Effectiveness Study Comparing Treatment With Drug(s) or Adjunctive VNS Therapy for Pharmacoresistant Partial Seizures

NCT ID: NCT00215215

Last Updated: 2006-02-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

360 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-02-28

Study Completion Date

2007-11-30

Brief Summary

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To compare outcomes over 12 months of treatment with antiepileptic drugs (AEDs) alone or vagus nerve stimulation (VNS) therapy plus AEDs in patients who have partial seizures refractory to at least two, but not more than five, AEDs.

Detailed Description

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Published data suggest that patients who continue to experience seizures after trials of two or three AEDs are unlikely to become seizure-free with further attempts at pharmacotherapy. Such patients may experience poor quality of life and functional outcomes from continuing seizures and the adverse effects associated with further attempts at pharmacotherapy. VNS is a non-pharmacologic treatment for epilepsy with well-established effectiveness as an adjunctive treatment (to AEDs) for partial seizures refractory to AEDs, but there are no randomized clinical trials comparing the effectiveness of adjunctive VNS therapy with further pharmacotherapy alone in such patients.

Conditions

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Epilepsies, Partial

Keywords

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Vagus Nerve Stimulation Therapy Epilepsies, Partial Seizures Antiepileptic Drugs Refractory Partial Seizures

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Vagus Nerve Stimulation Therapy

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient has a diagnosis of partial seizures with onset before age 50, and the patient's prior electroencephalography and magnetic resonance imaging studies are consistent with the diagnosis of partial seizures.
* Patient has at least 4 complex partial seizures, but less than 25 seizures (any type), per month during the 3 months preceding randomization; for the 8 weeks preceding randomization, the seizure frequency should be confirmed from a patient diary.
* Patient has not had an adequate response to an adequate dosage of -- or was intolerant to -- a minimum of 2 different AEDs.
* Patient has (in the investigator's judgment) sufficient impairment from his/her epilepsy and/or epilepsy treatment that the potential benefits/risks of VNS therapy are warranted.
* Patient must currently be receiving at least one AED, but not more than three AEDs, in a stable dosage regimen for at least one month before randomization.
* Patient must be 12 years of age or older.
* Patient must be able to provide reliable seizure counts and to complete the evaluations specified in the study procedures flow chart.
* Patient must provide written informed consent, or legal guardian must give written permission and the minor provide written assent.

Exclusion Criteria

* Patient has a history (lifetime) of having received more than 5 different AEDs.
* Patient has had a bilateral or left cervical vagotomy.
* Patient currently uses, or is expected to use during the study, short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy.
* A VNS Therapy System implant would (in the investigator's judgment) pose an unacceptable surgical or medical risk for the patient.
* Patient is expected to require full body magnetic resonance imaging during the clinical study.
* Patient has had a previous VNS Therapy System implant.
* Patient has a previous neuroimaging study that demonstrates mesial temporal sclerosis, cortical dysplasia, or a suspected brain tumor.
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cyberonics, Inc.

INDUSTRY

Sponsor Role lead

Principal Investigators

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Carol C Base, RN, MS

Role: STUDY_DIRECTOR

Cyberonics, Inc.

Locations

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Bronislav Shafran, M.D., P.C.

Phoenix, Arizona, United States

Site Status

Xenoscience

Phoenix, Arizona, United States

Site Status

Dedicated Clinical Research, Inc.

Sun City, Arizona, United States

Site Status

USC Comprehensive Epilepsy Center

Los Angeles, California, United States

Site Status

Certified Clinical Research

Roseville, California, United States

Site Status

Pediatric Diagnostic Center

Ventura, California, United States

Site Status

University of Florida, Department of Neurology

Gainesville, Florida, United States

Site Status

Neurology Associates, P.A.

Maitland, Florida, United States

Site Status

Child Neurology Center of Northwest Florida

Pensacola, Florida, United States

Site Status

Pediatric Neurology of Idaho

Boise, Idaho, United States

Site Status

Freeport Health Network, Department of Neurology

Freeport, Illinois, United States

Site Status

Wayne State University School of Medicine, Department of Neurology

Detroit, Michigan, United States

Site Status

Weill-Cornell Medical College, N.Y. Presbyterian Hospital, Comprehensive Epilepsy Center

New York, New York, United States

Site Status

William Huffstutter, M.D.

Asheville, North Carolina, United States

Site Status

Medford Neurological and Spine Clinic

Medford, Oregon, United States

Site Status

Neurology and Sleep Medicine

Bethlehem, Pennsylvania, United States

Site Status

Mid-South Physicians Group, P.L.L.C.

Germantown, Tennessee, United States

Site Status

Hermann Hospital, UT Comprehensive Epilepsy Center

Houston, Texas, United States

Site Status

Texas Tech University Health Sciences Center

Lubbock, Texas, United States

Site Status

Texas Association of Pediatric Neurology

San Antonio, Texas, United States

Site Status

Pivotal Research Centers

Midvale, Utah, United States

Site Status

Pharmaceutical Research Organization

South Ogden, Utah, United States

Site Status

Regional Epilepsy Center Saint Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Schachter SC. Vagus nerve stimulation therapy summary: five years after FDA approval. Neurology. 2002 Sep 24;59(6 Suppl 4):S15-20. doi: 10.1212/wnl.59.6_suppl_4.s15.

Reference Type BACKGROUND
PMID: 12270963 (View on PubMed)

Renfroe JB, Wheless JW. Earlier use of adjunctive vagus nerve stimulation therapy for refractory epilepsy. Neurology. 2002 Sep 24;59(6 Suppl 4):S26-30. doi: 10.1212/wnl.59.6_suppl_4.s26.

Reference Type BACKGROUND
PMID: 12270965 (View on PubMed)

Fisher RS, Handforth A. Reassessment: vagus nerve stimulation for epilepsy [RETIRED]: a report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 1999 Sep 11;53(4):666-9. doi: 10.1212/wnl.53.4.666. No abstract available.

Reference Type BACKGROUND
PMID: 10489023 (View on PubMed)

Heck C, Helmers SL, DeGiorgio CM. Vagus nerve stimulation therapy, epilepsy, and device parameters: scientific basis and recommendations for use. Neurology. 2002 Sep 24;59(6 Suppl 4):S31-7. doi: 10.1212/wnl.59.6_suppl_4.s31.

Reference Type BACKGROUND
PMID: 12270966 (View on PubMed)

Other Identifiers

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E-20

Identifier Type: -

Identifier Source: org_study_id