This study will assess the safety and efficacy of JZP258 (XYWAV) on sleepiness, polysomnography, and functional outcomes in patients with idiopathic hypersomnia (IH) or narcolepsy.
This prospective, multicenter, single-arm, open-label interventional study will assess the safety and efficacy of JZP258 on sleepiness, polysomnography measurements (eg, sleep stage transitions, sleep patterns, and sleep quality), daytime and nighttime symptoms, pharmacokinetics (in narcolepsy), and patient-reported outcomes that include subjective sleep quality and quality of life in patients with IH or narcolepsy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
199
Narcolepsy Cohort: Initiate dosage per XYWAV label and titrate to effect. IH Cohort: Initiate dosage per XYWAV label and titrate to effect. Exploratory Narcolepsy \>9-Gram Cohort: XYWAV titrated to a dosage of \>9 to 12 grams.
Change From Baseline in Epworth Sleepiness Scale (ESS) Total Score in Participants With IH and Narcolepsy Treated With XYWAV
The ESS total score (the sum of 8 item scores, each 0 to 3) can range from 0 to 24. Higher ESS total scores are associated with higher sleep propensity in daily life, also referred to as "daytime sleepiness."
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
Change From Baseline in Idiopathic Hypersomnia Severity Scale (IHSS) Total Score in Participants With IH Treated With XYWAV
The IHSS is a 14-item self-reported instrument that assesses the severity and functional consequences of IH symptoms. Questions capture symptoms of excessive sleepiness, sleep inertia, and long sleep duration. IHSS total scores range from 0 to 50 with higher score indicating worse clinical outcome.
Time frame: Baseline up to End of Treatment (approximately 10-21 weeks)
Change From Baseline in Number of Stage Shifts of Sleep in Participants With Narcolepsy Treated With XYWAV
Stage shifts of sleep are defined as the count of transitions of bouts of sleep from deeper to lighter stages of sleep/wake (ie from N3/N2/N1/REM to wake and from N3/N2/REM to N1).
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
Change From Baseline in Duration of Sleep Stages in Participants With Narcolepsy Treated With XYWAV
Duration of sleep stages is measured in minutes (ie N1/N2/N3/REM) and is recorded from sleep onset to awakening during the nocturnal polysomnograph.
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
Change From Baseline in Number of Nocturnal Awakenings and Nocturnal Arousals in Participants With Narcolepsy Treated With XYWAV
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
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Sleep Disorders Center of Alabama
Birmingham, Alabama, United States
Perseverance Research Center, LLC
Scottsdale, Arizona, United States
Amnova Clinical Research
Irvine, California, United States
Long Beach Research Institute
Lakewood, California, United States
Santa Monica Clinical Trials
Los Angeles, California, United States
Stanford School of Medicine
Redwood City, California, United States
TriValley Sleep Center
San Ramon, California, United States
SDS Clinical Trials, Inc.
Santa Ana, California, United States
Meris Clinical Research, LLC
Brandon, Florida, United States
PharmaDev Clinical Research Institute, LLC
Miami, Florida, United States
...and 22 more locations
Change From Baseline in Percentage of Sleep Stages in Participants With Narcolepsy Treated With XYWAV
The percentage of sleep stages is measured as minutes of each sleep stage (N3/N2/N1/REM) per hour of sleep time from sleep onset to awakening in the nocturnal polysomnograph.
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
Patient Global Impression of Change (PGI-C) in Participants With IH and Narcolepsy Treated With XYWAV (Overall, Sleep Inertia, and Fatigue)
The PGI-C is a single-item 7-point, Likert-type scale for rating change in disease or symptom severity. Responses for each question ranged from 1 (very much improved) to 7 (very much worse) relative to baseline. Participants rated the change from baseline in their overall (IH or narcolepsy) symptoms, sleep inertia (difficulty waking in the morning), and fatigue (extreme tiredness resulting from mental or physical exertion).
Time frame: End of Treatment (approximately 10-36 weeks)
Level of Rested or Refreshed Upon Awakening in Participants With IH and Narcolepsy Treated With XYWAV (Sleep Diary)
The participant was asked "How rested or refreshed did you feel when you woke up for the day?"
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
Patient Global Impression of Severity (PGI-S) Score in Participants With IH and Narcolepsy Treated With XYWAV (Overall, Sleep Inertia, and Fatigue)
The PGI-S is a single-item, 7-point, Likert-type scale for rating disease or symptom severity. Responses ranged from 0 (not present) to 7 (extremely severe). Participants rated the severity of their overall (IH or narcolepsy) symptoms, sleep inertia, and fatigue. Higher scores indicate worse clinical outcome.
Time frame: Baseline up to End of Treatment (approximately 10-36 weeks)
Pharmacokinetic Parameter Maximum Plasma Concentration (Cmax) In a Subset of Participants With Narcolepsy Treated With XYWAV
Blood samples were processed to obtain plasma samples and then analyzed for oxybate concentrations using a validated bioanalytical method.
Time frame: PK: Predose, 0.5 hour, 0.75 hour, 1 hour, 1.5 hour post-first dose and post-second dose, 6 hour post-first dose, 8 hour post-first dose
Pharmacokinetic Parameter Area Under the Concentration-Time Curve From Time 0 to Infinity (AUC0-inf) In a Subset of Participants With Narcolepsy Treated With XYWAV
Blood samples were processed to obtain plasma samples and then analyzed for oxybate concentrations using a validated bioanalytical method.
Time frame: PK: Predose, 0.5 hour, 0.75 hour, 1 hour, 1.5 hour post-first dose and post-second dose, 6 hour post-first dose, 8 hour post-first dose