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Xyrem

Phase 3

Fibromyalgia | Small molecule | Musculoskeletal |Jazz Pharmaceuticals plc|Last Updated: Apr 30, 2019

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials4
Total Enrollment1,876

FDA Designations

No designations recorded

Clinical trial landscape

Xyrem · 7 trials · 3 indications

Phase 3 6Phase 2 1
NCT02221869A Multicenter Study of the Efficacy and Safety of Xyrem With an Open- Label Pharmacokinetic Evaluation and Safety Extension in Pediatric Subjects With Narcolepsy With CataplexyNarcolepsy With Cataplexy
COMPLETED106 Analytics
NCT00423605Safety and Efficacy Study of Xyrem® (Sodium Oxybate) in Subjects With Fibromyalgia.Fibromyalgia
COMPLETED560 Analytics
NCT00423813A Safety and Efficacy Study of Xyrem® (Sodium Oxybate) to Treat Fibromyalgia.Fibromyalgia
COMPLETED573 Analytics
NCT00371137A Safety and Efficacy Study of Xyrem® in Subjects With FibromyalgiaFibromyalgia
COMPLETED548 Analytics
NCT00132873Trial of Xyrem® (Sodium Oxybate) for the Treatment of NarcolepsyNarcolepsy
COMPLETED59 Analytics
NCT00066170Trial Comparing Effects of Xyrem Taken Orally and Modafinil With Placebo in Treating Daytime Sleepiness in NarcolepsyNarcolepsy
COMPLETED231 Analytics
PHASE3COMPLETED
A Multicenter Study of the Efficacy and Safety of Xyrem With an Open- Label Pharmacokinetic Evaluation and Safety Extension in Pediatric Subjects With Narcolepsy With Cataplexy
Narcolepsy With CataplexyUnlock trial analytics
PHASE3COMPLETED
Safety and Efficacy Study of Xyrem® (Sodium Oxybate) in Subjects With Fibromyalgia.
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
A Safety and Efficacy Study of Xyrem® (Sodium Oxybate) to Treat Fibromyalgia.
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
A Safety and Efficacy Study of Xyrem® in Subjects With Fibromyalgia
FibromyalgiaUnlock trial analytics
PHASE3COMPLETED
Trial of Xyrem® (Sodium Oxybate) for the Treatment of Narcolepsy
NarcolepsyUnlock trial analytics
PHASE3COMPLETED
Trial Comparing Effects of Xyrem Taken Orally and Modafinil With Placebo in Treating Daytime Sleepiness in Narcolepsy
NarcolepsyUnlock trial analytics

Study Endpoints

Primary Endpoints

Change in Weekly Number of Cataplexy Attacks
From the end of the Stable Dose Period to the end of the Double-blind Treatment Period (2 weeks)

Double-blind comparison of the change in weekly number of cataplexy attacks from the last 2 weeks of the Stable Dose Period to the 2 weeks of the Double-blind Treatment Period.

Number of Subjects Reporting Adverse Events
Treatment Period (38 weeks)

Number of subjects reporting adverse events.

Pain VAS (Visual Analog Scale) Response. Percentage of Subjects With a Greater Than or Equal to 30% Reduction in Pain VAS From Baseline (BOCF).
Baseline to Week 14

Percentage of pain VAS responders. Subjects with a \>= 30% reduction in pain VAS from baseline to endpoint (week 14) were considered responders; all other subjects were considered non-responders. Missing data were handled using BOCF (Baseline Observation Carried Forward). The pain VAS ranges from 0 (no pain) to 100 (worst imaginable pain). The pain VAS was collected morning, afternoon and evening. Baseline is the average value recorded for the measure during the week prior to the end-of-baseline visit. Endpoint is the average value recorded for the measure during the week prior to week 14.

Adverse Experiences
continuous

Number of Subjects with treatment-emergent adverse events.

Vital Signs
At 1 year

Average Respiratory Rate at 1 year.

Daytime Sleep Latency as Measured by the Maintenance of Wakefulness Test (MWT)
Baseline to Week 8

The Maintenance of Wakefulness Test consisted of four 20 minute tests of the patient's ability to remain awake in soporific conditions. The Mean change from baseline to week 8 in the average MWT number of minutes until sleep onset was the primary endpoint.

