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0648 Phase 3 Randomized Placebo-Controlled Trial of Pitolisant for Excessive Daytime Sleepiness in Prader-Willi Syndrome

A. Revana, David Seiden, K. Rapchak, A. Adee, Eric Bauer, Grant Runyan, George Nomikos

Sleep, 2024

100 participants

Abstract

Prader-Willi syndrome (PWS) is a genetic, neurodevelopmental disorder characterized by global hypothalamic dysfunction that results in a variety of symptoms including behavioral disturbance, hyperphagia, and excessive daytime sleepiness (EDS). Pitolisant is approved for the treatment of EDS or cataplexy in adults with narcolepsy. In a phase 2, proof-of-concept study, pitolisant showed trends of reduction in EDS relative to placebo in patients with PWS.

This multicenter, randomized, double-blind, placebo-controlled, phase 3 study will evaluate the efficacy and safety of pitolisant in patients with PWS. The study will enroll patients ≥6 years of age with a genetically confirmed diagnosis of PWS, and have EDS as confirmed by the investigator. Selected exclusion criteria include patients with symptoms or diagnosis of psychosis or schizophrenia, inadequately treated sleep disordered breathing, and moderate or severe hepatic or renal impairment. Eligible patients will be randomly assigned (1:1) to receive pitolisant (weight-based dosing: 8.9-44.5 mg/d) or matching placebo tablets. The 11-week double-blind period will be followed by an optional 52-week open-label extension.

Up to 100 patients per group will be enrolled. The primary endpoint will be change from baseline at Week 11 in EDS as measured by the PROMIS-SRI (Patient-Reported Outcomes Measurement Information System - Sleep Related Impairment [Parent Proxy]). The secondary endpoints will include behavioral disturbance as…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 100 participants or records.

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