A Study on Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS) in Children, Teenagers and Adults in Portugal

Withdrawn

• Conditions: Lennox-Gastaut Syndrome (LGS); Dravet Syndrome (DS)
• Interventions: Other: No Intervention

• Registration Number: NCT06395792
• Lead Sponsor: Takeda

Brief Summary

The main aim of this study is to learn about the percentage of persons diagnosed with Dravet Syndrome (DS) and Lennox-Gastaut-Syndrome (LGS) in 2022 and of persons newly diagnosed in 2021 and 2022 compared to the overall population in Portugal. Other aims are to understand how many percent of the persons diagnosed with DS and LGS are children, teenagers or adults and gather additional information on diagnosis and persons diagnosed with DS and LGS in Portugal.

Information will be taken from a participant's existing medical hospital records. It is planned to review data in approximately 3 public hospitals in Portugal. No personal information of the participants will be collected.

Detailed Description

This is a non-interventional, multicentre, cross-sectional retrospective study of participants from Portugal with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) at public hospitals. The participants will be identified from their medical charts or hospital records and those who meet the eligibility criteria will be included.

This multi-center trial will be conducted in Portugal. Data will be retrospectively collected for the observation period between 01 January 2021 to 31 December 2022. The total duration of the study is approximately 24 months.

Basic Information
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Recruitment & Eligibility
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Study & Design

Study Timeline

• Study First Submitted: 2024-04-29
• Study First Submitted QC: 2024-04-29
• Study First Posted: 2024-05-02
• Status Verified: 2024-10
• Last Update Submitted: 2024-10-01
• Last Update Posted: 2024-10-03
• Study Start: 2024-12-01
• Primary Completion: 2025-07-01
• Study Completion: 2025-07-01

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

1. Diagnosis criteria for DS:

   • All the following criteria must be met: i. Seizures onset within 1-20 months (usually within the first year of life). ii. Normal initial development prior to presentation (no cognitive or behavioural disability before the onset of seizures) followed by behaviour and cognitive impairment.

   iii. Recurrent focal clonic (hemiclonic) febrile and afebrile seizures (which often alternate sides from seizure to seizure), focal to bilateral tonic-clonic, and/or generalized clonic seizures.

   • And at least one of the following criteria must be met: i. Emergence of other seizure type, including atypical absence seizures, myoclonic seizures, atonic seizures, or non-tonic-clonic status epilepticus between 1-4 years.

   ii. Seizures triggered by fever due to illness or vaccinations, hot baths, sudden temperature changes, high level of activity, or by strong lighting or exposure to certain visual patterns.

   iii. Mutations or copy number variants in the SCN1A gene.

2. Diagnosis criteria for LGS:

Given the uncertainties associated with the diagnosis of this condition, two different criteria will be used, a stricter criterion, intended to identify "pure" Lennox-Gastaut syndrome participants, and a wider criterion, intended to also include the so-called Lennox-Gastaut-like participants.

Lennox-Gastaut syndrome - stricter criteria:

• All the following criteria must be met: i. Seizures onset before 18 years of age, typically from 1 to 8 years. ii. Progressive development/cognition impairment after seizures onset. iii. Tonic seizures. iv. At least one additional seizure: generalised tonic-clonic seizures, atypical absence seizures, atonic seizures, myoclonic seizures, focal impaired awareness, epileptic spams, or non-convulsive status epilepticus v. Slow (less thank [<] 2.5 hertz [Hz]) spike-and-wave EEG pattern. vi. Paroxysmal fast activity (10 Hz or greater) in sleep.

Lennox-Gastaut syndrome - wider criteria:

• At least one the following criteria must be met:

  i. Tonic seizures. ii. Multiple types of seizures, including generalised tonic-clonic seizures, atypical absence seizures, atonic seizures, myoclonic seizures, myoclonic-atonic seizures, focal seizures, epileptic spams, or nonconvulsive status epilepticus.

• And at least one the following criteria must be met:

  i. Slow (<2.5 Hz) spike-and-wave EEG pattern. ii. Paroxysmal fast activity (10 Hz or greater) in sleep.

• And at least two of the following criteria must be met:

  i. Seizures onset before 18 years of age, typically from 1 to 8 years. ii. Progressive development/cognition impairment after seizures onset. iii. Development/cognition impairment starts prior to seizures onset. iv. History of Infantile epileptic spasms syndrome (IESS), West or Ohtahara syndromes.

Exclusion Criteria

1. Has epileptic condition other than DS or LGS.
2. Has DS or LGS not residents in the reference area of the hospital.

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Participants With DS or LGS	No Intervention	Participants with a medical record of diagnosis with either DS or LGS that are treated in the participating hospitals and reside in the reference area of these hospitals will be included and data will be retrospectively collected for the period between 01 January 2021 to 31 December 2022.

