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Open-label Study of Adjunctive GNX Treatment in Children and Adults With TSC-related Epilepsy

Phase 3
Conditions
Tuberous Sclerosis Complex
Interventions
Registration Number
NCT05604170
Lead Sponsor
Marinus Pharmaceuticals
Brief Summary

This is a Phase 3, global, open-label extension (OLE) study of adjunctive GNX treatment in children and adults with TSC who previously participated in either Study 1042-TSC-3001 or Study 1042-TSC-2001

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
132
Inclusion Criteria
  1. Completion of Study 1042-TSC-3001 or participants who continue to meet study requirements in Study 1042-TSC-2001.
  2. Participant/parent(s)/LAR(s) willing and able to give written informed consent/assent, after being properly informed of the nature and risks of the study and prior to engaging in any study-related procedures. If the participant is not qualified or able to provide written informed consent based on age, developmental stage, intellectual capacity, or other factors, parent(s)/LAR(s) must provide assent for study participation, if appropriate.
  3. Parent(s)/caregiver(s) is (are) willing and able to maintain an accurate and complete daily seizure diary for the duration of the study.
  4. Willing and able to take Investigational product (IP) (suspension) as directed with food TID.
  5. Women of childbearing potential (WOCBP) must be using a medically acceptable method of birth control and have a negative quantitative serum beta-human chorionic growth hormone (β-HCG) test collected at the initial visit. Childbearing potential is defined as a female who is biologically capable of becoming pregnant. Medically acceptable methods of birth control include intrauterine devices (that have been in place for at least 1 month prior to the screening visit), hormonal contraceptives (eg, combined oral contraceptives, patch, vaginal ring, injectables, and implants), and surgical sterilization (such as oophorectomy or tubal ligation). When used consistently and correctly, "double-barrier" methods of contraception can be used as an effective alternative to highly effective contraception methods. Contraceptive measures such as Plan B™, sold for emergency use after unprotected sex, are not acceptable methods for routine use
  6. Male participants must agree to use highly effective contraceptive methods during the study and for 30 days after the last dose of IP. Highly effective methods of contraception include surgical sterilization (such as a vasectomy) and adequate "double-barrier" methods.
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Exclusion Criteria
  1. Pregnant or breastfeeding.
  2. An active Central nervous system (CNS) infection, demyelinating disease, or degenerative neurological disease.
  3. History of psychogenic nonepileptic seizures.
  4. Any disease or condition (other than TSC) at the initial visit that could compromise the hematologic, cardiovascular (including any cardiac conduction defect), pulmonary, renal, gastrointestinal, or hepatic systems; or other conditions that might interfere with the absorption, distribution, metabolism, or excretion of the IP, or would place the participant at increased risk or interfere with the assessment of safety/efficacy. This may include any illness in the past 4 weeks which in the opinion of the investigator may affect seizure frequency.
  5. Unwillingness to avoid excessive alcohol use or cannabis use throughout the study.
  6. Have active suicidal plan/intent or have had active suicidal thoughts in the past 6 months or a suicide attempt in the past 6 months.
  7. Known sensitivity or allergy to any component in the IP(s), progesterone, or other related steroid compounds.
  8. Exposed to any other investigational drug (except for GNX in Study 1042-TSC-2001 or Study 1042-TSC-3001) or investigational device within 30 days or fewer than 5 half-lives prior to Visit 1 (first visit of the OLE). For therapies in which half-life cannot be readily established, the Sponsor's medical monitor should be consulted.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Ganaxolone (GNX) oral suspension, 3 times a day (TID)Ganaxolone-
Primary Outcome Measures
NameTimeMethod
Number of participants with abnormal vital signsWeek 1 through Week 160
Number of participants with abnormal physical, neurological and developmental examinationWeek 1 through Week 160
Number of participants with abnormal clinical laboratory testsWeek 1 through Week 156
Number of participants with adverse events (AEs), serious adverse events (SAEs) and withdrawals and dose-reductions due to AEsWeek 1 through Week 160
Number of participants with abnormal 12-lead electrocardiogram (ECG) findingsWeek 1 through Week 160
Number of participants with abnormal Columbia-Suicide Severity Rating Scale (C-SSRS)Week 1 through Week 160

The C-SSRS is a clinician administered assessment tool that evaluates suicidal ideation and behavior. Number of participants that have an affirmative response to the 5 items for suicidal ideation (1. Wish to be dead, 2. Non-specific active suicidal thoughts, 3. Active suicidal ideation with any methods (not plan) without intent to act, 4. Active suicidal ideation with some intent to act, without specific plan, 5. Active suicidal ideation with specific plan and intent) and/or to the 5 items for suicidal behavior (1. Preparatory acts or behavior, 2. Aborted attempt, 3. Interrupted attempt, 4. Actual attempt, 5. Completed suicide) will be reported. Higher scores indicate worse symptoms.

Secondary Outcome Measures
NameTimeMethod
Percent change from Baseline in 28-day seizure frequency during the long-term treatmentBaseline (Day 1) and Week 1 through Week 52
Number of participants who will be considered as Treatment RespondersWeek 1 through Week 52

Treatment responders are defined as those participants with ≥ 50% reduction from Baseline in seizure frequency during open-label treatment.

Change from Baseline in Caregiver Global Impression of Change in Seizure Intensity/Duration (CGI-CSID)Baseline (Day 1) and Week 1 through Week 156

The CGI-CSID is a 7-point Likert scale in which the parent(s)/caregiver(s)/LAR(s) assesses change in seizure intensity and/or duration after initiation of investigational product relative to Baseline (prior to treatment with investigational product). The scale ranges from 1- very much improved, 2- much improved, 3- minimally improved, 4- no change, 5- minimally worse, 6- much worse, and 7- very much worse. Higher scores indicate worse condition.