The Primary Outcome Measure Was a Composite of Changes From Baseline in Three Co-primary Self Report Measures: Pain Visual Analog Scale (PVAS, Electronic Diaries), Fibromyalgia Impact Questionnaire (FIQ), and Patient Global Impression of Change (PGI-C).
Baseline to week 8

The percentage of participants who met all 3 of the following criteria: Reduction of \>=20% from baseline to week 8 in both PVAS \& FIQ total score and PGI-C response of "very much better" or "much better". Analysis was based on LOCF (Last Observation Carried Forward) data. The PVAS ranges from 0 (no pain) to 100 (worst imaginable pain). The FIQ ranges from 0 (best function) to 100 (worst function). PGI-C is a 7 point likert scale measuring change in the participant's fibromyalgia symptoms that ranges from "very much worse" to "very much better"

Secondary Endpoints

Clinical Global Impression of Change (CGIc) for Cataplexy Severity
From the end of the Stable Dose Period to the end of the Double-blind Treatment Period (2 weeks)
Change in the Epworth Sleepiness Scale (ESS) (CHAD) Score
From the end of the Stable Dose Period to the end of the Double-blind Treatment Period (2 weeks)
CGIc for Narcolepsy Overall
From the end of the Stable Dose Period to the end of the Double-blind Treatment Period (2 weeks)
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
XyremEXPERIMENTALActive Xyrem at a dose ≤9 g/night
Xyrem PlaceboPLACEBO_COMPARATORXyrem placebo at a volume and regimen equivalent to the stable dose of Xyrem.
1EXPERIMENTAL -
2EXPERIMENTAL -
Group 1.EXPERIMENTALXyrem + Modafinil Placebo
Group 2:PLACEBO_COMPARATORXyrem Placebo + Modafinil Placebo
Group 3ACTIVE_COMPARATORXyrem Placebo + Modafinil at established dose
Group 4:EXPERIMENTALXyrem + Modafinil at established dose
3PLACEBO_COMPARATORPlacebo (one of two doses matching active treatment by volume).

Interventions

NameTypeDescription
XyremDRUG -
Xyrem®DRUGflexible dosing
placeboDRUGOral Solution
Xyrem (sodium oxybate) oral solutionDRUGXyrem (sodium oxybate) oral solution
Xyrem PlaceboDRUGXyrem Placebo oral solution 12 ml per day for 4 weeks and 18 ml per day for another 4 weeks.
Modafinil at established doseDRUGModafinil oral capsules at 200 to 600 mg per day for 8 weeks.
Modafinil (Placebo)DRUGModafinil Placebo oral capsules 1 to 3 capsules per day for 8 weeks.
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Eligibility Criteria

Age Range7 Years to 17 Years
SexALL
Healthy VolunteersNo
Study Sites20

Inclusion Criteria: 1. Male or female subjects aged 7-16 years at Visit 2 for subjects on Xyrem at study entry and at Visit 1.1 for Xyrem-naïve subjects (to ensure subjects are \<18 years of age at the end of the study) 2. Have a primary diagnosis of narcolepsy with cataplexy that meets Internation...

Countries:United StatesFranceItalyNetherlandsGermanySpainUnited KingdomPolandCanadaSwitzerland
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Competitive Landscape -Fibromyalgia 5 trials

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Frequently asked questions about Xyrem

What is Xyrem used for?

Xyrem is used for narcolepsy with cataplexy, fibromyalgia, and narcolepsy. It is a small molecule developed by Jazz Pharmaceuticals plc. Clinical trials have evaluated it in fibromyalgia patients, with completed studies enrolling adults aged 18 years and older.

Who makes Xyrem?

Xyrem is developed by Jazz Pharmaceuticals plc, a company traded under the ticker JAZZ. The drug is a small molecule being studied for narcolepsy with cataplexy, fibromyalgia, and narcolepsy.

What phase is Xyrem in?

Xyrem is in Phase 3 clinical development. It has completed four trials, including three Phase 3 studies in fibromyalgia. The drug remains investigational and is not approved for the studied indications based on the available data.

What clinical trials is Xyrem in?

Xyrem has completed four clinical trials, including NCT00087555, a Phase 2 study in fibromyalgia with 195 participants, and NCT00371137, NCT00423605, and NCT00423813, all Phase 3 studies in fibromyalgia with enrollments of 548, 560, and 573 participants respectively.

Is Xyrem the same as sodium oxybate?

Xyrem is the brand name for sodium oxybate. Clinical trial titles refer to Xyrem (Sodium Oxybate), confirming they are the same drug. Jazz Pharmaceuticals plc develops this small molecule for narcolepsy with cataplexy, fibromyalgia, and narcolepsy.