Idiopathic HypersomniaPhase 3NCT05156047
A Phase 3 Study to Assess the Safety and Efficacy of Pitolisant in Adult Patients With Idiopathic Hypersomnia
A Phase 3 study testing Open-label Pitolisant and Double-blind Pitolisant in people with Idiopathic Hypersomnia, run by Harmony Biosciences Management, Inc. at 58 sites in United States.
Trial summary
The primary objective of this study is to evaluate the safety and efficacy of pitolisant compared with placebo in treating excessive daytime sleepiness (EDS) in participants with idiopathic hypersomnia (IH) age ≥18 years. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Idiopathic Hypersomnia
- What is being tested?
- Open-label Pitolisant and Double-blind Pitolisant
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 214 participants
- Where
- 58 sitesUnited States
- Study dates
- 25 May 2022to 8 Sep 2023
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Is able to provide voluntary, written informed consent.
- Has a current diagnosis of IH per International Classification of Sleep Disorders Third Edition criteria.
- Male or female participant age ≥18 years at the time of Screening.
- Has an Epworth Sleepiness Scale score of ≥12 at Screening and at Baseline (Visit 2).
- Has a Patient Global Impression of Severity score of moderate, severe, or very severe at Screening and at Baseline (Visit 2).
- For participants being treated for obstructive sleep apnea (OSA) or other hypoventilatory conditions, participants must be compliant as demonstrated by bilevel positive airway pressure/continuous positive airway pressure (BiPAP/CPAP) therapy with 30 days of data showing ≥4 hours of BiPAP/CPAP therapy per night for ≥70% of nights. If not on BiPAP/CPAP therapy, participants being treated for OSA must be compliant as determined by the Investigator with their medical device or oral appliance. Data must be from within 90 days prior to the Screening visit. Participants must agree to maintain compliance with their treatment for OSA throughout the duration of the study.
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- If on a treatment that could affect daytime sleepiness (including but not limited to oxybates, stimulants, modafinil, and armodafinil):
- Must be on a stable dose for at least 2 months prior to Screening and agree to continue the stable dose for the duration of the study.
- If not on a stable dose for 2 months prior to Screening, washout for 5 half-lives or 14 days, whichever is longer, prior to Day 1 and agree to remain off these treatments until completion of the study.
- A participant who is a female of child-bearing potential must have a negative serum pregnancy test at the Screening Visit and negative urine pregnancy test at the Baseline Visit (Visit 2) and at the end of the Stable Dose Period (Visit 4) and agree to remain abstinent or use an effective method of non-hormonal contraception to prevent pregnancy for the duration of the study and for 21 days after final dose of study drug.
- Must have a negative result on urine drug screen at the Screening Visit, Baseline Visit (Visit 2) and at the end of the Stable Dose Period (Visit 4), except for medications that are prescribed by a healthcare provider for medical conditions.
- In the opinion of the Investigator, the participant is capable of understanding and complying with the protocol and administration of oral study drug.
Who cannot join
- Has hypersomnia due to another medical disorder (for example, narcolepsy).
- Has an Apnea Hypopnea Index of ≥10 as determined by the most recent sleep study or BiPAP/CPAP device readout.
- Has a clinically significant hypoventilatory condition as determined by the Investigator.
- Has a primary diagnosis of a psychiatric illness that is not well controlled.
- Participants taking antidepressants who have not been on a stable dose of their antidepressant for at least 12 weeks prior to Screening; participants on a stable dose of their antidepressant for at least 12 weeks prior to Screening must agree to continue their stable dose for the duration of the study.
- Experiences a mean of <6 hours of sleep per night based on sleep diary during Screening (participants need to record at least 7 nights within a 10-day period in their sleep diary within 14-days prior to the Baseline Visit [Visit 2]).
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- Consistently consumes >600 mg of caffeine per day and is unable/unwilling to reduce caffeine intake to ≤600 mg per day for the duration of the study.
- Does not agree to discontinue any prohibited medication or substance listed in the protocol.
- Is currently or has previously used pitolisant.
