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Aroxybutynin and Atomoxetine

Phase 3

OSA | Small molecule | Respiratory |Apnimed, Inc.|Trials Updated: Sep 11, 2026

Aroxybutynin and Atomoxetine development status

Highest phase Phase 3
Registered trials 6 across 1 sponsor since Oct 2020

Aroxybutynin and Atomoxetine target and mechanism

ModalitySmall molecule

Also known as AD109

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLED
Total Trials6
Total Enrollment2,980

FDA Designations

No designations recorded

Aroxybutynin and Atomoxetine clinical trials

Aroxybutynin and Atomoxetine · 6 trials · 3 indications

Phase 3 3Phase 2 3
NCT06566820Continuation Protocol for Obstructive Sleep Apnea (OSA)OSA
ENROLLING BY_INVITATION1,280 Analytics
NCT05813275Parallel-Arm Study to Compare AD109 to Placebo With Patients With OSA (SynAIRgy Study)OSA
COMPLETED646 Analytics
NCT05811247Parallel Arm Trial of AD109 and Placebo With Patients With OSA (LunAIRo)OSA
COMPLETED660 Analytics
PHASE3ENROLLING BY_INVITATION
Continuation Protocol for Obstructive Sleep Apnea (OSA)
OSAUnlock trial analytics
PHASE3COMPLETED
Parallel-Arm Study to Compare AD109 to Placebo With Patients With OSA (SynAIRgy Study)
OSAUnlock trial analytics
PHASE3COMPLETED
Parallel Arm Trial of AD109 and Placebo With Patients With OSA (LunAIRo)
OSAUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Adverse Events (AES) and Serious Adverse Events (SAEs)
through study completion, an average of 1 year

An AE is any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of a study treatment, whether or not considered related to the medicinal product. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study treatment. An SAE was an AE during any study phase that fulfills one or more of the following criteria: results in death, life threatening (The term 'life-threatening' in the definition of 'serious' refers to an event in which the participant was at risk of death at the time of the event. It does not refer to an event, which hypothetically might have caused death, if it were more severe), requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent disability/incapacity.

Number of Participants With Vital Signs Abnormalities
through study completion, an average of 1 year

Vital signs that are planned to be assessed include parameters such as weight,heart rate and systolic and diastolic blood pressure.

Number of Participants With Concomitant Therapy (Medication or Devices)
through study completion, an average of 1 year

Concomitant therapy with devices (i.e., CPAP) and concomitant medications are other prescription medications, over-the-counter (OTC) drugs or dietary supplements that a study participant takes in addition to the drug under investigation.

Change From Baseline in Apnea-Hypopnea Index (AHI)
6 months

AHI, Apnea-Hypopnea Index, is the number of apneas or hypopneas recorded via polysomnography during the study per hour of sleep. Apnea is defined as a cessation of airflow lasting at least 10 seconds, hypopnea as a decrease in airflow by at least 30% from baseline for at least 10 seconds occurring with a drop in oxygen saturation (SpO2) by at least 4%.

Primary Objective (Adverse Events)
6 weeks

General safety and tolerability will be assessed between treatment cohorts using the occurrence of spontaneously reported adverse events (AEs) at 6 weeks

Change in Apnea-Hypopnea Index (AHI4) From Baseline: Combined AD109 Arms vs. Placebo
Baseline (mean of PSG Visits 2 and 3) to Day 21 and Day 28 (PSG Visits 5 and 6)

Change in AHI4 (apnea-hypopnea index, 4% oxygen desaturation criterion; average respiratory events per hour of sleep) measured by in-lab polysomnography. Baseline was the mean of two pre-treatment PSG nights (Visits 2 and 3). Change from baseline was assessed at treatment PSG nights at approximately Day 21 (Visit 5) and Day 28 (Visit 6), modeled as repeated measures, with the reported value representing the model-based LS mean using equal (0.5/0.5) weighting between the Day 21 and Day 28 visits.

Change in Hypoxic Burden (HB) Log10HB[(%*Min)/Hour]
1 night (treatment duration) (0-8 hours collected continuously)

Change in Hypoxic Burden (HB) is calculated as the oxygen desaturation 'area under the curve' in association with individual apneas and hypopneas. Due to the known logarithmic distribution of HB, data are primarily expressed and analyzed as Log10HB 4%\[% min/hour\]. Events with 4% or greater desaturations were included in the calculation of HB.

Secondary Endpoints

Change in Apnea-Hypopnea Index (AHI4) From Baseline: Combined AD504 Arms vs. Placebo
Baseline (mean of PSG Visits 2 and 3) to Day 21 and Day 28 (PSG Visits 5 and 6)
Change in Apnea-Hypopnea Index (AHI4) From Baseline: Atomoxetine vs. Placebo
Baseline (mean of PSG Visits 2 and 3) to Day 21 and Day 28 (PSG Visits 5 and 6)
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeOTHER

Treatment Arms

ArmTypeDescription
AD109EXPERIMENTALOpen Label AD109
PlaceboPLACEBO_COMPARATOR -
Arm 1ACTIVE_COMPARATORTwenty patients who are taking GLP-1 at time of enrollment will be treated with AD109
Arm 2ACTIVE_COMPARATORTwenty patients who are not taking a GLP-1 will be treated with AD109 only
AD109 75/5mgEXPERIMENTALAtomoxetine 75 mg/Aroxybutynin 5 mg tablet
AD109 75/2.5mgEXPERIMENTALAtomoxetine 75 mg/Aroxybutynin 2.5 mg tablet
AD504 75/100mgEXPERIMENTALAtomoxetine 75 mg tablet/Trazodone 100 mg capsule
AD504 75/50mgEXPERIMENTALAtomoxetine 75 mg tablet/Trazodone 50 mg capsule
Atomoxetine 75mgACTIVE_COMPARATORAtomoxetine 75 mg tablet
Atomoxetine 75mg plus placeboACTIVE_COMPARATORAtomoxetine 75 mg tablet/placebo capsule
Placebo tabletPLACEBO_COMPARATOR -
Placebo tablet plus placebo capsulePLACEBO_COMPARATOR -
AtomoxetineACTIVE_COMPARATOROral capsule administered before sleep
R-oxybutyninACTIVE_COMPARATOROral capsule administered before sleep

Interventions

NameTypeDescription
Aroxybutynin and AtomoxetineDRUGFixed Dose Combination
AD109DRUGAroxybutynin 2.5 mg/atomoxetine 75 mg tablet, administered orally once daily at bedtime (Weeks 2-26). Week 1 run-in: aroxybutynin 2.5 mg/atomoxetine 37.5 mg tablet.
PlaceboDRUGMatching placebo tablet administered orally once daily at bedtime for 26 weeks, with run-in and target dose matched to active arm packaging
AD504DRUGOral administration at bedtime
Atomoxetine HydrochlorideDRUGOral administration at bedtime
AtomoxetineDRUGOral administration before bed
R-oxybutyninDRUGOral administration before bed
Digit System Substitution TestDIAGNOSTIC_TESTa neuropsychological test sensitive to brain damage, dementia, age and depression where numbers are assigned symbols. Under each digit the subject should write down the corresponding symbol as fast as possible. The number of correct symbols within the allowed time is measured.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersYes
Study Sites99

Inclusion Criteria: * Completion of APC-APN-304 without permanent discontinuation of IMP. * Completion of APC-APN-305 without permanent discontinuation of IMP. Exclusion Criteria: * Participants are excluded from the study if participation would be considered unsafe by the investigator based on t...

Countries:United StatesCanada
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