Efficacy of vestipitant, a neurokinin-1 receptor antagonist, in primary insomnia.

Abstract

STUDY OBJECTIVES:

Investigate the hypnotic effects of repeated doses of neurokinin-1 receptor antagonist, vestipitant, in primary insomnia.

DESIGN:

Randomized, double-blind, placebo-controlled 28-day parallel-group study.

SETTING:

Eleven sleep centers in Germany.

PATIENTS:

One hundred sixty-one patients with primary insomnia.

INTERVENTIONS:

Patients received vestipitant (15 mg) or placebo for 28 days; 2-night polysomnographic assessment occurred on nights 1/2 and 27/28.

MEASUREMENTS AND RESULTS:

Wake after sleep onset (WASO) was improved on nights 1/2 and 27/28 (ratio, vestipitant versus placebo [95% confidence interval]: 0.76 [0.65, 0.90], P = 0.001 and 0.79 [0.65, 0.96], P = 0.02, respectively), demonstrating maintenance of the effect following repeated dosing. Latency to persistent sleep was shorter with vestipitant on nights 1/2 (P = 0.0006 versus placebo), but not on nights 27/28. Total sleep time (TST) improved with vestipitant (nights 1/2: P < 0.0001, nights 27/28: P = 0.02 versus placebo). Next-day cognitive function tests demonstrated no residual effects of vestipitant (P > 0.05 versus placebo). Adverse events (AEs) occurred in 25% of vestipitant patients versus 22% for placebo. Headache was the most common AE (8% of vestipitant patients versus 9% for placebo).

CONCLUSIONS:

Vestipitant improved sleep maintenance in patients with primary insomnia, with no associated next-day cognitive impairment. The effects on wake after sleep onset and total sleep time were maintained following repeated dosing.

• Authors: Emiliangelo Ratti, David J Carpenter, Stefano Zamuner, Sofia Fernandes, Lisa Squassante, Heidi Danker-Hopfe, Graeme Archer, Jonathan Robertson, Robert Alexander, David G Trist, Emilio Merlo-Pich
• Journal: Sleep (Sleep) Vol. 36 Issue 12 Pg. 1823-30 (Dec 01 2013) ISSN: 1550-9109 [Electronic] United States
• PMID: 24293756 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Fluorobenzenes
• Neurokinin-1 Receptor Antagonists
• Piperidines
• vestipitant

Topics

• Adult
• Double-Blind Method
• Female
• Fluorobenzenes (therapeutic use)
• Humans
• Male
• Middle Aged
• Neurokinin-1 Receptor Antagonists (therapeutic use)
• Piperidines (therapeutic use)
• Polysomnography
• Sleep Initiation and Maintenance Disorders (drug therapy)
• Treatment Outcome
• Young Adult