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A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy, Safety, and Tolerability of TAK-935 (OV935) as an Adjunctive Therapy in Pediatric Participants With Developmental and/or Epileptic Encephalopathies

Phase 2
Completed
Conditions
Dravet Syndrome
Lennox-Gastaut Syndrome
Epilepsy
Interventions
Drug: Placebo
Drug: TAK-935
Registration Number
NCT03650452
Lead Sponsor
Takeda
Brief Summary

The purpose of this study is to investigate the effect on the frequency of all seizures (convulsive and drop) in participants treated with TAK-935 compared to placebo.

Detailed Description

The drug being tested in this study is called TAK-935 (OV935). This randomized, double-blind study will assess the effects of TAK-935 (OV935), compared to placebo, on efficacy, safety, and tolerability in pediatric participants with Dravet syndrome (DS) or Lennox Gastaut syndrome (LGS). This multi-center trial will be conducted worldwide and will enroll approximately 126 participants.

Participants will be randomized based on their diagnosis in 2 categories; DS or LGS. The study will consist of 2 periods: Screening Period and Treatment Period. The overall duration of Treatment Period is up to 20 weeks including 8-week Dose Optimization Period and 12-week Maintenance Period. The overall time to participants in this study is approximately 30 weeks.

Participants completing this study will have an option to enroll in the open-label extension study, under a separate protocol.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
141
Inclusion Criteria
  1. Male and female participants aged greater than or equal to (>=) 2 and less than or equal to (<=) 17 years
  2. Clinical diagnosis of DS or LGS
  3. Weight of >=10 kilogram (kg) at the Screening visit
  4. Currently taking 1 to 4 anti-epileptic drugs (AEDs) at a stable dose
  5. Failed to become and remain seizure free with trials of at least 2 AEDs
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Exclusion Criteria
  1. Has been admitted to a medical facility and intubated for treatment of status epilepticus 2 or more times in the 3 months immediately prior to the screening visit
  2. Non-epileptic events that cannot be reliably distinguished from epileptic seizures
  3. Participation in a clinical study involving another study drug in the previous month
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboTAK-935 placebo-matching tablets, orally or via gastrostomy tube (G-tube)/percutaneous endoscopic gastrostomy (PEG), twice a day (BID) up to Week 20.
TAK-935TAK-935TAK-935 tablets orally or via G-tube/PEG tube, BID. Participants weighing \<60 kg received total daily dose of study drug calculated based on body weight. Participants weighing ≥60 kg at Baseline, were administered with 200 mg/day followed by 400 mg/day, then 600 mg/day, up to Week 20.
Primary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Seizure Frequency Per 28 Days During the Maintenance PeriodBaseline; Maintenance Period: Weeks 9 to 20

Seizure frequency per 28 days is defined as total number of seizures (convulsive seizures for DS, drop seizures for LGS) reported during the period divided by number of days during the period seizures were assessed multiplied by 28. Percent change from Baseline is defined as (frequency of seizures per 28 days during maintenance period - frequency of seizures per 28 days at baseline) divided by frequency of seizures per 28 days at baseline multiplied by 100. Negative percent change from Baseline indicates improvement.

Secondary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Drop Seizure Frequency Per 28 Days in Participants With the Lennox-Gastaut Syndrome (LGS) Stratum During the Maintenance PeriodBaseline; Maintenance Period: Weeks 9 to 20

Drop seizure frequency per 28 days is defined as total number of drop seizures reported during the period divided by number of days during the period seizures were assessed multiplied by 28. Percent Change from Baseline (%) is defined as \[(Maintenance Period Drop Seizure Frequency - Baseline Period Drop Seizure Frequency) divided by Baseline Drop Seizure Frequency\] multiplied by 100. Negative percent change from Baseline indicates improvement.