- Is currently breastfeeding or planning to breastfeed over the course of the study. Lactating women must agree not to breastfeed for the duration of the study and for 21 days after final dose of study drug.
- Participation in an interventional research study involving another investigational medication, device, or behavioral treatment within 28 days or within 5 half-lives of the investigational medication (whichever is longer) prior to Screening.
- Has a diagnosis of end-stage renal disease (estimated glomerular filtration rate [eGFR] of <15 milliliters [mL]/minute/1.73 square meter [m^2]) or severe hepatic impairment (Child-Pugh C).
- Has a diagnosis of moderate or severe renal impairment (eGFR ≥15 to ≤59 mL/minute/1.73 m^2) or moderate hepatic impairment (Child-Pugh B) at Screening or at any time during the study.
- Has a history of long corrected QT interval syndrome or corrected QT interval using Fridericia's formula (QTcF) >450 milliseconds (msec) for males or >470 msec for females (QTcF = QT / 3√ RR) at Screening.
- Is receiving and is unable to discontinue a medication known to prolong the QT interval.
- Is receiving a concomitant medication that is known to be a strong cytochrome P450 3A4 inducer, or a centrally acting histamine 1 receptor antagonist; participants who undergo a washout of these medications of at least 5 half-lives or one week (whichever is longer) may be enrolled in the study. Use of strong CYP2D6 inhibitors is allowed; however, for these participants the maximum permitted daily dose of pitolisant is 17.8 mg.
- Is a known CYP2D6 poor metabolizer.
- Has abnormal laboratory values at Screening that are clinically significant as determined by the Investigator.
- Has initiated any new or change in allied health therapies or interventions that can interfere with the study outcomes within 28 days prior to Screening and at any time during the study, based on the Investigator's judgment.
- Has a current or recent (within 1 year) history of a substance use disorder or dependence disorder, including alcohol, tobacco, and caffeine use disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.
- Has planned surgery during the study.
- Has a significant risk of committing suicide or suicidality based on history; routine psychiatric examination; Investigator's judgment; or an answer of "yes" on any question other than questions 1 to 3 (for the previous month) or "yes" on any question in the suicidal behavior section (for the past year) of the Columbia-Suicide Severity Scale, Baseline/Screening.
- Based on the judgment of the Investigator, is unsuitable for the study for any reason, including but not limited to an unstable or uncontrolled medical condition or one that might interfere with the conduct of the study, confound interpretation of study results, pose a health risk to the participant, or compromise the integrity of the study. This exclusion criterion applies not only to entry into the study, but also to continuation in the study, should such an unstable, uncontrolled, or serious medical condition arise.
Trial locations and contacts
58 sites in 1 country.
58 sites in 1 country
United States58 sites
CardioVoyage
Ardmore, Oklahoma, 73401
Neurotrials Research Inc.
Atlanta, Georgia, 30328
FutureSearch Trials of Neurology LP
Austin, Texas, 78731
Boston Children's Hospital
Boston, Massachusetts, 02115
Alpine Clinical Research Center
Boulder, Colorado, 80301
Meris Clinical Research
Brandon, Florida, 33511
NeuroScience Research Center, LLC
Canton, Ohio, 44718
Medical University of South Carolina- Institute of Psychiatry
Charleston, South Carolina, 29425
Advanced Center for Sleep Disorders
Chattanooga, Tennessee, 37421
St. Luke's Sleep Medicine and Research Center
Chesterfield, Missouri, 63017
Helene A. Emsellem MD PC
Chevy Chase, Maryland, 20815
Northwestern University
Chicago, Illinois, 60611
Intrepid Research, LLC
Cincinnati, Ohio, 45245
St. Francis Medical Institute
Clearwater, Florida, 33765
Rainbow Babies Children's Hospital
Cleveland, Ohio, 44106
Cleveland Clinic
Cleveland, Ohio, 44195
Bogan Sleep Consultants
Columbia, South Carolina, 29201
Neurology Clinic, P.C.
