOSQ-10 consists of 10 questions, on a scale of 1-4(1=extreme difficulty 4=no difficulty), measures impact of sleepiness on activities of daily living. Lower score = more difficulty with activity due to lack of sleep. Total score = MEAN of subscale scores (vigilance, productivity, social outcome, intimacy, activity) multiplied by 5. Worst total score is 5 (maximum difficulty) the best is 20 (no difficulty). This data reports CHANGE in total score from baseline to endpoint, with higher (positive) values representing improvement. Worst possible CHANGE value would be -15 best would be +15.

Change From Baseline to Endpoint in the Functional Outcomes of Sleep Questionnaire (FOSQ-10) Social OutcomeBaseline and week 6 (or last observation after baseline)

FOSQ-10 consists of 10 questions rated on a scale of 1-4 (1=extreme difficulty, 4=no difficulty), and is used to measure the impact of daytime sleepiness on activities of daily living and quality of life. A total score and 5 subscale (vigilance, general productivity, social outcome, intimacy, and activity level) scores are calculated from the responses. Worst subscale score is 1 (maximum difficulty) and the best score is 4 (no difficulty). This score represents the CHANGE from Baseline in the Social Outcome subscale. Positive change scores represent improvement (possible range -3 to +3).

Change From Baseline to Endpoint in the Functional Outcomes of Sleep Questionnaire (FOSQ-10) Activity Level ScoreBaseline and week 6 (or last observation after baseline)

FOSQ-10 consists of 10 questions rated on a scale of 1 to 4 (1=extreme difficulty and 4=no difficulty), and is used to measure the impact of daytime sleepiness on activities of daily living and quality of life. A total score and 5 subscale (vigilance, general productivity, social outcome, intimacy, and activity level) scores are calculated from the responses. Worst subscale score is 1 (maximum difficulty) and the best score is 4 (no difficulty). This score represents the CHANGE from Baseline in the Activity level subscale. Positive change scores represent improvement (possible range -3 to +3).

Change From Baseline to Endpoint in the Functional Outcomes of Sleep Questionnaire (FOSQ-10) General Productivity ScoreBaseline and week 6 (or last observation after baseline)

FOSQ-10 consists of 10 questions rated on a scale of 1-4 (1=extreme difficulty, 4=no difficulty), and is used to measure the impact of daytime sleepiness on activities of daily living and quality of life. A total score and 5 subscale (vigilance, general productivity, social outcome, intimacy, and activity level) scores are calculated from the responses. Worst subscale score is 1 (maximum difficulty) and the best score is 4 (no difficulty). This score represents the CHANGE from Baseline in the General Productivity subscale. Positive change scores represent improvement (possible range -3 to +3).

Change From Baseline to Endpoint in the Functional Outcomes of Sleep Questionnaire (FOSQ-10) Vigilance ScoreBaseline and week 6 (or last observation after baseline)

FOSQ-10 consists of 10 questions rated on a scale of 1-4 (1=extreme difficulty, 4=no difficulty), and is used to measure the impact of daytime sleepiness on activities of daily living and quality of life. A total score and 5 subscale (vigilance, general productivity, social outcome, intimacy, and activity level) scores are calculated from the responses. Worst subscale score is 1 (maximum difficulty) and the best score is 4 (no difficulty). This score represents the CHANGE from Baseline in the Vigilance subscale. Positive change scores represent improvement (possible range -3 to +3).

Change From Baseline to Endpoint in the Functional Outcomes of Sleep Questionnaire (FOSQ-10) IntimacyBaseline and week 6 (or last observation after baseline)

FOSQ-10 consists of 10 questions rated on a scale of 1-4 (1=extreme difficulty, 4=no difficulty), and is used to measure the impact of daytime sleepiness on activities of daily living and quality of life. A total score and 5 subscale (vigilance, general productivity, social outcome, intimacy, and activity level) scores are calculated from the responses. Worst subscale score is 1 (maximum difficulty) and the best score is 4 (no difficulty). This score represents the CHANGE from Baseline in the Intimacy subscale. Positive change scores represent improvement (possible range -3 to +3).

