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Trial registered on ANZCTR
Registration number
ACTRN12621000158864
Ethics application status
Approved
Date submitted
20/01/2021
Date registered
16/02/2021
Date last updated
8/06/2022
Date data sharing statement initially provided
16/02/2021
Date results provided
15/02/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Trial of combination drug therapy to treat sleep apnoea
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Scientific title
The effect of antihistaminergic and antimuscarinic drugs on disease severity in adults with obstructive sleep apnoea
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Secondary ID [1]
303168
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n/a
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Universal Trial Number (UTN)
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Trial acronym
Beta-OxyOSA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obstructive sleep apnoea
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Condition category
Condition code
Respiratory
318213
318213
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0
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Sleep apnoea
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Randomised, placebo-controlled, two arm crossover study (~1 week washout between visits): Arm 1: oral capsules of betahistine (96 mg) and oxybutynin (5mg) immediately prior to sleep (single night, in laboratory study)
Arm 2: placebo oral capsules immediately prior to sleep (single night, in-laboratory study)
Interventions will be administered by a study investigator on each laboratory visit just prior to sleep for these acute sleep studies to ensure adherence.
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Intervention code [1]
319469
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Treatment: Drugs
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Comparator / control treatment
Placebo (maize starch capsules) compared to visually identical capsules of active drug.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Sleep apnoea severity using the apnoea/hypopnoea index (AHI) assessed from overnight polysomnogram
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Assessment method [1]
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Timepoint [1]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [1]
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Sleep efficiency from overnight polysomnogram
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Assessment method [1]
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Timepoint [1]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [2]
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Oxygen desaturation index from overnight polysomnogram measured using pulse oximetry
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Assessment method [2]
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Timepoint [2]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [3]
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Arousal index and other standard polysomnography parameters measured from overnight polysomnogram
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Assessment method [3]
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Timepoint [3]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [4]
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Daytime sleepiness measured by Karolinska Sleepiness Scale questionnaire
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Assessment method [4]
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Timepoint [4]
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Questionnaire administered upon waking after overnight sleep study after placebo and drug nights.
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Secondary outcome [5]
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Polysomnography-derived endotype (pharyngeal muscle responsiveness)
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Assessment method [5]
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Timepoint [5]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [6]
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Next day alertness (breaking reaction time) measured by driving simulator performance
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Assessment method [6]
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Timepoint [6]
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After each single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [7]
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Next day alertness (steering deviation) measured by driving simulator performance
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Assessment method [7]
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Timepoint [7]
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After each single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [8]
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Polysomngraphy-derived endotype (loop gain)
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Assessment method [8]
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Timepoint [8]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [9]
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Polysomnography-derived endotype ( upper airway collapsibility)
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Assessment method [9]
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Timepoint [9]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Secondary outcome [10]
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Polysomnography-derived endotype (arousal threshold)
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Assessment method [10]
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Timepoint [10]
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Single overnight acute sleep studies (placebo and drug nights, approximately 1 week washout between studies)
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Eligibility
Key inclusion criteria
Otherwise healthy adults with obstructive sleep apnoea aged 18 - 75 years with BMI < 40.0kg/m^2 at screening.
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Any acute or chronic medical condition other than well controlled hypertension , hyperlipidemia, compensated diabetes.
• Any medication known to influence breathing, sleep/arousal or muscle physiology.
• Any medication known to interact with mono amino oxidases.
• Inability to sleep supine (data collection requires a majority of supine position and body position is controlled)
• Any other condition which in the opinion of the investigator would present an unreasonable risk to the participant, or which would interfere with their participation in the study or unduly confound study interpretation, or would render the participant unable or unlikely to understand or comply with the study design, or the receive the specified medications.
• Allergy to oxymetazoline HCl, betahistine dihydrochloride, oxybutynin hydrochloride.
• Bronchial asthma and atopic family history, which are more susceptible to associate with bronchospasm following betahistine dihydrochloride administration.