Percent Change From Baseline in Seizure Frequency Per 28 Days During the Treatment PeriodBaseline; Treatment Period: Weeks 0 to 20

Seizure Frequency per 28 days is defined as total number of Seizures reported (convulsive seizures for DS, drop seizures for LGS) during the period divided by number of days during the period seizures were assessed multiplied by 28. Percent Change from Baseline is defined as (frequency of seizures per 28 days during treatment period - frequency of seizures per 28 days at baseline) divided by frequency of seizures per 28 days at baseline multiplied by 100. Negative percent change from Baseline indicates improvement.

Percent Change From Baseline in Convulsive Seizure Frequency Per 28 Days in Participants With Dravet Syndrome Stratum During the Maintenance PeriodBaseline; Maintenance Period: Weeks 9 to 20

Convulsive seizure frequency per 28 days is defined as total number of convulsive seizures reported during the period divided by number of days during the period seizures were assessed multiplied by 28. Percent Change from Baseline (%) is defined as \[(Maintenance Period Convulsive Seizure Frequency - Baseline Period Convulsive Seizure Frequency) divided by Baseline Convulsive Seizure Frequency\] multiplied by 100. Negative percent change from Baseline indicates improvement.

Percentage of Participants With LGS Stratum Considered Treatment Responders Throughout the Maintenance PeriodMaintenance Period: Weeks 9 to 20

Responders are defined as having over 50% drop seizure reduction compared to Baseline. Percent Reduction from Baseline (%) is defined as \[(Maintenance Period Drop Seizure Frequency - Baseline Period Drop Seizure Frequency) divided by Baseline Drop Seizure Frequency\] multiplied by 100. Data is reported as reduction of 25%, 50%, 75% and 100% or more in drop seizures from Baseline.

Percentage of Participants With Dravet Syndrome Stratum Considered Treatment Responders Throughout the Maintenance PeriodMaintenance Period: Weeks 9 to 20

Responders are defined as having over 50% convulsive seizure reduction compared to Baseline. Percent Reduction from Baseline (%) is defined as \[(Maintenance Period Convulsive Seizure Frequency - Baseline Period Convulsive Seizure Frequency) divided by Baseline Convulsive Seizure Frequency\] multiplied by 100. Data is reported as reduction of 25%, 50%, 75% and 100% or more in drop seizures from Baseline.

Change From Baseline in Clinician's Clinical Global Impression of Severity (CGI-S) Responses of Investigator Reported Impression of Efficacy and Tolerability of Study DrugBaseline and Week 20

The CGI-Severity (CGI-S) focuses on clinicians' observations of the participant's cognitive, functional, and behavioral performance since the beginning of the study. The CGI-S is rated on a 7-point scale, with the severity of illness scale using a range of responses from 1 (normal) through to 7 (amongst the most severely ill participants). A negative change from Baseline indicates improvement.

Percentage of Participants With Clinical Global Impression of Change (CGI-C) Responses as Per the Investigator Reported Impression of Efficacy and Tolerability TAK-935Week 20

CGI-Change (CGI-C) treatment response ratings should take account of both therapeutic efficacy and treatment-related AEs. Each component of the CGI is rated separately; the instrument does not yield a global score. The CGI-C is rated on a 7-point scale, where, 0 = Marked improvement and no side-effects, 1 = Marked improvement and minimal side-effects, 2 = No Change, 3 = Minimal improvement and marked side-effects and 4 = Unchanged or worse and side-effects outweigh the therapeutic effect. Lower scores indicated improvement.

Percentage of Participants With Caregiver Global Impression of Change (Care GI-C) Responses as Per the Parent/Family Reported Impression of Efficacy and Tolerability of TAK-935Week 20

The Care GI-C is rated on a 7-point scale, with the severity of illness scale where, 1 = Very much improved, 2 = Much improved, 3 = Slightly improved, 4 = No change, 5 = Slightly worse, 6 = Much worse and 7 = Very much worse. Lower scores indicated improvement.

Change From Baseline in Seizure Frequency in Participants Treated With TAK-935 as an Adjunctive TherapyBaseline and Week 20

Seizure frequency was based on convulsive seizures for the participants in the Dravet Syndrome Indication and Drop Seizures for the participants in the LGS Indication. Seizure frequency per 28 days = (total number of seizures reported during the period) / (number of days during the period seizures were assessed) \* 28. A negative change from Baseline indicates improvement.

