Double-blind Randomized Controlled Trial Comparing Suvorexant 20 mg to Placebo for Treatment of Insomnia in Cancer Survivors
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Cancer survivors have an incidence of sleep disturbance and insomnia higher than the general population, with significant potential implications on health outcomes including in survivorship domains and mortality outcomes. Available pharmacologic options for management of sleep disturbance are limited in efficacy and in their side effects. Investigators propose a double-blind placebo-controlled trial evaluating the use of the use of Suvorexant in breast cancer survivors on selective estrogen receptor modulators or aromatase inhibitors with sleep disturbance to assess the impact on insomnia symptoms and quality of life. Evaluation of breast cancer survivors on endocrine therapy uses a study population with high 5-year survival rate while retaining the capacity for recruitment and creating an opportunity to explore potential effects on vasomotor symptoms. Suvorexant has the potential to have a significant impact in cancer survivors not only on sleep related outcomes but also on cancer survivorship outcomes.
The purpose of the research study is to evaluate the ability of Suvorexant, a medication approved by the Food and Drug Administration (FDA) for insomnia, to treat sleep disturbance in breast cancer survivors on endocrine therapy.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Sarah Marrison, MD PhD
- Phone Number: 843-876-1210
- Email: marrison@musc.edu
Study Locations
-
-
South Carolina
-
Charleston, South Carolina, United States, 29425
- MUSC Department of Family Medicine
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult post menopausal breast cancer survivors (female, > 18 years old)
- current selective estrogen modulator or aromatase inhibitor use
- at least 6 weeks beyond completion of definitive treatment for breast cancer
- less than 5 years from time of diagnosis.
Exclusion Criteria:
- less than 6-month life expectancy
- current steroid use
- severe depression or anxiety
- severe hepatic impairment
- concurrent use of moderate or strong CYP3A inhibitors
- current receipt of hospice care
- severe mental illness
- current use of greater than 40 morphine milligram equivalents daily
- diagnosis of obstructive sleep apnea, narcolepsy or other sleep related illness other than insomnia
- pregnancy
- treatment with alternate pharmacotherapy for insomnia at the time of trial initiation
- menstrual cycle within the past year
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Suvorexant with information on sleep hygiene
Participants randomized to this arm will receive 10 mg of suvorexant daily with a dose increase to 20 mg after day 7. Medication will be administered as an oral medication.
Total duration of 28 days.
|
Suvorexant initially with 10-20 mg for 28 days
|
|
Placebo Comparator: Placebo with information on sleep hygiene
Participants randomized to this arm will receive placebo control daily with a switch to an alternate placebo control vial after 7 days, consistent with intervention arms.
Medication will be administered as an oral medication.
Total duration of 28 days.
|
Matched Placebo Control for 28 days
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Participant Reported Insomnia Symptoms Evaluated Using the Insomnia Severity Index (ISI)
Time Frame: 4 weeks
|
The ISI is scored on a scale of 0-28 based on responses to 7 questions, with higher values indicating more severe symptoms of sleep disturbance.
Five participants completed the study.
|
4 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Vasomotor Symptoms Assessed Using the Hot Flash Related Daily Interference Scale
Time Frame: 4 weeks
|
Vasomotor symptoms were assessed using the Hot Flash Related Daily Interference Scale.
This validated instrument measures the extent to which hot flashes interfere with daily activities and quality of life.
Scores range from 0 to 100, with higher scores indicating greater interference due to vasomotor symptoms.
Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
4 weeks
|
|
Quality of Life Evaluated Using the SF-36
Time Frame: 4 Weeks
|
Health-related quality of life was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).
We have reported the average domain score for the general health domain.
Each domain score ranges from 0 to 100, with higher scores indicating better health-related quality of life.
Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
4 Weeks
|
|
Quality of Life Evaluated Using the Cancer Problems in Living Scale (CPIL)
Time Frame: 4 weeks
|
Problems related to living with cancer were assessed using the Cancer Problems of Living (CPIL) Scale.
The CPIL consists of a multi-item list of cancer-related problems across practical, emotional, and social domains.
Participants rate each problem based on perceived severity, with higher ratings indicating greater problem severity.
Each item is scored on a scale of 0-2 with the composite score reported.
Score range from 0 to 58.
Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
4 weeks
|
|
Pain Evaluation Evaluated Using the Brief Pain Inventory (BPI)
Time Frame: 4 weeks
|
Pain severity was assessed using the Brief Pain Inventory (BPI).
The BPI asks participants to rate current pain, average pain, least pain, and worst pain on numeric rating scales ranging from 0 to 10, with higher scores indicating greater pain severity.
A total pain severity score can be calculated by averaging these items.
Score range is from 0 to 10. Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
4 weeks
|
|
Number of Participants Reported as Adherent Using the Simplified Medication Adherence Questionnaire (SMAQ)
Time Frame: 4 weeks
|
Medication adherence was assessed using the Simplified Medication Adherence Questionnaire (SMAQ).
The SMAQ is a brief, participant-reported questionnaire composed of six multiple-choice questions evaluating medication-taking behavior.
Non-adherence is indicated by any positive response suggesting missed doses or by reporting more than two missed doses during the preceding week.
The outcome reported was the number of participants who were adherent based on this evaluation.
Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
4 weeks
|
|
Vasomotor Symptoms Assessed Using the Hot Flash Related Daily Interference Scale
Time Frame: 2 weeks
|
Vasomotor symptoms were assessed using the Hot Flash Related Daily Interference Scale.
This validated instrument measures the extent to which hot flashes interfere with daily activities and quality of life.
Scores range from 0 to 100, with higher scores indicating greater interference due to vasomotor symptoms.
Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
2 weeks
|
|
Participant Reported Insomnia Symptoms Evaluated Using the Insomnia Severity Index (ISI)
Time Frame: 2 weeks
|
The Insomnia Severity Index (ISI) score was evaluated at baseline, 2 weeks, and 4 weeks.
The ISI is scored on a scale of 0-28 based on responses to 7 questions, with higher values indicating more severe symptoms of sleep disturbance.
Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
2 weeks
|
|
Pain Evaluation Evaluated Using the Brief Pain Inventory (BPI)
Time Frame: 2 weeks
|
Pain severity was assessed using the Brief Pain Inventory (BPI).
The BPI asks participants to rate current pain, average pain, least pain, and worst pain on numeric rating scales ranging from 0 to 10, with higher scores indicating greater pain severity.
A total pain severity score can be calculated by averaging these items.
Score range is from 0 to 10. Five participants completed the study.
Due to early study termination for insufficient accrual, the planned statistical analyses were not performed.
|
2 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sarah Marrison, MD PhD, Medical University of South Carolina
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Mental Disorders
- Neoplasms by Site
- Neoplasms
- Sleep Wake Disorders
- Skin Diseases
- Breast Diseases
- Sleep Disorders, Intrinsic
- Dyssomnias
- Skin and Connective Tissue Diseases
- Breast Neoplasms
- Sleep Initiation and Maintenance Disorders
- Substandard Drugs
- Pharmaceutical Preparations
- suvorexant
Other Study ID Numbers
Other Study ID Numbers
- Pro00130637
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.