• Gastric or peptic ulcer, which might be worsened by betahistine dihydrochloride administration on an empty stomach.
• Benign prostatic hyperplasia or urinary retention, which can be exacerbated by the antimuscarinic agent.
• Individuals with underlying cardiac disease, such as arrhythmias.
• Individuals with previous or recent history of phaeochromocytoma.
• Individuals taking tricyclic antidepressants.
• History of moderate or severe renal impairment.
• Pregnancy or breast feeding.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation via randomised code generated by the independent pharmacist.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A blocked sequence (groups of four) will be generated independently by the study pharmacist prior to the beginning of the trial.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The primary outcome of a difference in AHI between the placebo and drug conditions for each participant will be assessed using two-tailed paired t-test or Wilcoxon signed rank test as appropriate according to normality distribution.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/02/2021
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Actual
18/02/2021
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Date of last participant enrolment
Anticipated
30/11/2022
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Actual
3/06/2021
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Date of last data collection
Anticipated
31/12/2022
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Actual
11/06/2021
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Sample size
Target
12
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Accrual to date
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Final
13
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment postcode(s) [1]
32523
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5042 - Flinders University
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Flinders University
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Address [1]
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Sturt Road, Bedford park SA 5042
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Country [1]
307575
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Australia
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Primary sponsor type
University
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Name
Flinders University
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Address
Sturt Road, Bedford Park SA 5042
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Country
Australia
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Secondary sponsor category [1]
308267
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None
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Name [1]
308267
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Address [1]
308267
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Country [1]
308267
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307634
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Southern Adelaide Clinical HREC
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Ethics committee address [1]
307634
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Flinders Medical Centre, Southern Adelaide Local Health Network, SA Health Flinders Drive, Bedford Park SA 5042
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Ethics committee country [1]
307634
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Australia
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Date submitted for ethics approval [1]
307634
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01/10/2020
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Approval date [1]
307634
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18/12/2020
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Ethics approval number [1]
307634
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248.20
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Summary
Brief summary
Aim: To determine in a proof-of-concept study if re-purposing existing approved medications that target the sleep/wake system and upper airway muscle control reduce sleep apnoea severity. Research design: randomised, double -blind, placebo-controlled, cross-over. Methods: Participants will be required to attend 2 overnight visits, each separated by 1 week in the sleep laboratory. Standard sleep monitoring equipment will be applied including: electrodes on the surface of the head, face and chest to monitor wakefulness and sleep, a sensor placed on the finger to monitor oxygen levels, bands placed around the chest and abdomen along with airflow sensors or a mask over the nose to monitor breathing. Participants will be randomised to receive either a placebo (sugar pill) or a combination of two medications (betahistine 96 mg + oxybutynin 5 mg) just prior to sleep.
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Trial website
n/a
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Trial related presentations / publications
n/a
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Public notes
n/a
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Contacts
Principal investigator
Name
107942
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Prof Danny Eckert
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Address
107942
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Adelaide Institute for Sleep Health
Flinders University
Level 2, Mark Oliphant Building,
5 Laffer Drive
Bedford Park SA 5042
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Country
107942
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Australia
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Phone
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+61 874219780
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Carolin Tran
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Address
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Adelaide Institute for Sleep Health
Flinders University
Level 2, Mark Oliphant Building,
5 Laffer Drive
Bedford Park SA 5042
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Country
107943
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Australia
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Phone
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+61 874219873
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Danny Eckert
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Address
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Adelaide Institute for Sleep Health
Flinders University
Level 2, Mark Oliphant Building,
5 Laffer Drive
Bedford Park SA 5042
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Country
107944
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Australia
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Phone
107944
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+61 874219780
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Fax
107944
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Email
107944
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified individual data will be provided for key outcomes in the primary publication of the study
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When will data be available (start and end dates)?
After the study is complete and the findings are published. No end date.
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Available to whom?
Via journal publication to any interested readers
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
Via journal publication
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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