Percent change from Baseline in 28-day seizure frequency during open label extensionBaseline (Day 1) and Week 1 through Week 52

Seizure frequency will be calculated as the total number of seizures divided by the number of days with seizure data, multiplied by 28.

Change from Baseline in percentage of Seizure-Free Days during treatment, based on seizure typeBaseline (Day 1) and Week 1 through Week 52
Change from Baseline in quality-of-life scale Short Form-36 (SF-36)Baseline (Day 1) and Week 1 through Week 52

The SF-36 is a multi-purpose survey designed to capture participant or parent(s)/caregiver(s)/LAR(s) perceptions of own health and well-being. The SF-36 has 36 items grouped in 8 dimensions: physical functioning, physical and emotional limitations, social functioning, bodily pain, general, and mental health, which are the weighted sums of the questions in each section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. Higher scores represent better health-related quality-of-life.

Number of Participants with Clinical Global Impression of Improvement (CGI-I)Week 1 through Week 156

The CGI-I is a 7-point Likert scale that the parent(s)/caregiver(s)/legally authorized representative (LAR)(s) and clinician uses to rate the change in overall seizure control, behavior, safety, and tolerability after initiation of the Investigational product (IP) relative to Baseline (prior to treatment with the IP). It was rated as: 1- "very much improved", 2- "much improved', 3- "minimally improved", 4- "no change", 5- "minimally worse", 6- "much worse", and 7- "very much worse". Higher scores indicated worse condition.

Trial Locations

Locations (59)

UCLA Mattel Children's Hospital, TSC Center

🇺🇸

Los Angeles, California, United States

Children's Hospital of Orange County

🇺🇸

Orange, California, United States

Penn State Children's Hospital

🇺🇸

Hershey, Pennsylvania, United States

Mayo Clinic - Rochester

🇺🇸

Rochester, Minnesota, United States

University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Atrium Health/Levine Children's Hospital

🇺🇸

Charlotte, North Carolina, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Child Neurology Consultants of Austin (CNCA)

🇺🇸

Austin, Texas, United States

McGovern Medical School at the University of Texas Health Science Center

🇺🇸

Houston, Texas, United States

Le Bonheur Children's Hospital

🇺🇸

Memphis, Tennessee, United States

BC Children's Hospital

🇨🇦

Vancouver, Canada

Peking University First Hospital

🇨🇳

Beijing, China

The Affiliated Hospital of Guizhou Medical University

🇨🇳

Beijing, China

Beijing Children Hospital, Capital Medical University

🇨🇳

Beijing, China

Chinese PLA General Hospital

🇨🇳

Beijing, China

Chengdu's Women and Children's Central Hospital

🇨🇳

Qingyang, China

First Hospital of Jilin University

🇨🇳

Jilin, China

University Hospital of Rennes

🇫🇷

Rennes, France

Pediatric Neurology and Muscular Diseases Unit - University of Genoa

🇮🇹

Genova, Italy

Soroka University Medical Center

🇮🇱

Be'er Sheva, Israel

Tel-Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Ruber International

🇪🇸

Madrid, Spain

Hospital Sant Joan de Déu

🇪🇸

Barcelona, Spain

Hospital Infantil Universitario Niño Jesús

🇪🇸

Madrid, Spain

Hospital Regional Universitario de Málaga

🇪🇸

Málaga, Spain

Hospital Universitario y Politécnico La Fe

🇪🇸

Valencia, Spain

Bristol Royal Hospital for Children

🇬🇧

Bristol, United Kingdom

NHS acute tertiary referral centre, John Radcliffe Hospital

🇬🇧

Oxford, United Kingdom

Salford Royal Hospital

🇬🇧

Salford, United Kingdom

Sheffield Children's Hospital

🇬🇧

Sheffield, United Kingdom

Children's Hospital Colorado

🇺🇸

Aurora, Colorado, United States

Mid-Atlantic Epilepsy and Sleep Center

🇺🇸

Bethesda, Maryland, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Alfred Health

🇦🇺

Melbourne, Australia

Austin Health

🇦🇺

Heidelberg, Australia

Royal Melbourne Hospital

🇦🇺

Parkville, Australia

The Royal Children's Hospital Melbourne

🇦🇺

Parkville, Australia

ZNN - Epilepsiezentrum Frankfurt am Main

🇩🇪

Frankfurt, Germany

Arkansas Children's Research Institute

🇺🇸

Little Rock, Arkansas, United States

University of Strasbourg

🇫🇷

Strasbourg, France

Azienda Ospedaliero-Universitaria Meyer

🇮🇹

Firenze, Italy

Policlinico Umberto I

🇮🇹

Rome, Italy

University Hospital of Lyon

🇫🇷

Bron, France

University Hospital Bonn

🇩🇪

Bonn, Germany

Gemeinschaftskrankenhaus Herdecke

🇩🇪

Herdecke, Germany

Schneider Children´s Medical Center

🇮🇱

Petah Tikva, Israel

CHU Sainte-Justine

🇨🇦

Montréal, Canada

Epilepsiezentrum Kleinwachau gGmbH

🇩🇪

Radeberg, Germany

The Hospital for Sick Children

🇨🇦

Toronto, Canada

Toronto Western Hospital

🇨🇦

Toronto, Canada

Universitäts Krankenhaus Freiburg

🇩🇪

Freiburg, Germany

Robert-Debré Hospital

🇫🇷

Paris, France

Hôpital de la Pitié-Salpêtrière

🇫🇷

Paris, France

Hôtel Dieu de Montréal - CHUM

🇨🇦

Montréal, Canada

Epilepsie-Zentrum Bethel - Krankenhaus Mara

🇩🇪

Bielefeld, Germany

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

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