Use of Sodium Bicarbonate in Patients Treated With Topiramate

NCT ID: NCT03354507

Last Updated: 2017-11-28

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-31

Study Completion Date

2018-12-31

Brief Summary

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Effect of oral sodium bicarbonate therapy on renal tubular acidosis in epilepsy patients taking topiramate.

Detailed Description

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Children on topiramate are at a risk of renal tubular acidosis and subsequent development of renal stones. Sodium bicarbonate has been shown to reduce renal tubular acidosis in other populations. To date, no data exist on the efficacy of correction of renal tubular acidosis in pediatric patients on topiramate. We are proposing to investigate the efficacy of 4 weeks of oral sodium bicarbonate therapy to reduce tubular acidosis in patients on topiramate.

Conditions

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Epilepsy Metabolic Acidosis Tubular Acidosis; Renal

Keywords

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topiramate epilepsy sodium bicarbonate urine alkalinization

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Sodium Bicarbonate

Patients will receive sodium bicarbonate for 4 weeks, based on pre-calculated weight based doses. Patients are selected if they have metabolic acidosis at baseline.

\< 24 kg : 1/4 teaspoon bid. 24 - 42 kg : 1/2 teaspoon bid. \> 42kg : 3/4 teaspoon bid.

Group Type EXPERIMENTAL

Sodium bicarbonate

Intervention Type DIETARY_SUPPLEMENT

Sodium bicarbonate. See arms.

Control

Patients will not receive treatment if they do not have metabolic acidosis at baseline.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Sodium bicarbonate

Sodium bicarbonate. See arms.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Patients with epilepsy receiving oral topiramate for a minimum of 3 months

Exclusion Criteria

* pre-existing renal impairments (ie nephropathy, primary nephritis)
* receiving other medications or diet therapies that may influence renal function or urine acidity/ citrate concentration
Minimum Eligible Age

2 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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McMaster Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Mandeep Sidhu

Resident Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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McMaster Children's Hospital

Hamilton, Ontario, Canada

Site Status

Countries

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Canada

Central Contacts

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Mandeep Sidhu, MD

Role: CONTACT

Phone: 19055212100

Email: [email protected]

Surejini Tharmaradinam, MD

Role: CONTACT

Phone: 19055212100

Email: [email protected]

Facility Contacts

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Mandeep Sidhu, MD

Role: primary

Surejini Tharmaradinam, MD

Role: backup

References

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Ben-Menachem E, Sander JW, Stefan H, Schwalen S, Schauble B. Topiramate monotherapy in the treatment of newly or recently diagnosed epilepsy. Clin Ther. 2008 Jul;30(7):1180-95. doi: 10.1016/s0149-2918(08)80045-8.

Reference Type BACKGROUND
PMID: 18691980 (View on PubMed)

Caudarella R, Vescini F. Urinary citrate and renal stone disease: the preventive role of alkali citrate treatment. Arch Ital Urol Androl. 2009 Sep;81(3):182-7.

Reference Type BACKGROUND
PMID: 19911682 (View on PubMed)

Coe FL, Evan A, Worcester E. Kidney stone disease. J Clin Invest. 2005 Oct;115(10):2598-608. doi: 10.1172/JCI26662.

Reference Type BACKGROUND
PMID: 16200192 (View on PubMed)

Dell'Orto VG, Belotti EA, Goeggel-Simonetti B, Simonetti GD, Ramelli GP, Bianchetti MG, Lava SA. Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review. Br J Clin Pharmacol. 2014 Jun;77(6):958-64. doi: 10.1111/bcp.12283.

Reference Type BACKGROUND
PMID: 24219102 (View on PubMed)

Hall PM. Nephrolithiasis: treatment, causes, and prevention. Cleve Clin J Med. 2009 Oct;76(10):583-91. doi: 10.3949/ccjm.76a.09043.

Reference Type BACKGROUND
PMID: 19797458 (View on PubMed)

HANLEY T, PLATTS MM. Observations on the metabolic effects of the carbonic anhydrase inhibitor diamox: mode and rate of recovery from the drug's action. J Clin Invest. 1956 Jan;35(1):20-30. doi: 10.1172/JCI103248. No abstract available.

Reference Type BACKGROUND
PMID: 13278397 (View on PubMed)

Mirza N, Marson AG, Pirmohamed M. Effect of topiramate on acid-base balance: extent, mechanism and effects. Br J Clin Pharmacol. 2009 Nov;68(5):655-61. doi: 10.1111/j.1365-2125.2009.03521.x.

Reference Type BACKGROUND
PMID: 19916989 (View on PubMed)

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009 Aug 18;151(4):264-9, W64. doi: 10.7326/0003-4819-151-4-200908180-00135. Epub 2009 Jul 20. No abstract available.

Reference Type BACKGROUND
PMID: 19622511 (View on PubMed)

Silberstein SD, Ben-Menachem E, Shank RP, Wiegand F. Topiramate monotherapy in epilepsy and migraine prevention. Clin Ther. 2005 Feb;27(2):154-65. doi: 10.1016/j.clinthera.2005.02.013.

Reference Type BACKGROUND
PMID: 15811478 (View on PubMed)

Vega D, Maalouf NM, Sakhaee K. Increased propensity for calcium phosphate kidney stones with topiramate use. Expert Opin Drug Saf. 2007 Sep;6(5):547-57. doi: 10.1517/14740338.6.5.547.

Reference Type BACKGROUND
PMID: 17877442 (View on PubMed)

Wile D. Diuretics: a review. Ann Clin Biochem. 2012 Sep;49(Pt 5):419-31. doi: 10.1258/acb.2011.011281. Epub 2012 Jul 10.

Reference Type BACKGROUND
PMID: 22783025 (View on PubMed)

Other Identifiers

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1137

Identifier Type: -

Identifier Source: org_study_id