Cordova, Tennessee, 38018
Research Carolina Elite LLC
Denver, North Carolina, 28037
Ohio Sleep Medicine and Neuroscience Institute
Dublin, Ohio, 43017
Duke University School of Medicine
Durham, North Carolina, 27705
Minnesota Lung Center
Edina, Minnesota, 55125
The Neurological Center of North GA
Gainesville, Georgia, 30501
Clinical Research of Gastonia
Gastonia, North Carolina, 28054
NorthShore Uni HealthSys-Glenbrook Hospital
Glenview, Illinois, 60026
ARSM Research
Huntersville, North Carolina, 28078
Cedars-Sinai Medical Towers
Los Angeles, California, 90048
University of California- Los Angeles
Los Angeles, California, 90095
University of Wisconsin-Madison
Madison, Wisconsin, 53719
Sleep Medicine Specialists of South Florida, PA
Miami, Florida, 33126
North Star Medical Research
Middleburg, Ohio, 44130
West Virginia University - Department of Neurology
Morgantown, West Virginia, 26506
Northwell Health
New Hyde Park, New York, 11042
Neurocare, INC
Newton, Massachusetts, 02459
Children's Hospital of the King's Daughter
Norfolk, Virginia, 23507
Lowcountry Lung Critical Care
North Charleston, South Carolina, 29406
Great Plains Health
North Platte, Nebraska, 69101
Norwalk Hospital Sleep Center
Norwalk, Connecticut, 06850
Henry Ford Health System
Novi, Michigan, 48377
Brian Abaluck, LLC
Paoli, Pennsylvania, 19301
Phoenix Medical Group
Peoria, Arizona, 85381
OSF HealthCare Saint Francis Medical Center
Peoria, Illinois, 61637
Bronson Sleep Health
Portage, Michigan, 49024
Central Texas Neurology Consultants, PA
Round Rock, Texas, 78681
Sleep Medicine Specialists of California
San Ramon, California, 94583
SDS Clinical Trials Inc.
Santa Ana, California, 92705
Santa Monica Clinical Trials
Santa Monica, California, 90404
Mayo Clinic
Scottsdale, Arizona, 85259
Clayton Sleep Institute
St Louis, Missouri, 63123
Pasadena Center For Medical Research, LLC
St. Petersburg, Florida, 33763
Clinical Neurophysiology Services
Sterling Heights, Michigan, 48314
Comprehensive Sleep Medicine Associates
Sugar Land, Texas, 77478
Northwest Houston Neurology and Sleep
Tomball, Texas, 77375
Neurology Specialists of Monmouth County, PA
West Long Branch, New Jersey, 07764
Abington Neurological Associates
Willow Grove, Pennsylvania, 19090
Florida Pediatric Research Institute
Winter Park, Florida, 32789
Minnesota Lung Center
Woodbury, Minnesota, 55125
Respiratory Specialists
Wyomissing, Pennsylvania, 19610
About this study
Official title: A Double-Blind, Placebo-Controlled, Randomized Withdrawal Study to Evaluate the Safety and Efficacy of Pitolisant in Adult Patients With Idiopathic Hypersomnia
The primary objective of this study is to evaluate the safety and efficacy of pitolisant compared with placebo in treating excessive daytime sleepiness (EDS) in participants with idiopathic hypersomnia (IH) age ≥18 years.
Key secondary objectives of this study are to assess the impact of pitolisant on:
Read more
- Overall symptoms of IH
- Participant impression of overall change in their symptoms of IH
- Investigator assessment of overall disease severity of IH
Other secondary objectives of this study are to assess the impact of pitolisant in participants with IH on:
- Participant impression of overall severity of their EDS
- Functional status and activities of daily living
- Sleep-related impairment
- Sleep inertia
- Cognitive function
Read the detailed description
This is a double-blind, placebo-controlled, randomized withdrawal study in adult participants (ages ≥18 years) with IH. The study will consist of a Screening Period (up to 28 days), an 8-week Open-Label Phase, and a 4-week Double-Blind Randomized Withdrawal Phase.
