Single Dose of Clonazepam Versus Intermiittent Diazepam for Febrile Seizures Prevention

NCT ID: NCT04364321

Last Updated: 2021-08-30

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

74 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-05-13

Study Completion Date

2023-06-30

Brief Summary

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To study the efficacy and safety of single dose clonazepam compared with intermittent oral diazepam for prevention of recurrent febrile seizures in children who had three or more febrile seizures.

Detailed Description

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Febrile seizures are the most common type of seizures disorder of young children. The risk of recurrences are 33 percent overall, half of them had at least one recurrent seizure (the 3rd febrile seizures). After that the recurrent rate is 50-100 percent depend on their risk factors. A few studies found that multiple recurrent febrile seizures might associated with language developmental delayed, poor speed performance quotient, Attention deficit hyperactivity disorders. Moreover, seizures are upsetting both parents and children. During the febrile illness, the intermittent diazepam, continuous phenobarbital and valproate are effective for prevention of the recurrences. Because of the benign nature of a simple febrile seizures, the risks of side effects generally outweigh the benefits. However, there is no clinical guidelines for prevention of recurrent febrile seizures in the children who experienced multiple occurrences. The better prophylactic drug; safe, effective and easy to use, for prevention of recurrent febrile seizures in children with multiple recurrences might be needed. Clonazepam, the long half-life benzodiazepine, is commonly used for treatment of epilepsy may be effective in preventing recurrent febrile seizures. This study, a single-blind, randomized clinical trial, single dose clonazepam at the time of fever present compared with oral diazepam during the fever to prevent the recurrent febrile seizures.

Conditions

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Recurrent Febrile Convulsion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A pragmatic parallel group randomized trial comparing single dose clonazepam with intermittent oral diazepam for prevention recurrent febrile seizures
Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

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Single dose Clonazepam

Clonazepam(0.5 mg/tablet) 0.02 mg/kg orally once at the time of fever present. (body temperature more than 38 degree Celsius)

Group Type EXPERIMENTAL

Clonazepam 0.5 MG

Intervention Type DRUG

Clonazepam 0.02 mg/kg only one dose

Intermittent oral diazepam

Diazepam 0.3 mg/kg every 8 hours for 3 doses. (24 hr) start at the time of body temperature more than 38 degree Celsius.

Group Type ACTIVE_COMPARATOR

Diazepam Tablets

Intervention Type DRUG

Diazepam 0.3 mg/kg every 8 hours for 3 doses. (24 hr)

Interventions

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Clonazepam 0.5 MG

Clonazepam 0.02 mg/kg only one dose

Intervention Type DRUG

Diazepam Tablets

Diazepam 0.3 mg/kg every 8 hours for 3 doses. (24 hr)

Intervention Type DRUG

Other Intervention Names

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Rivotril Povanil

Eligibility Criteria

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Inclusion Criteria

* age 6-60 months at date of enrollment
* 3 or more episodes of clinically diagnosed febrile seizures

Exclusion Criteria

* history of afebrile seizures or any history suggested the epilepsy
* history of previous brain insults; CNS infection, birth trauma, traumatic brain injury.
* delayed developmental milestones
* abnormal neurological examinations
* currently treatment by continous antiepileptic drug(s)
* A contraindication to Clonazepam, Diazepam such as drug hypersensitivity, liver disease.
* Predictable lack of available of follow up.
Minimum Eligible Age

6 Months

Maximum Eligible Age

60 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Queen Sirikit National Institute of Child Health

OTHER_GOV

Sponsor Role lead

Responsible Party

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Kullasate Sakpichaisakul

Director of Pediatric Neurology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jinjutha Nithiuthai, MD

Role: PRINCIPAL_INVESTIGATOR

Queen Sirikit National Institute of Child Health

Locations

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Queen Sirikit National Institute of Child Health

Ratchathewi, Bangkok, Thailand

Site Status RECRUITING

Countries

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Thailand

Central Contacts

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Jinjutha Nithiuthai, MD

Role: CONTACT

66806218033

Sirorat Suwannachote, MD

Role: CONTACT

6623548333

Facility Contacts

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Jinjutha Nithiuthai, MD

Role: primary

References

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Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salomon ME, Crain EF, Hauser AW. Predictors of recurrent febrile seizures. A prospective cohort study. Arch Pediatr Adolesc Med. 1997 Apr;151(4):371-8. doi: 10.1001/archpedi.1997.02170410045006.

