Study Comparing Best Medical Practice With or Without VNS Therapy in Pharmacoresistant Partial Epilepsy Patients

NCT ID: NCT00522418

Last Updated: 2015-01-26

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

122 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-02-28

Study Completion Date

2008-07-31

Brief Summary

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This is a post-market medical device study. This study will compare best medical practice with or without adjunctive VNS Therapy in patients who are 16 years and older with pharmacoresistant partial epilepsy.

Detailed Description

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This is a post-market medical device study. This study will compare best medical practice with or without adjunctive VNS Therapy in patients who are 16 years and older with pharmaco-resistant partial epilepsy. The Sponsor, Cyberonics, provides funding for this study. Patients are followed for 26 months, 24 of those months are following the initiation of treatment. No study sites will be permitted to enroll study subjects until Institutional Review Board (IRB)/Ethics Committee (EC) approval has been received.

Conditions

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Epilepsy Partial Epilepsy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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VNS Therapy

VNS Therapy + Best Medical Practice

Group Type EXPERIMENTAL

Vagal Nerve Simulation (VNS) Therapy

Intervention Type DEVICE

VNS Therapy + Best Medical Practice including anti-epileptic drugs

Best Medical Practice

Best Medical Practice

Group Type ACTIVE_COMPARATOR

Best Medical Practive

Intervention Type DRUG

Best Medical Practice including anti-Epileptic Drugs

Interventions

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Vagal Nerve Simulation (VNS) Therapy

VNS Therapy + Best Medical Practice including anti-epileptic drugs

Intervention Type DEVICE

Best Medical Practive

Best Medical Practice including anti-Epileptic Drugs

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patient has confirmed partial onset seizures.
* Seizure activity is not adequately controlled by patient's current AED regimen.
* Patient is between 16 and 75 years of age.
* Patient is able to give accurate seizure counts and health outcomes information. Patient is able to complete study instruments with minimal assistance.
* Patient has previously failed at least 3 AEDs in single or combination use.
* During baseline evaluation period, patient should take at least 1 AED.
* Patient should have confirmed epilepsy for a minimum of 2 years.
* Patient's AED regimen is stable for at least 1 month prior to enrolment.
* Patient has at least 1 objective partial onset seizure per month during the 2 months prior to enrolment.
* Patient or legal guardian understands study procedures and has voluntarily signed an informed consent in accordance with institutional and local regulatory policies.

Exclusion Criteria

* Patient has pseudoseizures or a history of pseudoseizures.
* Patient has idiopathic generalised epilepsy or unclassified epilepsy.
* Patient has ever received direct brain stimulation (cerebella or thalamic) for treatment of epilepsy.
* Patient has had a unilateral or bilateral cervical vagotomy.
* Patient has a history of non-compliance with the completion of a seizure diary.
* Patient has taken an investigational drug within a period of 3 months prior to inclusion.
* Patient is currently using another investigational medical device.
* Patient has a significant cardiac or pulmonary condition currently under treatment.
* Patient has previously undergone brain surgery.
* Patient has a demand cardiac pacemaker, implantable defibrillator, or other implantable stimulator.
* Patient currently lives more than 2 hours from the study site or plans to relocate to a location more than 2 hours from the study site within one year of enrolment in the Study.
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Cyberonics, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Phillippe Ryvlin, MD

Role: PRINCIPAL_INVESTIGATOR

Hopital Neurologique, Lyon, France

Sophie Leyman, MD

Role: STUDY_DIRECTOR

Cyberonics Europe

Locations

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ULB-Hôpital Erasme, Centre de référence pour le traitement de l'épilepsie réfractaire - Neurologie

Brussels, , Belgium

Site Status

UZ Gent, Department of Neurology, 1K12/A

Ghent, , Belgium

Site Status

Foothills Hospital, Neurology Department

Calgary, Alberta, Canada

Site Status

QEII Health Sciences Centre

Halifax, Nova Scotia, Canada

Site Status

Hopital Notre Dame

Montreal, Quebec, Canada

Site Status

Montreal Neurological Institute, Clinical Research

Montreal, Quebec, Canada

Site Status

CHU Grenoble, Neurology Department

Grenoble, , France

Site Status

Hopital Roger Salengro, Service de Neurologie

Lille, , France

Site Status

Hôpital Neurologique, Untité d'épileptologie

Lyon, , France

Site Status

Hôpital Gui De Chauliac, Service Explorations Neurologiques et Epileptologie

Montpellier, , France

Site Status

Hôpital Sainte-Anne, Service de Neurochirurgie

Paris, , France

Site Status

Service d'exploration des épilepsies

Strasbourg, , France

Site Status

CHU Tours, Service de neurologie

Tours, , France

Site Status

Universitätskliniken Bonn, Klinik für Epileptologie

Bonn, , Germany

Site Status

Universitätsklinik Erlangen, Zentrum für Epilepsie ZEE

Erlangen, , Germany

Site Status

Klinik der Ernst-Moritz-Arndt-Universität, Neurologische Klinik

Greifswald, , Germany

Site Status

Epilepsiezentrum Kork

Kehl-Kork, , Germany

Site Status

Klinikum der Philips-Universität Marburg, Fachbereich, 20 - Medizin / Klinik Neurologie / Epilepsie Zentrum