Change From Baseline in Plasma 24S-Hydroxycholesterol (24HC) Levels in Participants Treated With TAK-935 as an Adjunctive TherapyBaseline and Week 24

A negative change from Baseline indicates improvement.

Trial Locations

Locations (44)

Szpital Kliniczny im. H.Swiecickiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu

🇵🇱

Poznan, Wielkopolskie, Poland

Schneider Childrens Medical Center of Israel

🇮🇱

Petach Tikva, Israel

Rare Disease Research, LLC

🇺🇸

Atlanta, Georgia, United States

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Hospital Universitari i Politecnic La Fe de Valencia

🇪🇸

Valencia, Spain

Peking University First Hospital

🇨🇳

Beijing, China

Columbia University Medical Center

🇺🇸

New York, New York, United States

Nicklaus Children's Hospital

🇺🇸

Miami, Florida, United States

Phoenix Children's Hospital

🇺🇸

Phoenix, Arizona, United States

Colorado Children's Hospital

🇺🇸

Aurora, Colorado, United States

Ann and Robert H Lurie Childrens Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

Wake Forest Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Monash Children's Hospital

🇦🇺

Clayton, Victoria, Australia

Austin Hospital

🇦🇺

Heidelberg West, Victoria, Australia

Hospital For Sick Children

🇨🇦

Toronto, Ontario, Canada

Beijing Children's Hospital,Capital Medical University

🇨🇳

Beijing, China

Capital Medical University (CMU) - Beijing Children's Hospital

🇨🇳

Beijing, China

Xiangya Hospital Central South University

🇨🇳

Changsha, China

Children's Hospital of Fudan University

🇨🇳

Shanghai, China

Shenzhen Children's Hospital

🇨🇳

Shenzhen, China

Sheba Medical Center-PPDS

🇮🇱

Tel Hashomer,, Ramat Gan, Israel

Edith Wolfson Medical Center

🇮🇱

Holon, Israel

Soroka University Medical Centre

🇮🇱

Bear Sheva, Israel

Bnai Zion Medical Center

🇮🇱

Haifa, Israel

Hadassah Medical Center

🇮🇱

Jerusalem, Israel

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Uniwersyteckie Centrum Kliniczne - PPDS

🇵🇱

Gdansk, Pomorskie, Poland

Clinica Universidad Navarra

🇪🇸

Pamplona, Navarra, Spain

Centro Hospitalar Lisboa Central- Hospital Dona Estefania

🇵🇹

Lisboa, Portugal

Centro Hospitalar Lisboa Norte, E.P.E. Hospital de Santa Maria

🇵🇹

Lisboa, Portugal

Hospital Vithas La Salud

🇪🇸

Granada, Spain

Center for Rare Neurological Diseases

🇺🇸

Norcross, Georgia, United States

Northeast Regional Epilepsy Group

🇺🇸

Hackensack, New Jersey, United States

Pediatric Neurology PA

🇺🇸

Orlando, Florida, United States

Mayo Clinic - PPDS

🇺🇸

Rochester, Minnesota, United States

Cook Children's Medical Center

🇺🇸

Fort Worth, Texas, United States

Children's Hospital at Saint Peter's University Hospital

🇺🇸

New Brunswick, New Jersey, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Hospital Ruber Internacional

🇪🇸

Madrid, Spain

NZOZ Centrum Neurologii Dzieciecej i Leczenia Padaczki

🇵🇱

Kielce, Swietokrzyskie, Poland

Instytut Pomnik Centrum Zdrowia Dziecka

🇵🇱

Warsaw, Poland

Largo da Maternidade de Julio DinisCentro Materno Infantil do Norte

🇵🇹

Porto, Portugal

Centrum Medyczne Plejady

🇵🇱

Krakow, Poland

Samodzielny Publiczny Dzieciecy Szpital Kliniczny w Warszawie

🇵🇱

Warsaw, Poland

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