Trial Outcomes & Findings for Treatment of REM Sleep Behavior Disorder (RBD) With Sodium Oxybate (NCT NCT04006925)
NCT ID: NCT04006925
Last Updated: 2023-05-10
Results Overview
Patients record any episode of dream enactment, such as talking, shouting, kicking, or punching, etc.
COMPLETED
PHASE4
24 participants
Assessed for 28 days at baseline and during last month of treatment (total treatment period of up to 12 weeks)
2023-05-10
Participant Flow
Participant milestones
| Measure |
Sodium Oxybate (SXB) Arm
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Overall Study
STARTED
|
12
|
12
|
|
Overall Study
COMPLETED
|
10
|
12
|
|
Overall Study
NOT COMPLETED
|
2
|
0
|
Reasons for withdrawal
| Measure |
Sodium Oxybate (SXB) Arm
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Overall Study
Side effects
|
2
|
0
|
Baseline Characteristics
Treatment of REM Sleep Behavior Disorder (RBD) With Sodium Oxybate
Baseline characteristics by cohort
| Measure |
Sodium Oxybate (SXB) Arm
n=12 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
Total
n=24 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
66.1 years
STANDARD_DEVIATION 8.2 • n=99 Participants
|
65.4 years
STANDARD_DEVIATION 7.3 • n=107 Participants
|
65.8 years
STANDARD_DEVIATION 7.6 • n=206 Participants
|
|
Sex: Female, Male
Female
|
3 Participants
n=99 Participants
|
3 Participants
n=107 Participants
|
6 Participants
n=206 Participants
|
|
Sex: Female, Male
Male
|
9 Participants
n=99 Participants
|
9 Participants
n=107 Participants
|
18 Participants
n=206 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
12 Participants
n=99 Participants
|
12 Participants
n=107 Participants
|
24 Participants
n=206 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Race (NIH/OMB)
Asian
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Race (NIH/OMB)
Black or African American
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Race (NIH/OMB)
White
|
12 Participants
n=99 Participants
|
12 Participants
n=107 Participants
|
24 Participants
n=206 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
|
Region of Enrollment
United States
|
12 Participants
n=99 Participants
|
12 Participants
n=107 Participants
|
24 Participants
n=206 Participants
|
|
Body Mass Index (BMI)
|
24.4 kg/m^2
STANDARD_DEVIATION 4.7 • n=99 Participants
|
27.0 kg/m^2
STANDARD_DEVIATION 7.6 • n=107 Participants
|
25.7 kg/m^2
STANDARD_DEVIATION 6.3 • n=206 Participants
|
|
RBD Symptom Duration
|
11.2 years
STANDARD_DEVIATION 6.9 • n=99 Participants
|
8.4 years
STANDARD_DEVIATION 4.3 • n=107 Participants
|
9.8 years
STANDARD_DEVIATION 5.8 • n=206 Participants
|
|
History of Injuries
|
10 Participants
n=99 Participants
|
12 Participants
n=107 Participants
|
22 Participants
n=206 Participants
|
|
Parkinson disease
|
6 Participants
n=99 Participants
|
6 Participants
n=107 Participants
|
12 Participants
n=206 Participants
|
|
Sleep Apnea
|
2 Participants
n=99 Participants
|
5 Participants
n=107 Participants
|
7 Participants
n=206 Participants
|
|
Insomnia
|
2 Participants
n=99 Participants
|
5 Participants
n=107 Participants
|
7 Participants
n=206 Participants
|
|
Current Treatment
Antidepressant
|
4 Participants
n=99 Participants
|
4 Participants
n=107 Participants
|
8 Participants
n=206 Participants
|
|
Current Treatment
Clonazepam
|
5 Participants
n=99 Participants
|
4 Participants
n=107 Participants
|
9 Participants
n=206 Participants
|
|
Current Treatment
Melatonin
|
8 Participants
n=99 Participants
|
6 Participants
n=107 Participants
|
14 Participants
n=206 Participants
|
|
Current Treatment
Cholinergic
|
2 Participants
n=99 Participants
|
1 Participants
n=107 Participants
|
3 Participants
n=206 Participants
|
|
Current Treatment
Dopaminergic
|
6 Participants
n=99 Participants
|
4 Participants
n=107 Participants
|
10 Participants
n=206 Participants
|
PRIMARY outcome
Timeframe: Assessed for 28 days at baseline and during last month of treatment (total treatment period of up to 12 weeks)Population: Participants with data at each time point are included in the analysis
Patients record any episode of dream enactment, such as talking, shouting, kicking, or punching, etc.
