A Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of SAGE-547 Injection in the Treatment of Subjects With Super-Refractory Status Epilepticus
Overview
- Phase
- Phase 3
- Intervention
- Placebo
- Conditions
- Super-Refractory Status Epilepticus
- Sponsor
- Supernus Pharmaceuticals, Inc.
- Enrollment
- 132
- Locations
- 2
- Primary Endpoint
- Number of Participants Able to be Weaned Off All Third-Line Agents Prior to End of Double-Blind SAGE-547 or Placebo Infusion, and Remain Off All Third-Line Agents for ≥ 24 Hours Following the End of SAGE-547 or Placebo Infusion
- Status
- Completed
- Last Updated
- 6 months ago
Overview
Brief Summary
This is a randomized, double-blind, placebo-controlled trial, designed to evaluate the efficacy and safety of SAGE-547 administered as a continuous intravenous infusion to subjects in Super-Refractory Status Epilepticus (SRSE).
Investigators
Eligibility Criteria
Inclusion Criteria
- •Subjects two (2) years of age and older
- •Subjects who have:
- •Failed to respond to the administration of at least one first-line agent (e.g., benzodiazepine or other emergent initial anti-epileptic drug \[AED\] treatment), according to institution standard of care, and;
- •Failed to respond to at least one second-line agent (e.g., phenytoin, fosphenytoin, valproate, phenobarbital, levetiracetam or other urgent control AED), according to institution standard of care, and;
- •Not previously been administered a third-line agent but have been admitted to an intensive care unit with the intent of administering at least one third-line agent for at least 24 hours; or who have previously failed zero, one or more wean attempts from third-line agents and are now on continuous intravenous infusions of one or more third-line agent and in an EEG burst or seizure suppression pattern; or who have previously failed one or more wean attempts from third-line agents and are now either not on a continuous intravenous infusion of at least one third-line agent or are on a continuous intravenous infusion of one or more third-line agent but not in an EEG burst or seizure suppression pattern
Exclusion Criteria
- •Subjects with SRSE due to anoxic/hypoxic encephalopathy with highly malignant/ malignant EEG features
- •Children (subjects aged less than 17 years) with an encephalopathy due to a rapidly progressing underlying neurological disorder
- •Subjects who have any of the following:
- •a glomerular filtration rate (GFR) low enough to warrant dialysis but for whatever reason, dialysis is not planned or non-continuous dialysis planned (that would not adequately remove Captisol®);
- •severe cardiogenic or vasodilatory shock requiring two or more pressors that is not related to third-line agent use;
- •fulminant hepatic failure;
- •no reasonable expectation of recovery (for instance, a likely outcome is persistent vegetative state) or life-expectancy, in the experience of the investigator, is less than 30 days.
- •Subjects who are being administered more than three third-line agents concomitantly or in whom the qualifying wean cannot be completed per protocol
Arms & Interventions
Placebo
Intravenous
Intervention: Placebo
SAGE-547
Intravenous
Intervention: SAGE-547
Outcomes
Primary Outcomes
Number of Participants Able to be Weaned Off All Third-Line Agents Prior to End of Double-Blind SAGE-547 or Placebo Infusion, and Remain Off All Third-Line Agents for ≥ 24 Hours Following the End of SAGE-547 or Placebo Infusion
Time Frame: 7 days
Third-line agents were anesthetic agents that were administered in order to reach a seizure or burst suppression electroencephalogram (EEG) pattern. For this study, third-line agents were defined as continuous intravenous infusions of pentobarbital/thiopental, midazolam, propofol, and ketamine at maintenance doses alone or in combination sufficient to produce a burst or seizure suppression pattern on the EEG. A responder was a participant who was able to be weaned off all third-line agents prior to the end of the SAGE-547 or placebo infusion and remain off all third-line agents for \>=24 hours after the end of the study drug infusion. The primary analysis was a comparison between SAGE-547 and placebo of the proportion of responders.
Secondary Outcomes
- Time Between the Primary Outcome Response and the Re-institution of Any Third-line Agent for Seizure or Burst Suppression(Up to 21 days)
- Number of Participants With a New Diagnosis of Epilepsy After Visit 11(Up to 21 days)
- Time Between the Secondary Outcome Measure Response and the Re-institution of Any Third-line Agent for Seizure or Burst Suppression(Up to 21 days)
- Number of Separate Episodes of Status Epilepticus Up to Visit 12(Up to 21 days)
- Number of Participants Able to be Weaned Off All Third-line Agents Before the End of the First SAGE-547 or Placebo Infusion(Day 6)
- Number of Days After the End of the First Study Drug Infusion Without Status Epilepticus, Up to Visit 12(Up to 21 days)
- Change in Clinical Global Impression Scale (CGI)(Up to 21 days)
- Number of Days After the End of the First Study Drug Infusion Without Seizures (Convulsive and Non-convulsive), up to Visit 12(Up to 21 days)