Study of Perampanel as Adjunctive Treatment for Inadequately Controlled Seizures Associated With Lennox-Gastaut Syndrome
NCT ID: NCT02834793
Last Updated: 2022-03-09
Study Results
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View full resultsBasic Information
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TERMINATED
PHASE3
101 participants
INTERVENTIONAL
2016-12-13
2021-07-19
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Matching placebo
During the Randomization Phase, participants will receive matching placebo for up to 18 weeks.
During the Extension A, participants who received placebo during the Randomization Phase will begin treatment with perampanel in a blinded manner in double-blind Conversion Period, starting at 2 mg/day and then up-titrated to a maximum target dose of 8 mg/day according to individual tolerability and efficacy. After the Conversion Period, participants can be titrated up to 12 mg/day (at 2-week intervals) per the investigator's discretion.
Placebo
Participants will receive matching placebo in Randomization phase.
Perampanel
Participants will receive perampanel in Randomization phase, open-label Extension A, and open-label Extension B.
Perampanel up to 8 mg/day
During the Randomization Phase, participants will receive perampanel at a starting dose of 2 milligrams per day (mg/day). Thereafter, the dose will be increased to a maximum target dose of 8 mg/day according to individual tolerability and efficacy for up to 18 weeks. Participants who enter into Extension A will continue to receive perampanel at the dose last received during randomization phase. Participants can be titrated up to 12 mg/day (at 2-week intervals) per the investigator's discretion.
Participants who continue in Extension B will continue to receive perampanel at the dose last received at the end of Extension A.
Perampanel
Participants will receive perampanel in Randomization phase, open-label Extension A, and open-label Extension B.
Interventions
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Placebo
Participants will receive matching placebo in Randomization phase.
Perampanel
Participants will receive perampanel in Randomization phase, open-label Extension A, and open-label Extension B.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
1. more than one type of generalized seizure, including drop seizures (atonic, tonic, or myoclonic) for at least 6 months before Visit 1;
2. an electroencephalogram (EEG) reporting diagnostic criteria for LGS at some point in their history (abnormal background activity accompanied by slow, spike, and wave pattern \<2.5 hertz \[Hz\]).
* Participants must be at least 2 years old at the time of consent/assent
* Participants must have been \<11 years old at the onset of LGS
* Participants must have experienced an average of at least 2 drop seizures per week in the 4-week Baseline Period preceding randomization
* Participants must have been receiving 1 to 4 concomitant antiepileptic drugs (AEDs) at a stable dose for at least 30 days before Visit 1 (vagal nerve stimulation (VNS) and ketogenic diet do not count as AEDs). Use of cannabidiol (CBD) products is allowed and is counted as one of the 4 maximum allowed concomitant AEDs. CBD dose and product must have remained stable for at least 30 days before Visit 1 and is to remain the same throughout the course of the Core Study
* In the investigator's opinion, parents or caregivers must be able to keep accurate seizure diaries
* Body weight at least 8 kilogram (kg)
Exclusion Criteria
* Presence of drop seizure clusters where individual seizures cannot be reliably counted (seizure clusters are defined as ≥2 drop seizures with \<5 minutes between any 2 consecutive seizures)
* Prior treatment with perampanel with discontinuation due to safety issues (related to perampanel)
* Prior treatment with perampanel within 30 days before Visit 1
* Evidence of clinically significant disease (eg, cardiac, respiratory, gastrointestinal, renal disease, hepatic disease) that in the opinion of the investigator(s) could affect the participant's safety or study conduct
* Scheduled for epilepsy-related surgery or any other form of surgery during the projected course of the study
* Ketogenic diet and VNS, unless stable and ongoing for at least 30 days before Visit 1
* Treatment with an investigational drug or device within 30 days before Visit 1
* Status epilepticus within 12 weeks of Visit 1
* If felbamate is used as a concomitant AED, participants must be on felbamate for at least 1 year, with a stable dose for 60 days before Visit 1. They must not have a history of white blood cell (WBC) count below ≤2500/microliters (μL), platelets \<100,000/μL, liver function tests (LFTs) \>3 times the upper limit of normal (ULN), or other indication of hepatic or bone marrow dysfunction while receiving felbamate
* Concomitant use of vigabatrin: participants who took vigabatrin in the past must be discontinued for at least 5 months before Visit 1, and must have documentation showing no evidence of a vigabatrin-associated clinically significant abnormality in an automated visual perimetry test
* Have had multiple drug allergies or a severe drug reaction to an AED(s), including dermatological (eg, Stevens-Johnson syndrome), hematological, or organ toxicity reactions
* Evidence of significant active hepatic disease. Stable elevations of liver enzymes, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) due to concomitant medication(s) will be allowed if they are \< 3 times the ULN
* Adrenocorticotropic hormone within the 6 months before Visit 1
* Had history of anoxic episodes requiring resuscitation within 6 months before Visit 1
* Females who are breastfeeding or pregnant at Screening or Baseline (as documented by a positive beta human chorionic gonadotropin \[ß-hCG\] with a minimum sensitivity of 25 International Units per Liter (IU/L) or equivalent units of ß-hCG or hCG). A separate baseline assessment is required if a negative screening pregnancy test was obtained more than 72 hours before the first dose of study drug.
