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Insomnia DisorderPhase 2/3MorfeuNCT02798367

Melatonin 3mg and 5mg Compared to Cognitive Behavioral Therapy for Insomnia (CBT-I) in the Treatment of Insomnia

A Phase 2/3 study testing CBT-I plus Melatonin 3 mg and CBT-I plus Melatonin 5 mg in people with Insomnia Disorder, run by Ache Laboratorios Farmaceuticos S.A. at 8 sites in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

National clinical trials, phase II/III, combined in two stages, randomized, double-blind, controlled, parallel, study of superiority, in which three hundred and seven (307) participants of both sexes, aged equal or more than 55 years will be randomly allocated to one of three treatment groups. In the first stage. Read more about this study

Who is it for?
Ages 55 years and older
Conditions the study is for
Insomnia Disorder
What is being tested?
CBT-I plus Melatonin 3 mg and CBT-I plus Melatonin 5 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
307 participants
Where
8 sitesBrazil
Study dates
22 Mar 2018to 30 Nov 2021
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Fulfill the criteria for insomnia disorder, according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition);
  • Complaint of difficulty falling asleep;
  • Ability to understand and consent their participation in this clinical study, expressed by signing the Informed Consent Form (ICF).

Who cannot join

  • Any finding of clinical/physical observation or laboratory examination to be interpreted by the investigator as a risk to the inclusion of the participant in the clinical study;
  • Known hypersensitivity to drug components used during the study;
  • Participant have any family relationship to the second degree or bond with employees or employees of Sponsor and Sites;
  • Participant has used beta-blockers (in the last 30 days prior to screening visit), psychoactive drugs or sedative effect, such as, but not limited to: sedatives (in the last 14 days prior to screening visit), hypnotics (in the last 07 days prior to screening visit), muscle relaxants (in the last 11 days prior to screening visit), antihistamines first generation (in the last 08 days prior to screening visit), and antidepressants, antiepileptics, antipsychotics, among others (in the last 30 days prior to screening visit);
  • Participants diagnosed with clinical diseases that interfere with sleep, such as chronic pain, nocturia, hypothyroidism, hyperthyroidism, severe heart disease, serious neurological and psychiatric disorders according to the assessment of the investigator;
  • Participants diabetics insulin dependent;
Show all 17Show fewer
  • Sleep apnea moderate to severe - AHI > 20 (Apnoea-Hypopnoea Index) assessed by polysomnography at the baseline;
  • Participants who work at night;
  • Participant who has BMI ≥ 30;
  • Participant score above 50 in Anxiety Inventory to assess the degree of anxiety;
  • Participant with cognitive impairment, based on the result obtained in the Mini-Mental State Examination. The cognitive impairment will be considered with score below 13 points for illiterates, below 18 for participants with one to eight incomplete years of schooling, below 26 for those with education of eight or more years;
  • Participant score above 20 on the Beck Inventory to assess depression;
  • Abuse of alcohol or illicit drugs, according to the assessment of the investigator;
  • Male participants who do not agree to use acceptable methods of contraception; 1) male participants: barrier methods, except surgically sterile (vasectomy) or participants who declare to perform sexual practices on a not to reproductive way. 2) methods of contraception for the male participant's partner: oral contraceptives, injectable contraceptives, intrauterine device (IUD), hormonal implants, hormonal patch, tubal ligation and barrier methods; except surgically sterile (bilateral oophorectomy or hysterectomy) or the menopausal for at least one year;
  • Female participants who are in the reproductive age and do not agree to use acceptable methods of contraception (oral contraceptives, injectable contraceptives, intrauterine device (IUD), hormonal implants, barrier methods, hormonal patch and tubal ligation); except surgically sterile (bilateral oophorectomy or hysterectomy), the menopausal for at least one year and participants who declare to perform sexual practices on a not to reproductive way;
  • Women in gestation period or who are breastfeeding;
  • Participant who has participated in clinical trial protocols in the last twelve (12) months (CNS Resolution 251 of August 7, 1997, Part III, sub-item J), unless the investigator considers that there may be a direct benefit to the same.

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

Brazil8 sites, 5 recruiting
  • Allergisa Pesquisa Dermato Cosmética Ltda.

