Placebo-Controlled, Double-Blind, Study to Determine the Safety and Efficacy of SDX in Patients With IH

Last updated: January 29, 2025
Sponsor: Zevra Therapeutics
Overall Status: Completed

Phase

2

Condition

Sleep Disorders

Idiopathic Hypersomnia

Treatment

Placebo

Serdexmethylphenidate

Clinical Study ID

NCT05668754
KP1077.D01
  • Ages > 18
  • All Genders

Study Summary

This is a study of the safety, efficacy and pharmacokinetics (PK) of Serdexmethylphenidate (SDX) compared to placebo in subjects with Idiopathic Hypersomnia (IH).

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. At least 18 years of age at the time of consent

  2. Body Mass Index (BMI) ≤35 kg/m2

  3. Documented primary diagnosis of IH according to the International Classification of Sleep Disorders (ICSD-3) criteria

  4. At the Screening Visit and Baseline Visit (start of OLTP), Epworth Sleepiness Scale (ESS) scores ≥11

  5. Average nightly Total Sleep Time (TST) of ≥7 hours, per subject history and confirmed during screening.

  6. Subject must be in general good health defined as the absence of any clinically relevant abnormalities as determined by the Investigator based on physical and neurological examinations, vital signs, ECGs, medical history, and clinical laboratory values (hematology, chemistry, and urinalysis) at Screening.

  7. If currently treated with nicotine replacement therapy, must have been taking the same regimen and dose for at least 2 months prior to screening and must agree to take the same dose during the study.

  8. Have used a medically acceptable method of contraception for at least 2 months prior to the first dose of study drug and consent to use a medically acceptable method of contraception from the first dose of study drug, throughout the entire study period, and for 90 days after the last dose of study drug.

Exclusion Criteria

  1. Hypersomnia due to another medical, behavioral, or psychiatric disorder condition (eg, narcolepsy, depression disorders, multiple sclerosis, Parkinson's disease, stroke).

  2. Clinically significant sleep-related breathing disorders, including sleep apnea, treatment with Continuous Positive Airway Pressure (CPAP) therapy, Obstructive Apnea Hypopnea Index (AHI) >15 episodes per hour, or hypoventilation.

  3. Clinically significant parasomnias (eg, sleep walking, rapid eye movement [REM] sleep behavior disorder, etc).

  4. Periodic Limb Movement Disorder (PLMD) Arousal Index (PLMA-I) >15 during Screening PSG, a historical diagnosis of PLMD (last 10 years), or a PLMD diagnosis older than 10 years with current (last 60 days) treatment or symptoms of rhythmic movements involving one or both legs during sleep.

  5. Occupation requiring nighttime shift work or variable shift work with early work start times (before 6 AM), if this occurs more than once per week.

  6. Planned travel during the study that includes more than 3 time zones, or planned travel that includes 3 time zones on more than 2 occasions during the study.

  7. Going to sleep for the night later than 1 AM at a frequency of more than once per week.

  8. Current or past (within 1 year) major depressive episode according to DSM-5 criteria.

  9. Any history of attempted suicide (lifetime) or clinically significant suicidal ideation, in the opinion of the Investigator, based on the C-SSRS assessment at Screening.

  10. Any clinically significant unstable medical abnormality, chronic disease (eg, asthma or diabetes), or a history of a clinically significant abnormality of the cardiovascular, central nervous system,

  11. Any of the following out-of-range vital signs at Screening: systolic blood pressure outside 90-145 mmHg; diastolic blood pressure outside 50-90 mmHg; resting heart rate outside 40-100 beats per minute.

  12. History or presence of abnormal ECGs, which in the Investigator's opinion is clinically significant, including the following:

  13. ECG findings of ischemia or infarct

  14. Complete bundle branch blocks

  15. Symptomatic arrhythmias as ventricular arrhythmias (non- sustained ventricular tachycardia (VT), multifocal or frequent premature ventricular contractions), bundle branch block, axis deviation, or abnormal or any predominantly non-sinus- conducted rhythm.