* Females of childbearing potential who: a. had unprotected sexual intercourse within 30 days before study entry and who do not agree to use a highly effective method of contraception (eg, total abstinence, an intrauterine device, a double-barrier method \[such as condom plus diaphragm with spermicide\], a contraceptive implant, an oral contraceptive, or have a vasectomized partner with confirmed azoospermia) throughout the entire study period or for 28 days after study drug discontinuation. Females using hormonal contraceptives containing levogesterol must be on another form of contraception as well. b. Are currently abstinent, and do not agree to use a double-barrier method (as described above) or refrain from sexual activity during the study period or for 28 days after study drug discontinuation. c. Are using hormonal contraceptives but are not on a stable dose of the same hormonal contraceptive product for at least 4 weeks before dosing and who do not agree to use the same contraceptive during the study or for 28 days after study drug discontinuation. (NOTE: All females will be considered to be of childbearing potential unless they are postmenopausal \[amenorrheic for at least 12 consecutive months, in the appropriate age group, and without other known or suspected cause\] or have been sterilized surgically \[i.e., bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at least 1 month before dosing\])
* Had intermittent use of benzodiazepine of more than 4 single administrations in the month before Visit 1
* A prolonged QT/QTc interval (QTc \>450 milliseconds \[ms\]) as demonstrated by a repeated electrocardiogram (ECG)
* Hypersensitivity to the study drug or any of the excipients
* Any history of a medical condition or a concomitant medical condition that in the opinion of the investigator(s) would compromise the participant's ability to safely complete the study
* Known to be human immunodeficiency virus (HIV) positive
* Active viral hepatitis (B or C) as demonstrated by positive serology at Screening
* Psychotic disorder(s) or unstable recurrent affective disorder(s) evident by use of antipsychotics or prior suicide attempt(s) within approximately the last 2 years
* History of drug or alcohol dependency or abuse within approximately the last 2 years; use of illegal recreational drugs
* Concomitant use of medications known to be inducers of cytochrome P450 (CYP3A) including, but not limited to: rifampin, troglitazone, St. John's Wort, efavirenz, nevirapine, glucocorticoids (other than topical usage), modafinil, pioglitazone, and rifabutin
* Use of AEDs not recommended by Epilepsy Treatment Guidelines for use in LGS including, but not limited to carbamazepine, gabapentin, oxcarbazepine, phenytoin, pregabalin, tiagabine, and vigabatrin
* Any suicidal ideation with intent with or without a plan within 6 months before Visit 2 (that is, answering "Yes" to questions 4 or 5 on the Suicidal Ideation section of the Columbia Suicide Severity Rating Scale (C -SSRS) in participants aged 8 and above.
* Participants with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
2 Years
ALL
No
Sponsors
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Eisai Inc.