    Campinas, São Paulo

    Mauro Crippa Jr., +55 19 3789-8615

    Recruiting
  • Hospital de Clínicas de Porto Alegre

    Porto Alegre, Rio Grande do Sul, 90035-903

    Terminated
  • Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto USP

    Ribeirão Preto, São Paulo, 14048-900

    Alan Eckeli

    Recruiting
  • Centro de Estudos Multidisciplinar CEPES da Faculdade de Medicina do ABC

    Santo André, São Paulo

    Terminated
  • Dr Consulta Clinica Medica Ltda

    São Paulo, 01141-020

    Tatiana Hirakawa

    Recruiting
  • Centro Paulista de Investigação Clínica e Serviços Médicos Ltda.

    São Paulo, 04266-010

    Terminated
  • Centro de Desenvolvimento em Estudo Clínicos Brasil - CDEC Brasil

    São Paulo

    Dalva Poyares, +55 11 5579 0373

    Recruiting
  • CEDOES - Centro de Diagnóstico e Pesquisa da Osteoporose do Espirito Santo.

    Vitória, Espírito Santo, 29055-450

    Karina Oliveira

    Recruiting

Other trials in Brazil

About this study

Official title: National, Phase II/III, Multicenter, Randomized, Double-blind, Controlled, Parallel,Effect of Melatonin 3mg and 5mg Plus Cognitive Behavioral Therapy for Insomnia (CBT-I) Compared to the CBT-I Alone in the Treatment of Insomnia Disorder

National clinical trials, phase II/III, combined in two stages, randomized, double-blind, controlled, parallel, study of superiority, in which three hundred and seven (307) participants of both sexes, aged equal or more than 55 years will be randomly allocated to one of three treatment groups. In the first stage. The group 01 will use Melatonin 3mg plus CBT-I, the group 02 will use Melatonin 5mg plus CBT-I and the group 03 will use CBT-I plus placebo.

Based on the results of an interim analysis will be making a decision on whether to proceed with the study and, if so, on which the doses will be selected for the second stage of the study, to be better studied. The final analysis of the treatments, melatonin in the selected dose plus CBT-I versus CBT-I alone and placebo, will include participants from both stages.

Read the detailed description

The treatment of insomnia disorder can be accomplished through pharmacological and nonpharmacological approaches. Behavioral techniques of Sleep Hygiene and Stimuli control are the most used. The Sleep hygiene is a psychoeducational intervention that teaches patients to prevent external or environmental factors generate adverse effects and harmful to sleep. The stimulus control technique is based on five instructions that encourages the patient to establish a proper sleep-wake rhythm and strengthens the links between the way for a quick sleep and well established. Melatonin is a hormone that participates in the regulation of the sleep-wake cycle, which is produced and secreted primarily by the pineal gland in the dark period and prepares the individual to sleep. Melatonin is involved in the induction of sleep and has proven therapeutic action in insomnia disorders, and may also play a role in the circadian timing system of mammals and serve as a marker for "biological clock".

Being tested
CBT-I plus placebo, CBT-I plus Melatonin 3 mg, CBT-I plus Melatonin 5 mg
Keywords
insomnia, cognitive behavioral therapy for insomnia, melatonin
Medical subject headings
Sleep Initiation and Maintenance Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CBT-I plus placeboBehavioural

    Behavioral techniques of Sleep Hygiene and Stimulus Control standardized in clinical protocol plus placebo (01 tablet, orally, always at night one hour before bedtime) for 21(±2) days)

  • CBT-I plus Melatonin 3 mgDrug

    Also called Melatonin

    Behavioral techniques of Sleep Hygiene and Stimulus Control standardized in clinical protocol plus Melatonin 3 mg (01 tablet, orally, always at night one hour before bedtime) for 21(±2) days.

  • CBT-I plus Melatonin 5 mgDrug

    Also called Melatonin

    Behavioral techniques of Sleep Hygiene and Stimulus Control standardized in clinical protocol plus Melatonin 5 mg (01 tablet, orally, always at night one hour before bedtime) for 21(±2) days.

