- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04639193
Combination Drug-Therapy for Patients With Untreated Obstructive Sleep Apnea (RESCUE-Combo)
Rescuing OSA Patients Unable to Tolerate CPAP Using Endotype-Targeted Combination Drug Therapy: a Randomized, Double-Blind, Placebo-Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
California
-
La Jolla, California, United States, 92037
- Recruiting
- Altman Clinical and Translational Research Institute Building
-
Contact:
- Dillon Gilbertson, MS
- Phone Number: 8582462155
- Email: dcgilbertson@health.ucsd.edu
-
La Jolla, California, United States, 92121
- Recruiting
- UCSD Health - Pulmonary and Sleep Clinic
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- BMI 18-40 kg/m2
- Untreated Moderate or Severe OSA (AHI during supine NREM sleep >15/h) with a fraction of hypopneas >25% of all events
Exclusion Criteria:
- Pregnancy
- Breastfeeding
- Prisoners
- Adherent with effective therapy for OSA
- Other known untreated sleep fragmenting disorder, such as periodic limb movement disorder, or narcolepsy
- Inability to sleep supine for overnight sleep studies
- Circadian rhythm disorder
- Unrevascularized coronary artery disease, angina, prior heart attack or stroke, congestive heart failure
- Uncontrolled hypertension (systolic blood pressure >160mmHg, diastolic blood pressure >95mmHg)
- Presence of tracheostomy
- Hospitalization within the past 90 days
- Prior peptic ulcer disease, esophageal varices, or gastrointestinal bleeding (< 5 years)
- Prior gastric bypass surgery
- Chronic liver disease or end-stage kidney disease
- Active illicit substance use or >2 oz daily alcohol use (i.e. >2 12 oz bottles of beers, >2 5 oz glasses of wine, >2 1.5 oz glasses of hard liquor such as spirits, gin, whiskey, etc.)
- Psychiatric disease, other than well controlled depression/anxiety
- Cognitive impairment, inability to provide consent, or inability to complete research procedures (e.g. questionnaires that are only available/validated in English)
- Chronically using study drugs or drugs with similar pharmacodynamic effects (acetazolamide - carbonic anhydrase inhibitors, eszopiclone - benzodiazepine receptor agonists, venlafaxine - serotonin/norepinephrine reuptake inhibitors and other antidepressants)
- Regular use of medications known to affect control of breathing (opioids, benzodiazepines, theophylline)
- Contraindications to taking study drugs, including allergies to any of the drugs or sulfa allergy; concomitant use of antidepressants, opioids, sedatives/hypnotics, thiazide diuretics or angiotensin-receptor blockers; or severe nocturnal hypoxia (SpO2 nadir <70% on diagnostic sleep study).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Placebo, then Dual-Therapy, then Single/Triple-Therapy
Subjects will start with a 3-day PLACEBO regimen:
After a wash-out period of 4+ days, subjects will then cross-over to a 3-day EXPERIMENTAL DUAL-regimen:
After a wash-out period of 4+ days, subjects will then undergo an OPEN-LABEL SINGLE/TRIPLE-regimen:
|
Acetazolamide tablet (encapsulated)
Other Names:
Eszopiclone tablet (encapsulated)
Other Names:
Sugar capsule manufactured to match encapsulated Acetazolamide/Eszopiclone
Venlafaxine capsule
Other Names:
|
Experimental: Dual-Therapy, then Placebo, then Single/Triple-Therapy
Subjects will start with a 3-day EXPERIMENTAL DUAL-regimen:
After a wash-out period of 4+ days, subjects will then cross-over to a 3-day PLACEBO regimen:
After a wash-out period of 4+ days, subjects will then undergo an OPEN-LABEL SINGLE/TRIPLE-regimen:
|
Acetazolamide tablet (encapsulated)
Other Names:
Eszopiclone tablet (encapsulated)
Other Names:
Sugar capsule manufactured to match encapsulated Acetazolamide/Eszopiclone
Venlafaxine capsule
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Apnea Hypopnea Index (AHI) during supine Non-Rapid Eye Movement (NREM) sleep
Time Frame: 3 nights
|
The AHI is a measure of sleep apnea severity and is defined as the number of apneas (no breathing for 10+ seconds) and hypopneas (reduced breathing for 10+ seconds associated with a >=3% desaturation or cortical arousal) per hour of sleep.
To avoid confounding by sleep stages and positions across study nights we will focus on the AHI during supine NREM sleep.
|
3 nights
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SpO2 Nadir
Time Frame: 3 nights
|
The lowest measured blood oxygen saturation during the overnight sleep study measured in percent.
|
3 nights
|
Pathophysiological Traits
Time Frame: 3 nights
|
Changes in pathophysiological traits (Vpassive, Vactive, Arousal Threshold, Loop Gain) will be quantified as %Veupnea from polysomnography data using a validated algorithm.
|
3 nights
|
Percent Responders
Time Frame: 3 nights
|
Responders will be defined as a drop in AHI>50% to <10/h.
|
3 nights
|
Subjective Sleepiness: Stanford Sleepiness Scale (SSS)
Time Frame: 3 nights
|
Subjective sleepiness will be assessed using the Stanford Sleepiness Scale (SSS) in the morning following the overnight sleep study.
The score ranges from 1 to 7, with greater values indicating more sleepiness.
|
3 nights
|
Vigilance
Time Frame: 3 nights
|
Vigilance will be assessed using the 5-minute psychomotor vigilance test (PVT) in the morning following the overnight sleep study.
|
3 nights
|
Sleep Quality: PROMIS (Patient-Reported Outcomes Measurement Information System) Sleep Disturbance
Time Frame: 3 nights
|
Sleep quality will be assessed based on a modified 8-question PROMIS Sleep Disturbance questionnaire in the morning following the overnight sleep study.
The raw score ranges from 8 to 40 and is translated into a T-score, a standardized score with a mean of 50 and a standard deviation of 10.
Greater T-scores indicate greater sleep disturbance.
|
3 nights
|
Blood Pressure
Time Frame: 3 nights
|
Systolic/Diastolic Blood Pressure (measured at rest in the morning following the overnight sleep study).
|
3 nights
|
Collaborators and Investigators
Investigators
- Principal Investigator: Christopher Schmickl, MD, PhD, Associate Physician and Postdoctoral Fellow
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Respiratory Tract Diseases
- Apnea
- Respiration Disorders
- Sleep Disorders, Intrinsic
- Dyssomnias
- Sleep Wake Disorders
- Sleep Apnea Syndromes
- Sleep Apnea, Obstructive
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Enzyme Inhibitors
- Carbonic Anhydrase Inhibitors
- Natriuretic Agents
- Psychotropic Drugs
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Antidepressive Agents
- Hypnotics and Sedatives
- Diuretics
- Anticonvulsants
- Antidepressive Agents, Second-Generation
- Serotonin and Noradrenaline Reuptake Inhibitors
- Acetazolamide
- Venlafaxine Hydrochloride
- Eszopiclone
Other Study ID Numbers
- 191990
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.
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