Double-Blind, Randomized, Historical Control Study of the Safety and Efficacy of Eslicarbazepine Acetate Monotherapy in Subjects With Partial Epilepsy Not Well Controlled by Current Antiepileptic Drugs
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 入组人数
- 172
- 试验地点
- 61
- 主要终点
- Cumulative 112-day Exit Rate as Estimated by Kaplan-Meier Method
研究概览
简要总结
This is an 18-week, double-blind, multicenter study with gradual conversion from previous antiepileptic therapy to eslicarbazepine acetate monotherapy in subjects with partial epilepsy.
详细描述
This is an 18-week, double-blind, randomized, historical control, multicenter study with gradual conversion to monotherapy in subjects with partial onset seizures who are not well controlled by current AEDs. The 18 week double-blind treatment period consists of a 2-week titration period, 6-week taper or conversion period, and a 10-week monotherapy period. This study was previously posted by Sepracor Inc. In October 2009, Sepracor Inc. was acquired by Dainippon Sumitomo Pharma., and in October 2010, Sepracor Inc's name was changed to Sunovion Pharmaceuticals Inc.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 16 Years 至 70 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of partial epilepsy as defined in the Classification of Seizures of the International League Against Epilepsy (ILAE) (simple partial seizures with observable motor component, or complex, with or without secondary generalization)
- •Medical history of seizures;
- •Absence of confounding factors (pseudoseizures, syncope);
- •Documented EEG recording (done within 5 years prior to screening) consistent with focal onset epilepsy
- •Documented CT or MRI scan conducted within 10 years prior to screening, showing the absence of a structural abnormality (eg, tumor or malformation)
- •≥ 4 partial onset seizures during the 8 weeks prior screening with no 28-day seizure free period
- •Stable treatment with 1-2 AEDs during the last 4 weeks prior to screening
- •Subjects must have the ability to comprehend the informed consent form and be willing to provide informed consent. For subjects who are unable to comprehend the written consent, a witness/caregiver who is able to describe and provide an understanding of the informed consent to the subject must sign the consent form on behalf of the subject.
- •Subjects must give written informed consent prior to participation in the study. For subjects <18 years of age, the informed consent must be signed by the subject's parent or legal guardian, and, when appropriate and/or required by state or local law, minor subjects must give written informed assent prior to participation in the study. Subjects of Asian ancestry are required to give written informed consent for genotyping. All subjects must sign a HIPAA Form. All females of child bearing potential must also sign the "Women of Childbearing Potential" Addendum.
- •A female subject is eligible to enter and participate in the study if she is of:
- •Non-childbearing potential (ie, physiologically incapable of becoming pregnant, including any female who is pre-menarchal or post-menopausal);
- •Child-bearing potential (all females ≤65 years of age), has a negative pregnancy test at screening and agrees to satisfy contraception requirements
排除标准
- •Subjects with only simple partial seizures without a motor component
- •Presence of generalized seizure syndromes (eg, juvenile myoclonic epilepsy or Lennox-Gastaut syndrome)
- •History of pseudo-seizures
- •Current seizures related to an acute medical illness
- •Seizures secondary to metabolic, toxic or infectious disorder or drug abuse
- •Status epilepticus within 2 years prior to screening
- •Seizures only occurring in a cluster pattern
- •Subjects taking 2 of the following sodium channel blocking AEDs: phenytoin, carbamazepine, oxcarbazepine, or lamotrigine
- •Subjects taking 2 AEDs with both being in the upper dose range (defined as approximately two-thirds of the defined daily dose)
- •Subjects taking more than 2 AEDs
- •Subjects with progressive structural central nervous system lesion or progressive encephalopathy
- •Psychiatric exclusion criteria
- •Medical exclusion criteria: known renal insufficiency (estimated creatinine clearance [CrCL]) <60 mL/min based on serum creatinine using the Cockcroft-Gault formula
- •Clinical and laboratory exclusion criteria: Subjects of Asian ancestry who tests positive for the presence of the HLA-B*1502 allele
- •Subjects who have been on benzodiazepines, phenobarbital, or primidone on a regular basis within 3 months prior to screening
- •Subjects taking antipsychotics, tricyclic antidepressants, anxiolytics, sedative hypnotics including non-benzodiazepines, central opioid agonists/antagonists, monoamine oxidase inhibitors (MAOIs) within at least 5 half lives (or for at least 2 weeks whichever is longer) prior to randomization
- •Subjects presently on felbamate or vigabatrin
研究组 & 干预措施
eslicarbazepine acetate 1600 mg
Subjects randomized to 1600 mg QD of eslicarbazepine acetate will titrate from 600 mg QD(Day 0) to 1200 mg once a day(Week 2) to 1600 mg QD (Weeks 3-18) and may taper down from 1600 mg to 800 mg QD 3 days after the Week 18 visit.