Primary Outcome Measures

Name	Time	Method
Incidence of DS	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of participants diagnosed annually with DS yearly.
One-Year Period Prevalence of DS	Up to 12 months	Number of participants with DS over a period of one year will be assessed.
One-Year Period Prevalence of LGS Based on Stricter Diagnosis Criterion	Up to 12 months	Number of participants with LGS over a period of one year based on stricter diagnosis criterion will be assessed.
Incidence of LGS Based on Stricter Diagnosis Criterion	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of participants diagnosed annually with LGS based on stricter diagnosis criterion.

Secondary Outcome Measures

Name	Time	Method
Incidence of Adult DS	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of adult participants diagnosed annually with DS.
DS Categorized Based on Gender Distribution	Up to 12 months	DS categorized participants based on gender distribution will be assessed.
DS Categorized Based on Age Distribution	Up to 12 months	DS categorized participants based on age distribution will be assessed.
Diagnosis Delay for Participants With DS	At two different 12 months periods (in consecutive years at Months 12 and 24)	Diagnosis delay is defined as time from symptoms onset to diagnosis.
One-Year Period Prevalence of Adult DS	Up to 12 months	Number of participants with adult DS over a period of one year will be assessed.
Incidence of Paediatric DS	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of paediatric participants diagnosed annually with DS.
LGS Categorized Based on Age Distribution According to Stricter and Wider Diagnoses Criteria	Up to 12 months	LGS categorized participants based on age distribution according to Stricter and Wider diagnoses criteria will be assessed.
One-Year Period Prevalence of LGS Based on Wider Diagnosis Criterion	Up to 12 months	Number of participants with LGS over a period of one year based on wider diagnosis criterion will be assessed.
Incidence of LGS Based on Wider Diagnosis Criterion	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of participants diagnosed annually with LGS based on wider diagnosis criterion.
Incidence of Paediatric LGS Based on Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of paediatric participants diagnosed annually with LGS based on stricter and wider diagnoses criteria.
LGS Categorized Based on Gender Distribution According to Stricter and Wider Diagnoses Criteria	Up to 12 months	LGS categorized participants based on gender distribution according to Stricter and Wider diagnoses criteria will be assessed.
DS Categorized Based on Gender Distribution at Diagnosis	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed DS participants will be categorized based on gender distribution at diagnosis.
DS Categorized Based on Age Distribution at Diagnosis	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed DS participants will be categorized based on age distribution at diagnosis.
DS Categorized Based on Gender Distribution at Symptoms Onset	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed DS participants will be categorized based on gender distribution at symptoms onset.
DS Categorized Based on Age Distribution at Symptoms Onset	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed DS participants will be categorized based on age distribution at symptoms onset.
Diagnosis Delay for Participants With LGS Based on Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Diagnosis delay is defined as time from tonic seizures onset to electroencephalography (EEG) confirmation.
One-Year Period Prevalence of Paediatric DS	Up to 12 months	Number of participants with paediatric DS over a period of one year will be assessed.
One-Year Period Prevalence of Paediatric LGS Based on Stricter and Wider Diagnoses Criteria	Up to 12 months	Number of participants with paediatric LGS over a period of one year based on stricter and wider diagnoses criteria will be assessed.
One-Year Period Prevalence of Adult LGS Based on Stricter and Wider Diagnoses Criteria	Up to 12 months	Number of participants with adult LGS over period of one year based on stricter and wider diagnoses criteria will be assessed.
Incidence of Adult LGS Based on Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of adult participants diagnosed annually with LGS based on stricter and wider diagnoses criteria.
LGS Categorized Based on Gender Distribution at Symptoms Onset According to Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed LGS participants will be categorized based on gender distribution at symptoms onset.
LGS Categorized Based on Gender Distribution at Diagnosis According to Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed LGS participants will be categorized based on gender distribution at diagnosis.
LGS Categorized Based on Age Distribution at Diagnosis According to Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed LGS participants will be categorized based on age distribution at diagnosis.
Participants With DS: Ratio of Participants Genetically and Clinically Diagnosed Versus Participants Clinically Diagnosed Only	At two different 12 months periods (in consecutive years at Months 12 and 24)	Participants with DS: ratio of participants genetically (Sodium Channel Protein Type 1 Subunit Alpha \[SCN1A\] Mutation) and clinically diagnosed versus participants clinically diagnosed only will be assessed.
Participants With DS: Number of Participants With Different Types of Comorbidities at Diagnosis	At two different 12 months periods (in consecutive years at Months 12 and 24)	Participants with DS: number of participants with different types of comorbidities at diagnosis will be assessed.
LGS Categorized Based on Age Distribution at Symptoms Onset According to Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Annually diagnosed LGS participants will be categorized based on age distribution at symptoms onset.
Participants With LGS: Number of Participants Distributed According to Aetiologies Based on Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Participants with LGS: number of participants distributed according to aetiologies based on Stricter and Wider Diagnoses Criteria will be assessed.
Participants With LGS: Number of Participants With Different Types of Comorbidities at Diagnosis Based on Stricter and Wider Diagnoses Criteria	At two different 12 months periods (in consecutive years at Months 12 and 24)	Number of participants with different types of comorbidities at diagnosis based on Stricter and Wider Diagnoses Criteria will be assessed.