The Open-Label Phase of the study will be 8 weeks, which includes a 6-week Dose Optimization Period and a 2-week Stable Dose Period. In the Dose Optimization Period, all participants will be titrated to their optimal dose of open-label pitolisant (17.8 milligrams [mg] or 35.6 mg) based on Investigator assessment of tolerability and efficacy. The 3-week titration period will be followed by 3 weeks of flexible dosing (weeks 4-6) during which participants will continue to receive their optimal dose of 17.8 mg or 35.6 mg open-label pitolisant. Participants taking a strong cytochrome P450 2D6 (CYP2D6) inhibitor will be allowed in the study; however, for these participants, the maximum permitted daily dose of pitolisant will be 17.8 mg. Following completion of the 6-week Dose Optimization Period, participants will enter the 2-week Stable Dose Period. During this period, participants will remain at their optimal dose (the same dose they were taking at the end of the Dose Optimization Period [17.8 mg or 35.6 mg]) of open-label pitolisant for 2 weeks; dose adjustments are not allowed during the Stable Dose Period. At the end of the Stable Dose Period, participants will be defined as responders or non-responders. Responders will be randomized in a 1:1 ratio to receive blinded study drug (pitolisant or matching placebo) in the Double-Blind Randomized Withdrawal Phase of the study. Non-responders will not be randomized to treatment in the Double-Blind Randomized Withdrawal Phase and will complete two safety follow-up telephone contacts (TCs) at 15 (±3) days and 30 (+3) days after their final dose of open-label pitolisant.
During the Double-Blind Randomized Withdrawal Phase, participants (approximately 64 participants per treatment group) will receive blinded study drug either at the same dose they were taking in the Stable Dose Period (17.8 mg or 35.6 mg pitolisant) or matching placebo. The duration of the Double-Blind Randomized Withdrawal Phase will be 4 weeks (weeks 9-12); dose adjustments are not permitted during this phase of the study. After completion of the Double-Blind Randomized Withdrawal Phase (End-of Treatment Visit is on Day 84, the last day of blinded treatment), participants will complete two safety follow-up TCs with the site at 15 (±3) days and 30 (+3) days after their final dose of blinded study drug, which will include assessment for adverse events and concomitant medication use; alternatively, participants will have the opportunity to enroll in a long-term, open-label safety study under a separate protocol. Participants who opt to enroll into the long-term, open-label study will not complete the 15-day and 30-day follow-up TCs.
- Conditions
- Idiopathic Hypersomnia
- Being tested
- Open-label Pitolisant, Double-blind Placebo, Double-blind Pitolisant
- Keywords
- Pitolisant, Histamine, Sleepiness
- Medical subject headings
- Idiopathic Hypersomnia, Sleepiness
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Open-label PitolisantDrug
Pitolisant 4.45 mg tablets: white, round, plain, biconvex film-coated tablet, 3.7 millimeters (mm) in diameter. Each tablet contains 5 mg of pitolisant hydrochloride equivalent to 4.45 mg of pitolisant.
Pitolisant 17.8 mg tablets: white, round, plain, biconvex film-coated tablet, 7.5 mm in diameter. Each tablet contains 20 mg of pitolisant hydrochloride equivalent to 17.8 mg of pitolisant.
Double-blind PlaceboDrug
Matching placebo tablets will be provided for each strength of active pitolisant film-coated tablets.
Double-blind PitolisantDrug
Pitolisant 4.45 mg tablets: white, round, plain, biconvex film-coated tablet, 3.7 mm in diameter. Each tablet contains 5 mg of pitolisant hydrochloride equivalent to 4.45 mg of pitolisant.