干预措施: Eslicarbazepine acetate 1600 mg (Drug)
eslicarbazepine acetate 1200 mg
Subjects randomized to 1200 mg QD eslicarbazepine acetate will titrate from 400 mg QD (Day0) to 800 mg QDweek2) to 1200 mg QD(weeks 3-18) and may taper down from 1200 mg to 600 mg QD 3 days after the Week 18 visit.
Subjects may continue in an open-label extension study with a starting dose of 1200 mg QD, or taper off their previous antiepileptic drugs during weeks 2-8.
干预措施: Eslicarbazepine acetate 1200 mg (Drug)
结局指标
主要结局
Cumulative 112-day Exit Rate as Estimated by Kaplan-Meier Method
时间窗: From beginning of Week 3 to end of Week 18
Cumulative exit rate was defined as the proportion of subjects meeting at least one of the following five exit criteria over a 16-week study period (from start of AED taper/con. period (Wk 3) to end of double blind monotherapy period (Wk 18)).1.One episode of status epilepticus.2.One secondary gen. partial seizure (in subjects who did not have gen.seizures during 6 mo. prior to screening).3.A two fold increase in any consecutive 28 day seizure rate compared to the highest consecutive 28 day seizure rate during the 8 week baseline period. 4.A two fold increase in any consecutive 2 day seizure rate compared to the highest consecutive 2 day seizure rate during the 8 week baseline period. If the highest number of seizures in any consecutive 2 day period during the 8 week baseline was 1 then 3 seizures in a consecutive 2 day period was required to exit. 5.Worsening of seizures or increase in seizure frequency considered serious or requiring intervention as judged by the investigator
次要结局
- Percentage of Subjects Seizure-free During the Last 4 Weeks on Eslicarbazepine Acetate Monotherapy.(Week 15 through 18)
- Completion Rate (% of Subjects Completing the 18 Weeks of Double-blind Treatment).(18 weeks)
- Time on Eslicarbazepine Acetate Monotherapy.(Week 8 to Week 18)
- Responder Rate (Proportion [%] of Subjects With a ≥50% Reduction of Seizure Frequency From Baseline).(Week 0 to Week 18, Double-blind weeks 1-18; baseline: weeks -8 to -1; Titration: weeks 1-2; AED taper/conversion; weeks 3-8; monotherapy weeks 9-18)
- Proportion (%) of Subjects Reaching Each Exit Criteria(Week 1 to Week 18, (beginning of week 1 to end of week 18))
- Change in Total Score From Baseline in 31-Item Quality of Life in Epilepsy (QOLIE-31).(Week 0 to Week 18, Baseline: Day 0: End of AED taper/conversion period: end of week 8; End of monotherapy period: end of week 18)
- Proportion (%) of Subjects That Are Seizure-free During the 10-week Double-blind Monotherapy Treatment Period.(Week 9 through 18)
- Proportion (%) of Subjects With Increase of Body Weight >= 7% From Baseline(18 Week Double-blind treatment period)
- Proportion (%) of Subjects With Normal Baseline Sodium Reaching Blood Sodium ≤135 mmol/L, ≤130 mmol/L, and ≤125 mmol/L.(Week 0 to Week 18)
- Proportion (%) of Events in Each Classification of the Columbia Suicide Severity Rating Scale (C SSRS).(18 Week Double-blind treatment period)
- Completion Rate During the 10 Weeks of Monotherapy (% of Subjects Entering the Monotherapy Period Who Complete).(Week 8 through 18)
- Change in Total Score of MADRS From Baseline in Those Subjects With a MADRS Score of ≥14 at Randomization.(Week 0 to Week 18, baseline:day 0;end of AED taper/conversion period; end of week 8; end of monotherapy period: end of week 18)
- Change in Seizure Frequency From Baseline.(18 weeks, Double-blind:weeks 1-18; Baseline: weeks -8to -1; titration: weeks 1 to 2; AED taper/conversion: weeks 3 to 8; monotherapy; weeks 9 to 18)
- Change in Total Score in Montgomery-Asberg Depression Rating Scale (MADRS),From Baseline .(Week 0 to Week 18,baseline day 0; end of AED taper/conversion period; end of week 8; end of monotherapy period; end of week 18)
- Standardized Seizure Frequency (SSF) by Period(Double-blind: week to 18; Baseline: weeks -8 to -1; titration: weeks 1 to 2; AED taper/conversion weeks 3 to 8; monotherapy: weeks 9 to 18)