• Emiliangelo Ratti, David J Carpenter, Stefano Zamuner, Sofia Fernandes, Lisa Squassante, Heidi Danker-Hopfe, Graeme Archer, Jonathan Robertson, Robert Alexander, David G Trist, and Emilio Merlo-Pich.
• GlaxoSmithKline Neuroscience Centre of Excellence for Drug Discovery, Verona, Italy.
• Sleep. 2013 Dec 1; 36 (12): 1823-30.

Study ObjectivesInvestigate the hypnotic effects of repeated doses of neurokinin-1 receptor antagonist, vestipitant, in primary insomnia.DesignRandomized, double-blind, placebo-controlled 28-day parallel-group study.SettingEleven sleep centers in Germany.PatientsOne hundred sixty-one patients with primary insomnia.InterventionsPatients received vestipitant (15 mg) or placebo for 28 days; 2-night polysomnographic assessment occurred on nights 1/2 and 27/28.Measurements And ResultsWake 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).ConclusionsVestipitant 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.

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