Pitolisant 17.8 mg tablets: white, round, plain, biconvex film-coated tablet, 7.5 mm in diameter. Each tablet contains 20 mg of pitolisant hydrochloride equivalent to 17.8 mg of pitolisant.
| Study group | Role | What they receive |
|---|---|---|
| Double-blind Pitolisant | Active comparator | Double-blind pitolisant administered once daily in the morning upon wakening for 4 weeks during the Double-Blind Randomized Withdrawal Phase Receives: Drug: Double-blind Pitolisant |
| Double-blind Placebo | Placebo comparator | Matching placebo administered once daily in the morning upon wakening for 4 weeks during the Double-Blind Randomized Withdrawal Phase Receives: Drug: Double-blind Placebo |
| Open-label Pitolisant | Experimental | Open-label pitolisant administered once daily in the morning upon wakening for 8 weeks during the Open-Label Phase Receives: Drug: Open-label Pitolisant |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Epworth Sleepiness Scale (ESS) Score From Week 8 to Week 12
The Epworth Sleepiness Scale (ESS) is an 8-item, 4-point rating scale that asks participants to rate the likelihood of falling asleep over the past week. The rating scale ranges from 0 (no chance of dozing) to 3 (high chance of dozing). The total score is calculated by summing the item level ratings. Total scores range from 0 to 24. Higher point totals represent more severe daytime sleepiness.
Measured: Week 8 to Week 12
Secondary outcomes (10)
Change in Idiopathic Hypersomnia Severity Scale (IHSS) From Week 8 to Week 12
The Idiopathic Hypersomnia Severity Scale (IHSS) is a self-administered questionnaire with a total of 14 items that assess long sleep duration and sleep inertia (5 items), daytime functioning (7 items), and napping (2 items). All items are scored from 0 to 3 or from 0 to 4. The total score is a sum of the item scores. The total score ranges from 0 to 50. A higher score indicates more severe and frequent symptoms.
Measured: Week 8 to Week 12
Proportion of Participants Who Worsened on the Patient Global Impression of Change for Idiopathic Hypersomnia (PGI-C [IH]) From Week 8 to Week 12
The Patient Global Impression of Change for Idiopathic Hypersomnia (PGI-C [IH]) is a single-item questionnaire that assesses a participant's overall impression of the change in their symptoms of IH. The scale asks participants to rate their overall impression of the change in their symptoms of IH since a specific timepoint on a 5-point verbal rating scale ranging from "much better" to "much worse."
Measured: Week 8 to Week 12
Change in Clinical Global Impression of Severity for IH (CGI-S [IH]) From Week 8 to Week 12
The CGI-S (IH) is an investigator-rated assessment. It uses a single-item, 5-point Likert-type rating scale that ranges from: none (1); mild (2); moderate (3); severe (4); very severe (5). An assessment of less severe symptoms represents an improvement in the investigator's perception of the participant's overall clinical status related to idiopathic hypersomnia and is reflected by a decrease in score.
Measured: Week 8 to Week 12
Change in Patient Global Impression of Severity Scale for Excessive Daytime Sleepiness (PGI-S [EDS]) From Week 8 to Week 12
The Patient Global Impression of Severity for Excessive Daytime Sleepiness (PGI-S [EDS]) asks participants to rate their overall impression of the severity of their EDS over the past 7 days on a 5-point verbal rating scale ranging from "none" to "very severe". Scores are: 1=None, 2=Mild, 3=Moderate, 4=Severe, and 5=Very Severe.
Measured: Week 8 to Week 12
Change in Functional Outcomes of Sleep Questionnaire 10-Item Version (FOSQ-10) From Week 8 to Week 12
The Functional Outcomes of Sleep Questionnaire 10-Item Version (FOSQ-10) consists of 10 items assessing the impact of sleepiness on daily functioning across 5 domains: vigilance, general productivity, social outcomes, intimacy, and activity level. Each item is rated on a scale of 0 (activity not performed for other reasons), 1 (extreme difficulty), 2 (moderate difficulty), 3 (a little difficulty), and 4 (no difficulty). The FOSQ-10 total score is calculated by multiplying the mean of the subscale scores by five, with final scores ranging from 5-20. Higher scores correspond to less impairment/symptomatic severity.