  16. QTcF >450 msec for males or >470 msec for females, on Screening ECG.

  17. PR interval outside the range of 120 to 220 msec on Screening ECG

  18. Estimated glomerular filtration rate (GFR) at Screening <60 mL/min/1.73 m2.

  19. Malignant neoplastic disease requiring therapy within 2 years prior to Screening or during the study, or clinically relevant as judged by the Investigator.

  20. Uncontrolled thyroid disorder as evidenced by thyroid stimulating hormone (TSH) ≤0.8 x the lower limit of normal (LLN) or ≥1.25 x the upper limit of normal (ULN) for the reference laboratory at Screening.

  21. Laboratory value for aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >3 x upper limits of normal (ULN).

  22. Excessive caffeine use during the 10 days prior to first dose of study drug or anticipated excessive use defined as >600 mg/day of caffeine during the treatment periods of the study.

  23. Treatment or planned treatment with prohibited medications (including medications that may affect daytime sleepiness and nighttime sleep) or unwilling to refrain from any prohibited medications. Treatment must have been discontinued 14 days or 5 half-lives, whichever is longer, prior to the first dose of study medication (and at least 30 days for sedating antidepressants; at least 14 days for CNS stimulants).

  24. Current or past (within 12 months prior to Screening) substance use disorder (including alcohol and psychoactive cannabinoids) according to DSM-5 criteria; current or past history of substance abuse treatment (including alcohol), or unwilling to refrain from substance use (including alcohol) during the study.

  25. Nicotine dependence that has an effect on sleep (eg, a subject who routinely awakens at night to smoke).

  26. Evidence of substance or alcohol use or has a positive urine or breath alcohol or positive urine drug screen at Screening.

Study Design

Total Participants: 50
Treatment Group(s): 2
Primary Treatment: Placebo
Phase: 2
Study Start date:
December 28, 2022
Estimated Completion Date:
March 21, 2024

Study Description

SDX is a prodrug of dexmethylphenidate (d-MPH). SDX behaves as a prototypical prodrug that is devoid of pharmacological effects until metabolized to active d-MPH. Central nervous system (CNS) stimulants, including d-MPH products, are being used off-label by patients with IH. The potential advantage of SDX-derived d-MPH is its unique PK profile with rising d-MPH plasma concentrations at approximately 3 hours postdose followed by a broad peak from approximately 8 to 12 hours postdose (without sharp exposure spikes), and a gradual decline after the peak.

The optimal dose of SDX will be determined for each participant by titration based on individual tolerability and response during the 5-week SDX-only Open-Label Titration period (OLTP), after which 2/3 of the participants will continue to receive SDX and 1/3 of the participants will receive placebo (withdrawal design) in the 2-week Double-Blind Withdrawal Period (DBWP).

The study will evaluate safety (primary endpoint), efficacy and PK in patients with IH after daily oral administration of SDX either once per day in the evening (qd pm) or twice per day (morning and evening: bid). The study is expected to inform about the optimal SDX dose range and the best dose regimen (nighttime dosing or twice-per-day) for further studies in patients with IH and narcolepsy. The evening dosing regimen (just before bedtime) is of interest since there is little or no exposure to d-MPH for the first several hours post-dose and the mean peak d-MPH concentration occurs at 10-12 hours post-dose (ie, in the morning after a nighttime dose).

Connect with a study center

  • Sleep Disorders Center Of Alabama

    Birmingham, Alabama 35201
    United States

    Site Not Available

  • Amr Daphne

    Daphne, Alabama 36526
    United States

    Site Not Available

  • Lakeview Clinical Research

    Guntersville, Alabama 35976
    United States

    Site Not Available

  • Mayo Clinic - Arizona

    Phoenix, Arizona 85004
    United States

    Site Not Available

  • SOCAL Clinical Research

    Huntington Beach, California 92647
    United States

    Site Not Available

  • Stanford University

    Redwood City, California 94063
    United States

    Site Not Available

  • Sleep Medicine Specialists of California

    San Ramon, California 94583
    United States

    Site Not Available

  • SDS Clinical Trials, Inc

    Santa Ana, California 92701
    United States

    Site Not Available

  • Delta Waves, Inc.