Marburg, , Germany

Site Status

Sächsisches Epilepsiezentrum Radeberg, Epilepsiezentrum Kleinwachau

Radeberg, , Germany

Site Status

Azienda Ospedaliero Universitaria - Ospedali Riuniti Umberto I - Lancisi - Salesi, NeuroPsichiatria Infantile

Ancona, , Italy

Site Status

Universita di Bologna, Clinica Neurologica

Bologna, , Italy

Site Status

Azienda Ospendaliero-Universitaria, Caressi Dep Neuroscience

Florence, , Italy

Site Status

Ospedale San Paolo, Centro Epilessia

Milan, , Italy

Site Status

Universita degli Studi di Cagliari - Policlinico Monserrato, Clinica Neurologica

Monserrato, , Italy

Site Status

Universita di Pisa, Clinica Neurologica

Pisa, , Italy

Site Status

Ospedale F. Lotti, NeuroFisioPatalogia

Pontedera, , Italy

Site Status

Azienda Ospedaliera "Bianchi Melacrino Morelli", Centro Regionale Epilessie

Reggio Calabria, , Italy

Site Status

Università Cattolica Del Sacro Cuore, Istituto di NeuroChirurgia

Roma, , Italy

Site Status

Centro Epilessia, Dipartimento di Neuroscienze

Torino, , Italy

Site Status

Tergooiziekenhuizen, Dienst Neurologie

Blaricum, , Netherlands

Site Status

Medisch Spectrum Twente, Dienst Neurologie

Enschede, , Netherlands

Site Status

Stichting Epilepsie Instituut Nederland, Dienst Neurologie

Heemstede, , Netherlands

Site Status

Kempenhaeghe, Dienst Neurologie

Oosterhout, , Netherlands

Site Status

Medisch Centrum Rijnmond-Zuid, locatie Clara, Dienst Neurologie

Rotterdam, , Netherlands

Site Status

Spesialsykehuset for Epilepsi, Dep of Neurodiagnostics

Sandvika, , Norway

Site Status

Hospital Ruber Internacional, Servicio de neurología

Madrid, , Spain

Site Status

Hospital Clínico de Santiago

Santiago de Compostela, , Spain

Site Status

Hospital Clínico Universitario, Servicio de neurología

Valencia, , Spain

Site Status

Hospital General de Valencia, Neurology/Neurophisiology

Valencia, , Spain

Site Status

Hospital General Basico De La Defensa de Valencia, Servicio de neurología

Valencia, , Spain

Site Status

Institute of Neuroscience and Physiology, Clinical Neuroscience and Rehabilitation

Gothenburg, , Sweden

Site Status

Universitetssjukhuset i Lund, Neurologiska kliniken

Lund, , Sweden

Site Status

Norrlands Universitetssjukhus, Neurocentrum

Umeå, , Sweden

Site Status

Akademiska sjukhuset, Neurocentrum

Uppsala, , Sweden

Site Status

Addenbrookes Hospital, Dept of Neurosurgery

Cambridge, , United Kingdom

Site Status

Walton Centre, Dept of Neurosciences, Clinical Sciences Centre

Fazakerley, , United Kingdom

Site Status

Kings College Hospital, Dept of Neurosurgery

London, , United Kingdom

Site Status

National Hospital for Neurology and Neurosurgery

London, , United Kingdom

Site Status

Countries

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Belgium Canada France Germany Italy Netherlands Norway Spain Sweden United Kingdom

References

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Gilliam F. Optimizing health outcomes in active epilepsy. Neurology. 2002 Apr 23;58(8 Suppl 5):S9-20. doi: 10.1212/wnl.58.8_suppl_5.s9.

Reference Type BACKGROUND
PMID: 11971128 (View on PubMed)

Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9. doi: 10.1056/NEJM200002033420503.

Reference Type BACKGROUND
PMID: 10660394 (View on PubMed)

Sillanpaa M, Jalava M, Kaleva O, Shinnar S. Long-term prognosis of seizures with onset in childhood. N Engl J Med. 1998 Jun 11;338(24):1715-22. doi: 10.1056/NEJM199806113382402.

Reference Type BACKGROUND
PMID: 9624191 (View on PubMed)

Mattson RH, Cramer JA, Collins JF, Smith DB, Delgado-Escueta AV, Browne TR, Williamson PD, Treiman DM, McNamara JO, McCutchen CB, et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med. 1985 Jul 18;313(3):145-51. doi: 10.1056/NEJM198507183130303.