Study groups in NCT02798367
Study groupRoleWhat they receive
CBT-I plus Melatonin 3 mgExperimentalIt's a tablet manufactured by Aché S.A., composed of melatonin 3mg. Melatonin 3mg tablet will be dispensed to 65 participants (first stage) of this group in a cartridge of 3 blisters with 10 tablets each, totalizing 30 tablets. If this arm is the best set for the second stage, more 56 participants will be randomly allocated in this group.The participant shall administer 01 tablet orally every 24 hours one hour before bedtime. The duration of treatment may be 21(±2) days. CBT-I is a non-pharmacological effective treatment for insomnia disorder. Behavioral techniques of Sleep Hygiene and Stimuli control are the most used. The CBT-I guidelines are standardized in protocol.
Receives: Behavioral: CBT-I plus placebo; Drug: CBT-I plus Melatonin 3 mg
CBT-I plus Melatonin 5 mgExperimentalIt's a tablet manufactured by Aché S.A., composed of melatonin 5mg. Melatonin 5mg tablet will be dispensed to 65 participants (first stage) of this group in a cartridge of 3 blisters with 10 tablets each, totalizing 30 tablets. If this arm is the best set for the second stage, more 56 participants will be randomly allocated in this group.The participant shall administer 01 tablet orally every 24 hours one hour before bedtime. The duration of treatment may be 21(±2) days. CBT-I is a non-pharmacological effective treatment for insomnia disorder. Behavioral techniques of Sleep Hygiene and Stimuli control are the most used. The CBT-I guidelines are standardized in protocol.
Receives: Behavioral: CBT-I plus placebo; Drug: CBT-I plus Melatonin 5 mg
CBT-I plus placeboOtherIt's a tablet manufactured by Aché S.A,. composed of placebo. The participants shall administer the placebo tablets to enable the double-blind study. Placebo will be dispensed to 65 (first stage) and 56 (second stage) participants of this group and shall administer 01 tablet orally every 24 hours one hour before bedtime for 21(±2) days. Sleep hygiene is a psychoeducational intervention that teaches patients to prevent external or environmental factors generate adverse effects and harmful to sleep. The stimulus control technique is based on five instructions that encourages the patient to establish a proper sleep-wake rhythm and strengthens the links between the way for a quick and well consolidated sleep. The CBT-I guidelines are standardized in clinical protocol.
Receives: Behavioral: CBT-I plus placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change of Sleep Latency after 21 (±2) days of the treatment.

    Absolute change in sleep latency (in minutes) at the end of treatment compared to baseline. Sleep latency will be assessed by polysomnography.

    Measured: 21 (±2) days

Secondary outcomes (9)
  1. Quality of Sleep - Pittsburgh Sleep Quality Index

    Absolute change the overall score PSQI-BR, at the end of treatment from baseline

    Measured: 21 (±2) days

  2. Wellness Day - Well-Being Index-5 (WHO-5)

    Absolute change the overall score of the WHO-5 level, in the range of 0 to 100 points, at the end of treatment from baseline.

    Measured: 21 (±2) days

  3. Severity of Insomnia - Insomnia Severity Index

    Absolute change the overall score of the Insomnia Severity Index at the end of treatment from baseline

    Measured: 21 (±2) days

  4. Total Sleep Time - Polysomnography

    Evaluate the total sleep time by polysomnography at the end of treatment from baseline

    Measured: 21 (±2) days

  5. Sleep Architecture - the length and proportion of N1(non-rapid eyes movement) stages, N2, N3 and REM

    Proportion of participants with sleep architecture classified as normal or abnormal, assessed by polysomnography at the end of treatment from baseline.

    Measured: 21 (±2) days

  6. Sleep Efficiency - Polysomnography

    Sleep efficiency variation assessed by polysomnography at the end of treatment from baseline

    Measured: 21 (±2) days

  7. The Latency of Persistent Sleep - Polysomnography

    Latency of persistent sleep variation assessed by polysomnography at the end of treatment from baseline

    Measured: 21 (±2) days

  8. Latency of REM (rapid eyes movement) Sleep - Polysomnography

    Latency of REM sleep variation assessed by polysomnography at the end of treatment from baseline

    Measured: 21 (±2) days

  9. Satisfaction of the participants with the treatment.

    Proportion of participants in each level of satisfaction category Likert 5 point (1. totally dissatisfied, 2. dissatisfied, 3. neither satisfied nor dissatisfied, 4. satisfied, 5. completely satisfied) evaluated comparing the groups at the end of treatment

    Measured: 21 (±2) days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jun 2016 (estimated)
  2. Study start22 Mar 2018
  3. Primary completion31 Oct 2021 (estimated)
  4. Study completion30 Nov 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
307 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02798367
Sponsor's protocol ID
ACH-MSZ-02-03(05/16)
Acronym
Morfeu
Status last verified
Sep 2020
First submitted
9 Jun 2016
Last updated
3 Sep 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing CBT-I plus Melatonin 3 mg and CBT-I plus Melatonin 5 mg in people with Insomnia Disorder, run by Ache Laboratorios Farmaceuticos S.A. at 8 sites in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 3 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Elisangela Rorato (+55 11 2608-6130, elisangela.rorato@ache.com.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change of Sleep Latency after 21 (±2) days of the treatment. (time frame: 21 (±2) days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Sep 2020.

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