Measured: Week 8 to Week 12
Change in Patient-Reported Outcomes Measurement Information System Sleep-Related Impairment Short Form 8a (PROMIS-SRI SF 8a) From Week 8 to Week 12
The PROMIS-SRI SF 8a is a self-report measure that includes 8 questions designed to assess a participant's perceptions of their waking alertness, sleepiness, and tiredness during usual waking hours, and the perceived functional impairments during wakefulness associated with sleep problems or impaired alertness over the past week. Responses are rated using a 5-point scale, with responses ranging from: 1=not at all; 2=a little bit; 3=somewhat; 4=quite a bit; 5=very much, with average scores ranging from 8 to 40. Raw scores are converted to a T-score using the conversion table from the PROMIS-SRI Scoring Manual. Raw score ranges from 8 to 40; T-score ranges from 30 to 80.1. Higher scores represent greater impairment.
Measured: Week 8 to Week 12
Change in Sleep Inertia Questionnaire (SIQ) From Week 8 to Week 12
The Sleep Inertia Questionnaire (SIQ) consists of 21 questions that assess sleep inertia. Each question is rated on a scale of 1 to 5, where: 1=not at all; 2=a little; 3=somewhat; 4=often; 5=all the time. Total scores range from 21 to 105. Higher scores represent greater sleep inertia.
Measured: Week 8 to Week 12
Change in Cogstate One Back Test (ONB) From Week 8 to Week 12
Cognition was assessed using the Cogstate Computerized Cognitive Battery tests. The cognitive domain of working memory was assessed specifically with the One Back Test (ONB), which measures the speed of the participant's response. Results are reported as the mean of the common logarithm (log 10) transformed reaction time (in milliseconds [msec]) for correct responses. A decrease in score represents an increase in working memory performance.
Measured: Week 8 to Week 12
Change in Cogstate Identification Test (IDN) From Week 8 to Week 12
Cognition was assessed using the Cogstate Computerized Cognitive Battery tests. The cognitive domain of visual attention was assessed using the Identification Test (IDN). Results reported as the mean of the log 10 transformed reaction time for correct responses. A decrease in score represents an increase in visual attention performance.
Measured: Week 8 to Week 12
Change in Cogstate Detection Test (DET) From Week 8 to Week 12
Cognition was assessed using the Cogstate Computerized Cognitive Battery tests. The cognitive domain of psychomotor function was assessed specifically using the Detection Test (DET). The test measures the speed of the participant's response. Results reported as the mean of the log 10 transformed reaction time (msec) for the correct responses. A decrease in score represents an increase in psychomotor function performance.
Measured: Week 8 to Week 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Dec 2021
- Study start25 May 2022
- Primary completion8 Sep 2023
- Study completion8 Sep 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Idiopathic HypersomniaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Double-blind, randomized withdrawal
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 214 participants (actual)
Sponsor and investigators
- Lead sponsor
- Harmony Biosciences Management, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05156047
- Sponsor's protocol ID
- HBS-101-CL-010
- Status last verified
- Sep 2026
- First submitted
- 1 Dec 2021
- Last updated
- 25 Sep 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 25 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Double-Blind, Placebo-Controlled, Randomized Withdrawal Study to Evaluate the Safety and Efficacy of Pitolisant in Adult Patients With Idiopathic Hypersomnia
- ClinicalTrials.gov ID
- NCT05156047
- Acronym / sponsor ID
- HBS-101-CL-010
- Conditions
- Idiopathic Hypersomnia
- Keywords
- Pitolisant, Histamine, Sleepiness
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 214 participants (actual)
- Lead sponsor
- Harmony Biosciences Management, Inc.Industry (pharma, biotech, devices)
- Study start
- 25 May 2022 (actual)
- Primary completion
- 8 Sep 2023 (actual)
- Study completion
- 8 Sep 2023 (actual)
- First posted
- 14 Dec 2021 (actual)
- Results
- Posted 25 Sep 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective of this study is to evaluate the safety and efficacy of pitolisant compared with placebo in treating excessive daytime sleepiness (EDS) in participants with idiopathic hypersomnia (IH) age ≥18 years.