Reference Type BACKGROUND
PMID: 9111436 (View on PubMed)

Berg AT, Shinnar S, Hauser WA, Leventhal JM. Predictors of recurrent febrile seizures: a metaanalytic review. J Pediatr. 1990 Mar;116(3):329-37. doi: 10.1016/s0022-3476(05)82816-1.

Reference Type BACKGROUND
PMID: 2137875 (View on PubMed)

Kolfen W, Pehle K, Konig S. Is the long-term outcome of children following febrile convulsions favorable? Dev Med Child Neurol. 1998 Oct;40(10):667-71. doi: 10.1111/j.1469-8749.1998.tb12326.x.

Reference Type BACKGROUND
PMID: 9851235 (View on PubMed)

Visser AM, Jaddoe VW, Ghassabian A, Schenk JJ, Verhulst FC, Hofman A, Tiemeier H, Moll HA, Arts WF. Febrile seizures and behavioural and cognitive outcomes in preschool children: the Generation R study. Dev Med Child Neurol. 2012 Nov;54(11):1006-11. doi: 10.1111/j.1469-8749.2012.04405.x. Epub 2012 Sep 3.

Reference Type BACKGROUND
PMID: 22937894 (View on PubMed)

Bertelsen EN, Larsen JT, Petersen L, Christensen J, Dalsgaard S. Childhood Epilepsy, Febrile Seizures, and Subsequent Risk of ADHD. Pediatrics. 2016 Aug;138(2):e20154654. doi: 10.1542/peds.2015-4654. Epub 2016 Jul 13.

Reference Type BACKGROUND
PMID: 27412639 (View on PubMed)

Billstedt E, Nilsson G, Leffler L, Carlsson L, Olsson I, Fernell E, Gillberg C. Cognitive functioning in a representative cohort of preschool children with febrile seizures. Acta Paediatr. 2020 May;109(5):989-994. doi: 10.1111/apa.15059. Epub 2019 Nov 10.

Reference Type BACKGROUND
PMID: 31618476 (View on PubMed)

Rosman NP, Colton T, Labazzo J, Gilbert PL, Gardella NB, Kaye EM, Van Bennekom C, Winter MR. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. N Engl J Med. 1993 Jul 8;329(2):79-84. doi: 10.1056/NEJM199307083290202.

Reference Type RESULT
PMID: 8510706 (View on PubMed)

Knudsen FU. Recurrence risk after first febrile seizure and effect of short term diazepam prophylaxis. Arch Dis Child. 1985 Nov;60(11):1045-9. doi: 10.1136/adc.60.11.1045.

Reference Type RESULT
PMID: 3907504 (View on PubMed)

Capovilla G, Mastrangelo M, Romeo A, Vigevano F. Recommendations for the management of "febrile seizures": Ad Hoc Task Force of LICE Guidelines Commission. Epilepsia. 2009 Jan;50 Suppl 1:2-6. doi: 10.1111/j.1528-1167.2008.01963.x.

Reference Type RESULT
PMID: 19125841 (View on PubMed)

Offringa M, Newton R, Cozijnsen MA, Nevitt SJ. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2017 Feb 22;2(2):CD003031. doi: 10.1002/14651858.CD003031.pub3.

Reference Type RESULT
PMID: 28225210 (View on PubMed)

Other Identifiers

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QSNICH63-017

Identifier Type: -

Identifier Source: org_study_id

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