Outcome measures
| Measure |
Sodium Oxybate (SXB) Arm
n=12 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Number of RBD Episodes in One Month (Per Patient RBD Log)
Final dose
|
23.5 episodes
Interval 6.0 to 47.0
|
25.5 episodes
Interval 14.5 to 46.0
|
|
Number of RBD Episodes in One Month (Per Patient RBD Log)
Baseline
|
37.5 episodes
Interval 27.5 to 48.5
|
35.0 episodes
Interval 28.5 to 45.5
|
PRIMARY outcome
Timeframe: Assessed for 28 days at baseline and during last month of treatment (total treatment period of up to 12 weeks)Population: Participants with data at each time point are included in the analysis
Patients record any episode of dream enactment, such as talking, shouting, kicking, or punching, etc. Severity is scored from 1 to 3 (1: least severe, 3 most severe): 1. non injurious behaviors: facial expressions, non-aggressive vocalizations (mumbling, gentle talking, casual conversation, singing, laughing...), twitches, gentle shaking, non-aggressive movements of fingers, arms or legs...; 2. potentially injurious: punching, kicking, arm flailing or thrashing around, at least one limb or head out of bed, sitting up in bed, crawling, attempting to stand up or leave bed, near falls, cursing, screaming, shouting, yelling, or any behavior requiring bed partner to wake up participant; 3. injurious: any contact with bed partner (hitting or grabbing), wall or furniture, any fall or leaving bed (doving out, walking, jumping). The number of injurious (severe) episodes is reported.
Outcome measures
| Measure |
Sodium Oxybate (SXB) Arm
n=12 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Number of Severe of RBD Episodes in One Month (Per Patient RBD Log)
Baseline
|
1.5 episodes
Interval 0.5 to 4.0
|
1.5 episodes
Interval 0.0 to 3.5
|
|
Number of Severe of RBD Episodes in One Month (Per Patient RBD Log)
Final dose
|
0.5 episodes
Interval 0.0 to 1.0
|
1.0 episodes
Interval 0.0 to 2.5
|
SECONDARY outcome
Timeframe: Assessed at week 12 (end of treatment period).Clinical Global Impression-Efficacy index (CGI-E) is a 4x4 rating scale that assesses the therapeutic effect (Marked, Moderate, Minimal, Unchanged or worse) of treatment medication and associated side effects (none, do not significantly interfere with patient's functioning, significantly interfere with patient's functioning, Outweigh therapeutic effect). Therapeutic effect: Marked and Side effects: None is the best. Therapeutic effect: Unchanged or worse and Side effects: outweigh therapeutic effect is the worst. Each combination of an estimated therapeutic effect and side effect is assigned a score from 1-16, 1 being the best, 16 being the worst. Participants scoring below 4 were considered to be "responders."
Outcome measures
| Measure |
Sodium Oxybate (SXB) Arm
n=12 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Number of Responders According to the CGI Efficacy Scale (CGI-E)
|
10 Participants
|
6 Participants
|
SECONDARY outcome
Timeframe: Assessed at week 12 (end of treatment period).Clinical Global Impression-Improvement scale (CGI-I) is a 7-point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention and rated as: 1. Very much improved, 2. Much improved, 3. Minimally improved, 4. No change, 5. Minimally worse, 6. Much worse, 7. Very much worse. 1 is the best and 7 is the worst. Participants scoring below 4 were considered to be "responders."
Outcome measures
| Measure |
Sodium Oxybate (SXB) Arm
n=12 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Number of Responders According to the CGI Improvement Scale (CGI-I)
|
10 Participants
|
7 Participants
|
SECONDARY outcome
Timeframe: Assessed at baseline and week 12Population: Participants with data at each time point are included in the analysis
Epworth Sleepiness Scale (ESS) is a scale to assess patients' general level of sleepiness. Patients choose the most appropriate number (0=would never doze, 1=slight chance of dozing, 2=moderate chance of dozing, 3=high chance of dozing) for the each situation: Sitting and reading, Watching TV, Sitting and inactive in a public place, As a passenger in a car for an hour, Lying down to rest in the afternoon, Sitting and talking to someone, Sitting quietly after a lunch, While stopped for a few minutes in the traffic in a car. 0-10: Normal range, 10-12: Borderline, 12-24: Abnormal. Participants recorded their scores for 28 days at baseline and during the 28 days leading up to week 12; scores were then averaged to calculate the score for each time point per participant, and then the median for all participants is reported.
