Pediatric Prolonged-Release Melatonin for Sleep Disturbances in Children and Adolescents With Anorexia Nervosa (MELSom-ANOREXIA)

NCT07576764 | Not Yet Recruiting Phase 3 DMC

• 1 other identifier: RCAPHM23_0329
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

Sleep disturbances are reported by more than 50% of patients with Anorexia Nervosa (AN) and are associated with increased AN severity, psychiatric comorbidities, and poorer quality of life. To date, no pharmacological treatment has been approved or recommended for sleep disorders in children and adolescents with AN. Many drugs are currently prescribed off-label for their sedative side effects, without proven safety or efficacy in this population. Pediatric prolonged-release melatonin (PedPRM, Slenyto®) is the only melatonin formulation approved by the European Medicines Agency (EMA) for chronic insomnia in children aged 2 to 18 years with neurodevelopmental disorders. Its excellent safety profile, absence of tolerance, and long-acting formulation make it a prime candidate for treating sleep disturbances in children and adolescents with AN. MELSom-ANOREXIA is a multicenter, randomized, double-blind, placebo-controlled, parallel-group Phase IIIb trial. Its primary objective is to assess the efficacy of PedPRM compared to placebo in improving Total Sleep Time (TST) in children and adolescents aged 6 to 18 years with AN and impaired sleep. Participants are randomized into two groups: the experimental group receives PedPRM (2 mg or 5 mg depending on response at Day 22) and the control group receives a matching placebo, both administered 0.5 to 1 hour before habitual bedtime for 13 weeks. Sleep is assessed by Sleep Diary and actigraphy. Secondary outcomes include other sleep parameters, AN severity (BMI, EDI-2, EDE-Q), associated symptoms (anxiety, depression, physical activity, executive function, emotionality), and quality of life. Melatonin secretion profiles and specific subgroups (ASD traits, early-onset AN) are also explored. The study includes a 2-week run-in period (D-14 to D0) for baseline sleep assessment, followed by 13 weeks of treatment, with visits at D0, D22, and D93. A total of 120 participants will be enrolled across 7 French pediatric psychiatry centers over 24 months.

Conditions

Anorexia Nervosa; Sleep Disorders in Children

Keywords

anorexia

Outcome Measures

Primary Outcomes (1)

• Change from baseline in mean Total Sleep Time (TST) measured by Sleep Diary

  Baseline (Day-14 to Day 0) and end of treatment (Day 78 to Day 93)

Secondary Outcomes (11)

• Change from baseline in mean Sleep Latency (SL) measured by Sleep Diary

  Baseline and end of treatment (Day 78 to Day 93)

• Change from baseline in mean Wake After Sleep Onset (WASO) measured by Sleep Diary

  Baseline and end of treatment (Day 78 to Day 93)

• Change from baseline in mean number of awakenings measured by Sleep Diary

  Baseline and end of treatment (Day 78 to Day 93)

• Change from baseline in mean Longest Sleep Episode (LSE) measured by Sleep Diary

  Baseline and end of treatment (D78 to D93)

• Change from baseline in mean Total Sleep Time

  Baseline and end of treatment (Day 78 to Day 93)

Study Arms (2)

PedPRM (Pediatric Prolonged-Release Melatonin)

EXPERIMENTAL

Participants receive pediatric prolonged-release melatonin (PedPRM, Slenyto®) orally, 0.5 to 1 hour before habitual bedtime, every evening for 13 weeks. Starting dose is 2 mg (2 × 1 mg tablets). At Day 22, dose is increased to 5 mg (1 × 5 mg tablet) in case of insufficient sleep improvement (less than 1 hour improvement in sleep latency and/or total sleep time from baseline).

Drug: Pediatric Prolonged-Released Melatonin (PedPRM)

Placebo

PLACEBO COMPARATOR

Participants receive a matching placebo orally, 0.5 to 1 hour before habitual bedtime, every evening for 13 weeks. At Day 22, placebo units are adjusted in the same manner as the experimental group to maintain blinding.

Drug: Placebo

Interventions

Pediatric Prolonged-Released Melatonin (PedPRM) DRUG

Pediatric prolonged-release melatonin mini-tablets (Slenyto® 1 mg and 5 mg, Neurim Pharmaceuticals). Oral administration 0.5 to 1 hour before habitual bedtime every evening for 13 weeks. Initial dose: 2 mg/day (2 × 1 mg tablets). Dose may be increased to 5 mg/day (1 × 5 mg tablet) at Day 22 in case of insufficient sleep improvement.

PedPRM (Pediatric Prolonged-Release Melatonin)

Placebo DRUG

Matching placebo mini-tablets, identical in appearance and formulation to the PedPRM therapeutic units. Oral administration 0.5 to 1 hour before habitual bedtime every evening for 13 weeks. Number of units adjusted at Day 22 to match the experimental group and maintain blinding.

Placebo

Eligibility Criteria

• Age: 6 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Participants aged 6 to 18 years, inclusive, with a diagnosis of Anorexia Nervosa (AN) according to DSM-5 criteria Presence of a sleep problem for at least 1 month, defined as ≤ 6 hours of continuous sleep and/or ≥ 0.5 hours sleep latency from lights-off on 3 out of 5 nights, based on participant report (with or without parental assistance according to age), confirmed at D0 by 2-week sleep diary No response to at least 4 weeks of sleep hygiene Negative pregnancy test at baseline, prior to randomization, for female participants of childbearing potential Women of childbearing potential must agree to use a highly effective method of contraception during the study treatment period and for at least 4 weeks after the last dose of study treatment Written informed consent obtained in accordance with the participant's legal status and applicable regulations Affiliation to a social security system or equivalent

Sponsors & Collaborators

• Assistance Publique Hopitaux De Marseille: lead

Study Sites (1)

AP-HM Hopital Salvator

Marseille, France

Location

MeSH Terms

Conditions

Anorexia Nervosa; Anorexia

Condition Hierarchy (Ancestors)

Feeding and Eating Disorders; Mental Disorders; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• FRANCOIS CREMIEUX

  DIRECTION DE LA RECHERCHE SANTE

  STUDY DIRECTOR

Central Study Contacts

Flora MD PHD BAT-PITAULT

CONTACT

+33491745857; flora.bat@ap-hm.fr

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Blinding is maintained through the use of placebo therapeutic units identical in appearance and formulation to the PedPRM therapeutic units. Preparation, packaging and labelling of melatonin or placebo units are performed by the Pharmaceutical Expertise and Clinical Research Unit of AP-HM Sponsor to ensure double-blindness. Unblinding may only occur in cases where knowledge of the administered product is strictly necessary for participant management, or in the event of unexpected serious adverse events requiring regulatory reporting.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants are randomly assigned in a 1:1 ratio to one of two parallel groups: the experimental group receiving pediatric prolonged-release melatonin (PedPRM) and the control group receiving a matching placebo. Treatment is administered for 13 weeks.

Study Record Dates

• First Submitted: April 27, 2026
• First Posted: May 8, 2026
• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): January 1, 2029
• Study Completion (Estimated): January 1, 2029
• Last Updated: May 8, 2026

Record last verified: 2026-04

Locations

FR (1)