INDUSTRY
Responsible Party
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Locations
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University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States
Stanford University
Palo Alto, California, United States
Northwest Florida Clinical Research Group, LLC
Gulf Breeze, Florida, United States
University of Florida Jacksonville
Jacksonville, Florida, United States
Pediatric Neurologists of Palm Beach
Loxahatchee Groves, Florida, United States
Axcess Medical Research
Loxahatchee Groves, Florida, United States
Nicklaus Children's Hospital
Miami, Florida, United States
Pediatric Neurology PA
Orlando, Florida, United States
Children's Healthcare of Atlanta
Atlanta, Georgia, United States
Consultants In Epilepsy and Neurology PLLC
Boise, Idaho, United States
Carle Foundation Hospital
Urbana, Illinois, United States
Midatlantic Epilepsy and Sleep Center
Bethesda, Maryland, United States
Children's Hospital of Michigan
Detroit, Michigan, United States
Wayne State University
Detroit, Michigan, United States
Mercy Health Saint Mary's Campus
Grand Rapids, Michigan, United States
Minnesota Epilepsy Group PA
Saint Paul, Minnesota, United States
Children's Mercy Hospital
Kansas City, Missouri, United States
Children's Hospital at Saint Peter's University Hospital
New Brunswick, New Jersey, United States
Cincinnati Children's Hospital Medical Center - PIN
Cincinnati, Ohio, United States
Cleveland Clinic
Cleveland, Ohio, United States
Allegheny General Hospital
Pittsburgh, Pennsylvania, United States
The University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Austin Epilepsy Care Center
Austin, Texas, United States
Road Runner Research Ltd
San Antonio, Texas, United States
Baylor Scott and White Research Institute
Temple, Texas, United States
Clinical Neurosciences Center
Salt Lake City, Utah, United States
Virginia Commonwealth University
Richmond, Virginia, United States
MultiCare Institute for Research and Innovation
Tacoma, Washington, United States
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, United States
Columbia Saint Mary's
Milwaukee, Wisconsin, United States
Medical College of Wisconsin
Wauwatosa, Wisconsin, United States
Queensland Children's Hospital
South Brisbane, Queensland, Australia
Austin Health
Heidelberg, Victoria, Australia
Royal Brisbane & Women's Hospital
Brisbane, , Australia
Royal Melbourne Hospital
Melbourne, , Australia
St Vincent's Hospital Melbourne
Melbourne, , Australia
The Alfred Hospital
Melbourne, , Australia
Cliniques Universitaires Saint-Luc
Brussels, Brussels Capital, Belgium
Hôpital Universitaire des Enfants Reine Fabiola
La Louvière, Hainaut, Belgium
Hôpital Erasme
Brussels, , Belgium
UZ Brussel
Jette, , Belgium
Centre Neurologique William Lennox
Ottignies-Louvain-la-Neuve, , Belgium
Fakultni nemocnice Ostrava
Poruba, , Czechia
Thomayerova nemocnice
Prague, , Czechia
Synexus Affiliate - Panchshil Hospital
Ahmedabad, Gujarat, India
Synexus Affiliate - Nirmal Hospitals Pvt. Ltd
Surat, Gujarat, India
Synexus Affiliate - Mallikatta Neuro Center
Mangalore, Karnataka, India
Synexus Affiliate - Amrita Institute of Medical Sciences and Research Centre
Kochi, Kerala, India
Synexus Affiliate - Jaslok Hospital and Research Centre
Mumbai, Maharashtra, India
Synexus Affiliate - Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute
Mumbai, Maharashtra, India
Synexus Affiliate - Bharati Hospital
Pune, Maharashtra, India
Nizams Institute of Medical Sciences
Hyderabad, , India
Synexus Affiliate - Sir Ganga Ram Hospital
New Delhi, , India
Eisai Trial Site #1
Fukuoka, , Japan
Eisai Trial Site #3
Fukuoka, , Japan
Eisai Trial Site #7
Hakodate, , Japan
EIsai Trial Site #9
Kagoshima, , Japan
Eisai Trial Site #4
Niigata, , Japan
EIsai Trial Site #8
Osaka, , Japan
Eisai Trial Site #6
Sapporo, , Japan
Eisai Trial Site #2
Shizuoka, , Japan
Kyungpook National University Chilgok hospital
Daegu, , South Korea
Severance Hospital Yonsei University Health System - PPDS
Seoul, , South Korea
Samsung Medical Center - PPDS
Seoul, , South Korea
Seoul National University Hospital
Seoul, , South Korea
Countries
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References
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Brigo F, Jones K, Eltze C, Matricardi S. Anti-seizure medications for Lennox-Gastaut syndrome. Cochrane Database Syst Rev. 2021 Apr 7;4(4):CD003277. doi: 10.1002/14651858.CD003277.pub4.
Provided Documents
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Document Type: Study Protocol
Document Type: Statistical Analysis Plan
Other Identifiers
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2014-002321-35
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
E2007-G000-338
Identifier Type: -
Identifier Source: org_study_id
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