Outcome measures
| Measure |
Sodium Oxybate (SXB) Arm
n=12 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Epworth Sleepiness Scale (ESS) Score
Baseline
|
8.0 score on a scale
Interval 5.5 to 10.0
|
9.5 score on a scale
Interval 4.0 to 10.0
|
|
Epworth Sleepiness Scale (ESS) Score
Final dose
|
5.0 score on a scale
Interval 4.0 to 8.0
|
7.5 score on a scale
Interval 5.0 to 10.5
|
SECONDARY outcome
Timeframe: Assessed at baseline and week 12 (average approximately 8 hours to assess at each time point)Population: Participants with data available at the respective time points are presented.
The average number of dream-enactment episodes (resulting in motor behaviors, or movements) weighted for severity. Frequency and severity were calculated as the sum of RBD episodes (frequency) times severity (mild = 1; moderate = 5, severe = 10) occurring over one night's sleep, then averaged to calculate the number of episodes per 10 minutes of REM sleep.
Outcome measures
| Measure |
Sodium Oxybate (SXB) Arm
n=8 Participants
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=10 Participants
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
RBD Episode Severity and Frequency During REM Sleep by Quantitative Video-PSG (Polysomnography) Analysis Per 10 Minutes of REM Sleep
Baseline
|
13.2 episodes*severity per 10 minutes of REM
Standard Deviation 12.3
|
10.1 episodes*severity per 10 minutes of REM
Standard Deviation 8.4
|
|
RBD Episode Severity and Frequency During REM Sleep by Quantitative Video-PSG (Polysomnography) Analysis Per 10 Minutes of REM Sleep
Final dose
|
7.2 episodes*severity per 10 minutes of REM
Standard Deviation 7.4
|
10.5 episodes*severity per 10 minutes of REM
Standard Deviation 10.0
|
SECONDARY outcome
Timeframe: Assessed for 28 days at baseline and during last month of treatment (total treatment period of up to 12 weeks)Population: Analysis was not possible because the data that were collected were corrupted and uninterpretable.
Measure of "activity score" using in-home 4-week actigraphy
Outcome measures
Outcome data not reported
Adverse Events
Sodium Oxybate (SXB) Arm
Placebo (PBO) Arm
Serious adverse events
| Measure |
Sodium Oxybate (SXB) Arm
n=12 participants at risk
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 participants at risk
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Musculoskeletal and connective tissue disorders
Myoclonus episode
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Psychiatric disorders
Sleep terror
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Psychiatric disorders
Suicidal ideation
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Psychiatric disorders
Anxiety
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Nervous system disorders
Dizziness
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
Other adverse events
| Measure |
Sodium Oxybate (SXB) Arm
n=12 participants at risk
For each participant, Sodium Oxybate (SXB) starting at a 4.5g total nightly dose then titrated up weekly by 1.5g increments over 8 weeks to establish their optimal individualized dose (based on their clinical response on RBD symptoms and tolerance). Participant then receive their optimal dose for at least 4 weeks.
|
Placebo (PBO) Arm
n=12 participants at risk
Placebo similar in appearance, smell and flavor so that it is indistinguishable from sodium oxybate.
|
|---|---|---|
|
Psychiatric disorders
Anxiety
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
General disorders
Asthenia
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Psychiatric disorders
Auditory hallucination
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
General disorders
Brain fog
|
16.7%
2/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Renal and urinary disorders
Enuresis
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Gastrointestinal disorders
Gastrointestinal discomfort
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Nervous system disorders
Headache
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
General disorders
Hot flashes
|
8.3%
1/12 • Up to 12 weeks
|
8.3%
1/12 • Up to 12 weeks
|
|
Musculoskeletal and connective tissue disorders
Myalgia
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Gastrointestinal disorders
Nausea
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
General disorders
Sensation of being "wired"
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Nervous system disorders
Tremor
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Psychiatric disorders
Anorexia
|
16.7%
2/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
General disorders
Catathrenia
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
General disorders
Increased sweating
|
16.7%
2/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
|
Psychiatric disorders
Insomnia
|
0.00%
0/12 • Up to 12 weeks
|
8.3%
1/12 • Up to 12 weeks
|
|
Gastrointestinal disorders
Dysgeusia
|
8.3%
1/12 • Up to 12 weeks
|
0.00%
0/12 • Up to 12 weeks
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place