Reference Type BACKGROUND
PMID: 3925335 (View on PubMed)

Mattson RH, Cramer JA, Collins JF. A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group. N Engl J Med. 1992 Sep 10;327(11):765-71. doi: 10.1056/NEJM199209103271104.

Reference Type BACKGROUND
PMID: 1298221 (View on PubMed)

Mattson RH, Cramer JA, Collins JF. Prognosis for total control of complex partial and secondarily generalized tonic clonic seizures. Department of Veterans Affairs Epilepsy Cooperative Studies No. 118 and No. 264 Group. Neurology. 1996 Jul;47(1):68-76. doi: 10.1212/wnl.47.1.68.

Reference Type BACKGROUND
PMID: 8710127 (View on PubMed)

Schmidt D. The clinical impact of new antiepileptic drugs after a decade of use in epilepsy. Epilepsy Res. 2002 Jun;50(1-2):21-32. doi: 10.1016/s0920-1211(02)00065-7.

Reference Type BACKGROUND
PMID: 12151114 (View on PubMed)

Lhatoo SD, Wong IC, Polizzi G, Sander JW. Long-term retention rates of lamotrigine, gabapentin, and topiramate in chronic epilepsy. Epilepsia. 2000 Dec;41(12):1592-6. doi: 10.1111/j.1499-1654.2000.001592.x.

Reference Type BACKGROUND
PMID: 11114218 (View on PubMed)

Morris GL 3rd, Mueller WM. Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. The Vagus Nerve Stimulation Study Group E01-E05. Neurology. 1999 Nov 10;53(8):1731-5. doi: 10.1212/wnl.53.8.1731.

Reference Type BACKGROUND
PMID: 10563620 (View on PubMed)

Malow BA, Edwards J, Marzec M, Sagher O, Ross D, Fromes G. Vagus nerve stimulation reduces daytime sleepiness in epilepsy patients. Neurology. 2001 Sep 11;57(5):879-84. doi: 10.1212/wnl.57.5.879.

Reference Type BACKGROUND
PMID: 11552020 (View on PubMed)

Harden CL, Pulver MC, Ravdin LD, Nikolov B, Halper JP, Labar DR. A Pilot Study of Mood in Epilepsy Patients Treated with Vagus Nerve Stimulation. Epilepsy Behav. 2000 Apr;1(2):93-99. doi: 10.1006/ebeh.2000.0046.

Reference Type BACKGROUND
PMID: 12609137 (View on PubMed)

Elger G, Hoppe C, Falkai P, Rush AJ, Elger CE. Vagus nerve stimulation is associated with mood improvements in epilepsy patients. Epilepsy Res. 2000 Dec;42(2-3):203-10. doi: 10.1016/s0920-1211(00)00181-9.

Reference Type BACKGROUND
PMID: 11074193 (View on PubMed)

Clark KB, Naritoku DK, Smith DC, Browning RA, Jensen RA. Enhanced recognition memory following vagus nerve stimulation in human subjects. Nat Neurosci. 1999 Jan;2(1):94-8. doi: 10.1038/4600.

Reference Type BACKGROUND
PMID: 10195186 (View on PubMed)

McLachlan RS, Sadler M, Pillay N, Guberman A, Jones M, Wiebe S, Schneiderman J. Quality of life after vagus nerve stimulation for intractable epilepsy: is seizure control the only contributing factor? Eur Neurol. 2003;50(1):16-9. doi: 10.1159/000070853.

Reference Type BACKGROUND
PMID: 12824707 (View on PubMed)

Cramer JA, Ben Menachem E, French J. Review of treatment options for refractory epilepsy: new medications and vagal nerve stimulation. Epilepsy Res. 2001 Nov;47(1-2):17-25. doi: 10.1016/s0920-1211(01)00286-8.

Reference Type BACKGROUND
PMID: 11673017 (View on PubMed)

Gilliam FG, Fessler AJ, Baker G, Vahle V, Carter J, Attarian H. Systematic screening allows reduction of adverse antiepileptic drug effects: a randomized trial. Neurology. 2004 Jan 13;62(1):23-7. doi: 10.1212/wnl.62.1.23.

Reference Type BACKGROUND
PMID: 14718691 (View on PubMed)

Ryvlin P, Gilliam FG, Nguyen DK, Colicchio G, Iudice A, Tinuper P, Zamponi N, Aguglia U, Wagner L, Minotti L, Stefan H, Boon P, Sadler M, Benna P, Raman P, Perucca E. The long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: the PuLsE (Open Prospective Randomized Long-term Effectiveness) trial. Epilepsia. 2014 Jun;55(6):893-900. doi: 10.1111/epi.12611. Epub 2014 Apr 22.

Reference Type RESULT
PMID: 24754318 (View on PubMed)

Other Identifiers

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E-100

Identifier Type: -

Identifier Source: org_study_id

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