Key secondary objectives of this study are to assess the impact of pitolisant on:
- Overall symptoms of IH
- Participant impression of overall change in their symptoms of IH
- Investigator assessment of overall disease severity of IH
Other secondary objectives of this study are to assess the impact of pitolisant in participants with IH on:
- Participant impression of overall severity of their EDS
- Functional status and activities of daily living
- Sleep-related impairment
- Sleep inertia
- Cognitive function
Detailed description
This is a double-blind, placebo-controlled, randomized withdrawal study in adult participants (ages ≥18 years) with IH. The study will consist of a Screening Period (up to 28 days), an 8-week Open-Label Phase, and a 4-week Double-Blind Randomized Withdrawal Phase.
The Open-Label Phase of the study will be 8 weeks, which includes a 6-week Dose Optimization Period and a 2-week Stable Dose Period. In the Dose Optimization Period, all participants will be titrated to their optimal dose of open-label pitolisant (17.8 milligrams [mg] or 35.6 mg) based on Investigator assessment of tolerability and efficacy. The 3-week titration period will be followed by 3 weeks of flexible dosing (weeks 4-6) during which participants will continue to receive their optimal dose of 17.8 mg or 35.6 mg open-label pitolisant. Participants taking a strong cytochrome P450 2D6 (CYP2D6) inhibitor will be allowed in the study; however, for these participants, the maximum permitted daily dose of pitolisant will be 17.8 mg. Following completion of the 6-week Dose Optimization Period, participants will enter the 2-week Stable Dose Period. During this period, participants will remain at their optimal dose (the same dose they were taking at the end of the Dose Optimization Period [17.8 mg or 35.6 mg]) of open-label pitolisant for 2 weeks; dose adjustments are not allowed during the Stable Dose Period. At the end of the Stable Dose Period, participants will be defined as responders or non-responders. Responders will be randomized in a 1:1 ratio to receive blinded study drug (pitolisant or matching placebo) in the Double-Blind Randomized Withdrawal Phase of the study. Non-responders will not be randomized to treatment in the Double-Blind Randomized Withdrawal Phase and will complete two safety follow-up telephone contacts (TCs) at 15 (±3) days and 30 (+3) days after their final dose of open-label pitolisant.
During the Double-Blind Randomized Withdrawal Phase, participants (approximately 64 participants per treatment group) will receive blinded study drug either at the same dose they were taking in the Stable Dose Period (17.8 mg or 35.6 mg pitolisant) or matching placebo. The duration of the Double-Blind Randomized Withdrawal Phase will be 4 weeks (weeks 9-12); dose adjustments are not permitted during this phase of the study. After completion of the Double-Blind Randomized Withdrawal Phase (End-of Treatment Visit is on Day 84, the last day of blinded treatment), participants will complete two safety follow-up TCs with the site at 15 (±3) days and 30 (+3) days after their final dose of blinded study drug, which will include assessment for adverse events and concomitant medication use; alternatively, participants will have the opportunity to enroll in a long-term, open-label safety study under a separate protocol. Participants who opt to enroll into the long-term, open-label study will not complete the 15-day and 30-day follow-up TCs.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 3
- Model description
- Double-blind, randomized withdrawal
| Arm | Type | Receives |
|---|---|---|
| Double-blind Pitolisant | Active comparator | Drug: Double-blind PitolisantDouble-blind pitolisant administered once daily in the morning upon wakening for 4 weeks during the Double-Blind Randomized Withdrawal Phase |
| Double-blind Placebo | Placebo comparator | Drug: Double-blind PlaceboMatching placebo administered once daily in the morning upon wakening for 4 weeks during the Double-Blind Randomized Withdrawal Phase |
| Open-label Pitolisant | Experimental | Drug: Open-label PitolisantOpen-label pitolisant administered once daily in the morning upon wakening for 8 weeks during the Open-Label Phase |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Is able to provide voluntary, written informed consent.
- Has a current diagnosis of IH per International Classification of Sleep Disorders Third Edition criteria.