    Colorado Springs, Colorado 80903
    United States

    Site Not Available

  • Saint Francis Sleep Allergy and Lung Institute LLC

    Clearwater, Florida 33755
    United States

    Site Not Available

  • New Generation of Medical Trials

    Hialeah, Florida 33010
    United States

    Site Not Available

  • Angels Clinical Research

    Miami, Florida 33122
    United States

    Site Not Available

  • Clinical Trial Services, Corp

    Miami, Florida 33144
    United States

    Site Not Available

  • Ivetmar Medical Group

    Miami, Florida 33130
    United States

    Site Not Available

  • Somnology Research Associates

    Miami, Florida 33130
    United States

    Site Not Available

  • Pasadena Center for Medical Research

    Saint Petersburg, Florida 33707
    United States

    Site Not Available

  • Clinical Site Partners, LLC - Winter Park

    Winter Park, Florida 32789
    United States

    Site Not Available

  • Global Research Associates

    Atlanta, Georgia 30303
    United States

    Site Not Available

  • Neurotrials Research, Inc

    Atlanta, Georgia 30303
    United States

    Site Not Available

  • The Neurological Center of North Georgia

    Gainesville, Georgia 30501
    United States

    Site Not Available

  • Clinical Research Institute - Stockbridge

    Stockbridge, Georgia 30281
    United States

    Site Not Available

  • The University of Kansas Medical Center Research Institution Inc.

    Kansas City, Kansas 64106
    United States

    Site Not Available

  • Mid-Atlantic Epilepsy and Sleep Center - Bethesda

    Bethesda, Maryland 20817
    United States

    Site Not Available

  • Sleep Doc

    Chevy Chase, Maryland 20815
    United States

    Site Not Available

  • Neurocare, Inc.

    Newton, Massachusetts 02459
    United States

    Site Not Available

  • Western Michigan University Homer Stryker Md School of Medicine

    Kalamazoo, Michigan 49007
    United States

    Site Not Available

  • Henry Ford Health - Columbus

    Novi, Michigan 48375
    United States

    Site Not Available

  • Clinical Neurophysiology Services PC

    Sterling Heights, Michigan 48313
    United States

    Site Not Available

  • University of Missouri School Of Medicine

    Columbia, Missouri 65211
    United States

    Site Not Available

  • Clayton Sleep Institute, Llc

    Saint Louis, Missouri 63123
    United States

    Site Not Available

  • Barrett Clinic

    La Vista, Nebraska 68128
    United States

    Site Not Available

  • Global Medical Institutes LLC- Princeton Medical Institute

    Lawrence Township, New Jersey 08648
    United States

    Site Not Available

  • Clinical Research of Gastonia (CRG)

    Gastonia, North Carolina 28052
    United States

    Site Not Available

  • Intrepid Research

    Cincinnati, Ohio 45202
    United States

    Site Not Available

  • Ohio Sleep Medicine Institute

    Dublin, Ohio 43017
    United States

    Site Not Available

  • Brian Abaluck, LLC

    Malvern, Pennsylvania 19355
    United States

    Site Not Available

  • Thomas Jefferson University

    Philadelphia, Pennsylvania 19107
    United States

    Site Not Available

  • Medical University Of South Carolina (MUSC) - Institute Of Psychiatry (IOP)

    Charleston, South Carolina 29401
    United States

    Site Not Available

  • Bogan Sleep Consultants

    Columbia, South Carolina 29201
    United States

    Site Not Available

  • Futuresearch Trials Of Neurology

    Austin, Texas 78701
    United States

    Site Not Available

  • Dfw Clinical Research Associates

    Fort Worth, Texas 76244
    United States

    Site Not Available

  • Houston Clinical Research Associates

    Houston, Texas 77002
    United States

    Site Not Available

  • Sleep Therapy & Research Center

    San Antonio, Texas 78205
    United States

    Site Not Available

  • TPMG Clinical Research - Williamsburg

    Williamsburg, Virginia 23185
    United States

    Site Not Available

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