Perampanel in Focal Status Epilepticus

NCT ID: NCT04309721

Last Updated: 2023-12-14

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

PHASE3

Total Enrollment

1 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-02

Study Completion Date

2023-11-13

Brief Summary

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Randomized controlled trial on focal motor status epilepticus (SE), studying the add-on efficacy of the enteral administration of perampanel (PER) to a conventional intravenous antiepileptic drug.

Detailed Description

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In spite of the use of various antiepileptic drugs, the SE, generalized or focal, are refractory to the treatment in around 25 % of the cases. There is therefore a need to develop new therapy with novel synaptic targets.

New antiepileptic drugs emerge as potential drugs for SE. Perampanel (PER) is a new drug available for add-on therapy in patients with a focal epilepsy. The mechanism of action of this drug is original, as it is a non-competitive α-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) receptor antagonist. Several studies suggested that AMPA-mediated glutamatergic transmission plays an important rule during the SE.

In this study the investigator will focus on patients suffering from early focal motor SE, for several reasons:

(i) There is no randomized controlled double-blind trial in this population, and therefore no evidence to help physicians.

(ii) The investigator aims to perform a trial on early SE, after failure of only one drug (a benzodiazepine, recommended as first line treatment), in order to properly evaluate the effect of the tested drug (add-on of perampanel).

(iii) The perampanel is available only for oral administration. Focal SE usually does not affect the vital prognosis and can be treated less aggressively. Use of oral loading doses of antiepileptic drugs is frequent, and therapies may be changed or adapted in the time-frame of hours or days.

(iv) Patients with a focal SE, presenting motor symptoms, can be included without the need of an EEG. Similarly, the primary end-point, cessation of the motor events, does not require specific exam, and can also be done clinically.

Conditions

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Epilepticus; Status, Focal Motor

Keywords

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Perampanel Placebo Antiepileptic drug

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Perampanel

immediate enteral administration of Perampanel, 12 mg

Group Type EXPERIMENTAL

Perampanel

Intervention Type DRUG

Single-dose of Perampanel 12 mg film-coated tablet, will be given orally in patients with status epilepticus that do not involve the oral and pharyngeal musculatures. In alternative, perampanel will be administered by a nasogastric feeding tube, a procedure which has been recently reported to be safe and tolerated in patients with generalised status epilepticus

Placebo

immediate enteral administration of placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Single-dose of placebo of Perampanel, administered orally. Placebo of perampanel will be given orally, in patients with status epilepticus that do not involve the oral and pharyngeal musculatures. In alternative, Placebo of perampanel will be administered by a nasogastric feeding tube, a procedure which has been recently reported to be safe and tolerated in patients with generalised status epilepticus

Interventions

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Perampanel

Single-dose of Perampanel 12 mg film-coated tablet, will be given orally in patients with status epilepticus that do not involve the oral and pharyngeal musculatures. In alternative, perampanel will be administered by a nasogastric feeding tube, a procedure which has been recently reported to be safe and tolerated in patients with generalised status epilepticus

Intervention Type DRUG

Placebo

Single-dose of placebo of Perampanel, administered orally. Placebo of perampanel will be given orally, in patients with status epilepticus that do not involve the oral and pharyngeal musculatures. In alternative, Placebo of perampanel will be administered by a nasogastric feeding tube, a procedure which has been recently reported to be safe and tolerated in patients with generalised status epilepticus

Intervention Type DRUG

Other Intervention Names

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Experimental group Control group

Eligibility Criteria

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Inclusion Criteria

1. Patients aged 18 years or above, including the protected adults with a focal motor status epilepticus, defined by prominent clinically objective focal motor symptoms (clonic, tonic, myoclonic, adversive or oculoclonic), lasting for more than 10 minutes before any treatment or repeated focal motor seizures during this period (≥ 4 seizures in 10 min)
2. The focal motor status continues (or patients show ≥ 2 focal motor seizures) 5 minutes or more after the beginning of administration of benzodiazepines. The delay between administration of benzodiazepines and randomization must not exceed 6 hours.
3. Affiliation to a French social security system (recipient or assign) excluding "Aide Médicale" Etat (AME)

Exclusion Criteria

1. Known severe liver (Factor V \<50 %) or kidney (glomerular filtration rate : 15-29 ml/min/1,72 m2) insufficiency
2. Women with known or clinically detected pregnancy
3. Patients with known allergies to perampanel or to any of the excipients mentioned in the summary of product characteristics(SmPC)
4. Patients with postanoxic status
5. Patients in coma (Glasgow\<8)
6. Patients with motor events for which a nonepileptic psychogenic origin is suspected
7. Patients whose status epilepticus is linked to a pathological condition, such as trauma, who needed immediate surgery
8. Known current treatment by perampanel
9. Known galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome (rare hereditary diseases)
10. Known participation in another trial with medication and/or previously included in PEPSI study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vincent Navarro, DDS,PhD

Role: PRINCIPAL_INVESTIGATOR

Groupe Hospitalier Pitié-Salpêtrière

Locations

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Urgences, CHU Lille (Hôpital Roger Salengro)

Lille, , France

Site Status

Neuro-physiologie clinique, CHU Lille (Hôpital Roger Salengro)

Lille, , France

Site Status

Réanimation polyvalente, CHU (Hopital Roger Salengro)

Lille, , France

Site Status

Department of Neurology, Epilepsy Unit, Pitié-Salpêtrière Hospital

Paris, , France

Site Status

Hôpital Pitié Salpêtrière - ICU

Paris, , France

Site Status

Réanimation Polyvalente, GH Paris Saint Joseph

Paris, , France

Site Status

Neurologie et Neurovasculaire, GH Paris Saint Joseph

Paris, , France

Site Status

S.A.U, Pitié-Salpêtrière Hospital

Paris, , France

Site Status

Accueil des Urgences, Centre Hospitalier de Versailles - André Mignot

Versailles, , France

Site Status

Neurologie, Centre Hospitalier de Versailles - André Mignot

Versailles, Île-de-France Region, France

Site Status

Countries

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France

Other Identifiers

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2019-000882-19

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

P160949J

Identifier Type: -

Identifier Source: org_study_id