- Male or female participant age ≥18 years at the time of Screening.
- Has an Epworth Sleepiness Scale score of ≥12 at Screening and at Baseline (Visit 2).
- Has a Patient Global Impression of Severity score of moderate, severe, or very severe at Screening and at Baseline (Visit 2).
Key exclusion criteria (23 listed)
- Has hypersomnia due to another medical disorder (for example, narcolepsy).
- Has an Apnea Hypopnea Index of ≥10 as determined by the most recent sleep study or BiPAP/CPAP device readout.
- Has a clinically significant hypoventilatory condition as determined by the Investigator.
- Has a primary diagnosis of a psychiatric illness that is not well controlled.
- Participants taking antidepressants who have not been on a stable dose of their antidepressant for at least 12 weeks prior to Screening; participants on a stable dose of their antidepressant for at least 12 weeks prior to Screening must agree to continue their stable dose for the duration of the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Open-label PitolisantPitolisant 4.45 mg tablets: white, round, plain, biconvex film-coated tablet, 3.7 millimeters (mm) in diameter. Each tablet contains 5 mg of pitolisant hydrochloride equivalent to 4.45 mg of pitolisant. Pitolisant 17.8 mg tablets: white, round, plain, biconvex film-coated tablet, 7.5 mm in diameter. Each tablet contains 20 mg of pitolisant hydrochloride equivalent to 17.8 mg of pitolisant. | Drug | Open-label Pitolisant |
| Double-blind PlaceboMatching placebo tablets will be provided for each strength of active pitolisant film-coated tablets. | Drug | Double-blind Placebo |
| Double-blind PitolisantPitolisant 4.45 mg tablets: white, round, plain, biconvex film-coated tablet, 3.7 mm in diameter. Each tablet contains 5 mg of pitolisant hydrochloride equivalent to 4.45 mg of pitolisant. Pitolisant 17.8 mg tablets: white, round, plain, biconvex film-coated tablet, 7.5 mm in diameter. Each tablet contains 20 mg of pitolisant hydrochloride equivalent to 17.8 mg of pitolisant. | Drug | Double-blind Pitolisant |
Primary outcome
Change in Epworth Sleepiness Scale (ESS) Score From Week 8 to Week 12
Time frame: Week 8 to Week 12
The Epworth Sleepiness Scale (ESS) is an 8-item, 4-point rating scale that asks participants to rate the likelihood of falling asleep over the past week. The rating scale ranges from 0 (no chance of dozing) to 3 (high chance of dozing). The total score is calculated by summing the item level ratings. Total scores range from 0 to 24. Higher point totals represent more severe daytime sleepiness.
10 secondary outcomes
Change in Idiopathic Hypersomnia Severity Scale (IHSS) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Proportion of Participants Who Worsened on the Patient Global Impression of Change for Idiopathic Hypersomnia (PGI-C [IH]) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Clinical Global Impression of Severity for IH (CGI-S [IH]) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Patient Global Impression of Severity Scale for Excessive Daytime Sleepiness (PGI-S [EDS]) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Functional Outcomes of Sleep Questionnaire 10-Item Version (FOSQ-10) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Patient-Reported Outcomes Measurement Information System Sleep-Related Impairment Short Form 8a (PROMIS-SRI SF 8a) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Sleep Inertia Questionnaire (SIQ) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Cogstate One Back Test (ONB) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Cogstate Identification Test (IDN) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Change in Cogstate Detection Test (DET) From Week 8 to Week 12
Time frame: Week 8 to Week 12
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Sep 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
58 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Open-label Pitolisant and Double-blind Pitolisant in people with Idiopathic Hypersomnia, run by Harmony Biosciences Management, Inc. at 58 sites in United States.
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 12 inclusion and 23 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: finished, as of the sponsor's last update on 25 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 58 sites in United States. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
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?
Yes. Results are posted in the registry (first posted 25 Sep 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Epworth Sleepiness Scale (ESS) Score From Week 8 to Week 12 (time frame: Week 8 to Week 12). 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 25 Sep 2026.