Literature DB >> 20098520

The effect of eszopiclone in patients with insomnia and coexisting rheumatoid arthritis: a pilot study.

Thomas Roth1, Janet M Price, David A Amato, Robert P Rubens, James M Roach, Thomas J Schnitzer.   

Abstract

OBJECTIVE: To evaluate the efficacy and safety of eszopiclone 3 mg, a nonbenzodiazepine medication/hypnotic indicated for the treatment of insomnia with comorbid rheumatoid arthritis (RA).
METHOD: This multicenter, double-blind, placebo-controlled pilot study was conducted in 153 patients aged 25-64 years with American College of Rheumatology-defined RA who met DSM-IV criteria for insomnia. The data were collected from February to November of 2004. Patients were randomly assigned to either eszopiclone or placebo nightly for 4 weeks, followed by a 2-week placebo run out. Efficacy was evaluated using patient reports of sleep (wake time after sleep onset [WASO], sleep latency [SL], and total sleep time [TST]), daytime function, pain, and RA assessments. Insomnia severity was evaluated using the Insomnia Severity Index. Safety was also evaluated.
RESULTS: Eszopiclone significantly improved all patient-reported sleep measures (WASO, SL, and TST), sleep quality, depth of sleep, and daytime function (P < .05 vs placebo). At week 4, 48% of eszopiclone-treated patients had no clinically meaningful insomnia as assessed by ISI score (versus 30% of placebo-treated patients, P = .03). Eszopiclone was significantly better than placebo on some RA-associated pain measures: (1) overall (P = .05), pain (P = .006), and pain and other symptoms (P = .02) scores of the Arthritis Self-Efficacy Scale, (2) tender joint counts (P = .03) and pain severity scores (P = .023), (3) the activities domain of the Health Assessment Questionnaire-Disability Index (P = .04), and (4) the role physical (P = .03) and bodily pain (P = .01) scales of the 36-item Medical Outcomes Study Short-Form General Health Survey. The most commonly reported adverse events with eszopiclone were unpleasant taste and transient increases in RA symptoms.
CONCLUSIONS: In this pilot study of patients with insomnia comorbid with RA, eszopiclone 3 mg improved all assessed sleep and daytime function measures over the treatment period, as well as some measures of RA-associated pain, disability, and quality of life. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00367965.

Entities:  

Year:  2009        PMID: 20098520      PMCID: PMC2805564          DOI: 10.4088/PCC.08m00749bro

Source DB:  PubMed          Journal:  Prim Care Companion J Clin Psychiatry        ISSN: 1523-5998


  37 in total

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Authors:  J F Fries; P W Spitz; D Y Young
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Authors:  C L Hill; J Parsons; A Taylor; G Leach
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5.  The SF-36 Health Survey as a generic outcome measure in clinical trials of patients with osteoarthritis and rheumatoid arthritis: relative validity of scales in relation to clinical measures of arthritis severity.

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7.  Disturbed sleep in patients complaining of chronic pain.

Authors:  R M Wittig; F J Zorick; D Blumer; M Heilbronn; T Roth
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9.  Objective and subjective sleep disturbances in patients with rheumatoid arthritis. A reappraisal.

Authors:  M Hirsch; B Carlander; M Vergé; M Tafti; J M Anaya; M Billiard; J Sany
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10.  Sleep fragmentation in rheumatoid arthritis.

Authors:  M W Mahowald; M L Mahowald; S R Bundlie; S R Ytterberg
Journal:  Arthritis Rheum       Date:  1989-08
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Authors:  Andrew D Krystal; W Vaughn McCall; Maurizio Fava; Hadine Joffe; Claudio N Soares; Holly Huang; Todd Grinell; Jacqueline Zummo; William Spalding; Randall Marshall
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