Trial Locations

Locations (61)

Sleepmed Inc

🇺🇸

Macon, Georgia, United States

Fort Wayne Neurological Center

🇺🇸

Fort Wayne, Indiana, United States

Neurotrials Research Inc

🇺🇸

Atlanta, Georgia, United States

Sleep Disorders Center of Georgia-Peachtree

🇺🇸

Atlanta, Georgia, United States

Vince and Associates Clinical Research

🇺🇸

Overland Park, Kansas, United States

SleepMed of South Carolina

🇺🇸

Columbia, South Carolina, United States

MD Clinical

🇺🇸

Hallandale Beach, Florida, United States

Mid-South Neurology Center

🇺🇸

Germantown, Tennessee, United States

Sleep Health Center

🇺🇸

Brighton, Massachusetts, United States

PAB Clinical Research

🇺🇸

Brandon, Florida, United States

Compass Research LLC

🇺🇸

Orlando, Florida, United States

The Center for Sleep Medicine

🇺🇸

Hattiesburg, Mississippi, United States

Avastra Clinical Trials

🇺🇸

Midvale, Utah, United States

Miami Research Associates

🇺🇸

South Miami, Florida, United States

Broward Research Group

🇺🇸

Pembroke Pines, Florida, United States

Central Arkansas Research

🇺🇸

Hot Springs, Arkansas, United States

REM Medical Sleep Center

🇺🇸

Phoenix, Arizona, United States

Dormir Clinical Trials, Inc.

🇺🇸

San Diego, California, United States

SomnoMedics

🇺🇸

Tampa, Florida, United States

Goldpoint Clinical Research

🇺🇸

Indianapolis, Indiana, United States

Clinical Research Center of Nevada

🇺🇸

Las Vegas, Nevada, United States

Community Research Inc

🇺🇸

Cincinnati, Ohio, United States

Tri State Sleep Disorders Center

🇺🇸

Cincinnati, Ohio, United States

Duke Insomnia & Sleep Research Program

🇺🇸

Durham, North Carolina, United States

Lynn Health Science Institute

🇺🇸

Oklahoma City, Oklahoma, United States

REM Medical Clinical Research

🇺🇸

Tucson, Arizona, United States

Clinical Study Centers LLC

🇺🇸

Little Rock, Arkansas, United States

Peninsula Sleep Center

🇺🇸

Burlingame, California, United States

Southwestern Research Inc

🇺🇸

Santa Ana, California, United States

Pacific Sleep Medicine Services Inc

🇺🇸

Los Angeles, California, United States

Stanford University Medical Center

🇺🇸

Redwood City, California, United States

Pacific Sleep Medicnie Services Inc

🇺🇸

Redlands, California, United States

St Johns Medical Plaza Sleep Disorders Center

🇺🇸

Santa Monica, California, United States

Florida Sleep Institute

🇺🇸

Spring Hill, Florida, United States

Clinical Research Group of St Petersburg

🇺🇸

St Petersburg, Florida, United States

Sleep Disorders Center of Georgia-Gainesville

🇺🇸

Gainesville, Georgia, United States

Chicago Research Center

🇺🇸

Chicago, Illinois, United States

Suburban Lung Associates

🇺🇸

Elk Grove Village, Illinois, United States

The Center for Sleep and Wake Disorders d/b/a Midwest Neuro

🇺🇸

Danville, Indiana, United States

University of Iowa Hospitals

🇺🇸

Iowa City, Iowa, United States

Rehabilitation Associates of Indiana

🇺🇸

Indianapolis, Indiana, United States

Kentucky Research Group

🇺🇸

Louisville, Kentucky, United States

Community Research

🇺🇸

Crestview, Kentucky, United States

Helene A. Emsellem, MD

🇺🇸

Chevy Chase, Maryland, United States

Washington University Sleep Medicine Center

🇺🇸

St Louis, Missouri, United States

Clayton Sleep Institute LLC

🇺🇸

St Louis, Missouri, United States

Somnos Laboratories, Inc d/b/a Somnos Clinical Research

🇺🇸

Lincoln, Nebraska, United States

CliniLabs Inc

🇺🇸

New York, New York, United States

Wake Research Associates

🇺🇸

Raleigh, North Carolina, United States

North Coast Clinical Trials Inc

🇺🇸

Beachwood, Ohio, United States

North Star Medical Research LLC

🇺🇸

Middleburg Heights, Ohio, United States

Mercy St Anne Sleep Disorder Center

🇺🇸

Toledo, Ohio, United States

CRI Worldwide

🇺🇸

Philadelphia, Pennsylvania, United States

Consolidated Clinical Trials

🇺🇸

Jefferson Hills, Pennsylvania, United States

Southeastern PA Medical Institute

🇺🇸

Broomall, Pennsylvania, United States

FutureSearch Trials of Neurology

🇺🇸

Austin, Texas, United States

Sleep Lab of Northeastern PA

🇺🇸

Summit Hill, Pennsylvania, United States

Sleep Therapy and Research Center

🇺🇸

San Antonio, Texas, United States

Kingwood Research Institute

🇺🇸

Kingwood, Texas, United States

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

St Mary's of Michigan

🇺🇸

Saginaw, Michigan, United States

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