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CANnabinoids for Drug Resistant Epilepsy (DRE) in Adults and Children

Phase 2
Not yet recruiting
Conditions
Drug Resistant Epilepsy
Interventions
Drug: Placebo
Drug: CBD CHE
Registration Number
NCT07023744
Lead Sponsor
University of Manitoba
Brief Summary

Epilepsy is a neurological disorder affecting more than 50 million people globally, including more than 260,000 Canadians. Cannabidiol (CBD) reduces seizure frequency and improves quality of life for adults and children with Drug Resistant Epilepsy (DRE). Several uncontrolled, small, open label studies reported that CBD-enriched Cannabis Herbal Extract (CHE) resulted in a reduction of seizure frequency, but we lack critical information on efficacy, comparative effectiveness and dosing of CBD and ∆9-tetrahydrocannabinol (THC) in children and adults with DRE. CAN-DRE is an early phase, triple-blind, placebo-controlled, randomized clinical trial to answer the questions of if cannabinoids work to reduce seizures in children and adults (24 months to 55 years) with DRE and if CBD works better in an isolate or in a CBD-enriched Cannabis Herbal Extract. The primary outcome of CAN-DRE is reported monthly seizure count from baseline to maintenance phase.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
90
Inclusion Criteria
  1. Ages 24 months to 55 years old at the time of enrollment
  2. Diagnosed with DRE: not achieved seizure freedom, with adequate trials of 2 antiseizure medications 29
  3. Medical history of 4 + clinically recognizable seizures (any type with clusters counted as a single event) per month
  4. Have a negative pregnancy test at screening for patients who have experienced menarche
  5. Agree to abstain from driving and recreational cannabis use throughout the study
Exclusion Criteria
  1. Diagnosis of psychogenic non-epileptic seizure
  2. Recent (<30 days) change in anticonvulsant therapies including anticonvulsant medications, or settings on vagal nerve stimulator
  3. Ketogenic diet started within 6 months (participants stable on the ketogenic diet for more than 6 months are eligible to participate)
  4. Vagal nerve stimulator implanted and activated within 12 months
  5. Concomitant regular use of narcotics (except in emergencies and physician supervised)
  6. Initiation or dosage change of oral or injected steroids within 3 months
  7. Allergy or intolerance to compounds in trial preparations
  8. DRE secondary to progressive neurological disease
  9. Clinically significant cardiac, renal or hepatic disease (as assessed by site investigator); elevated liver enzymes (GGT and/or AST and/or ALT) or lipase >3 times upper limit, adjusted for age
  10. History of psychotic disorders
  11. Uncontrolled (in the perspective of the qualified investigator) medical conditions including substance use disorders
  12. History or concurrent cannabis use disorder
  13. Unwilling or unable to use highly effective methods of contraception throughout the study period and three months post-trial, where applicable

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1 - Placebo Arm (MPL-012)PlaceboPlacebo arm -\> MPL-012 oil, each mL contains 0mg CBD and 0mg THC.
Arm 2 - CBD Isolate (MPL-015)CBD IsolateCBD-Isolate arm -\> MPL-015 oil, each ml contains 100mg CBD and 0mg THC.
Arm 3 - CBD-CHE (MPL-016)CBD CHECBD-CHE arm -\> MPL-016 oil, a CBD-enriched cannabis herbal extract, each ml contains 100mg CBD and 3mg THC.
Primary Outcome Measures
NameTimeMethod
Efficacy in reducing seizure frequency116 days

reported monthly seizure count from baseline to maintenance

Cannabinoid-related AEs and DLTs116 + 60 days

The frequency and type of adverse events and dose limiting toxicities (DLTs) reported by caregivers and participants throughout the trial participation

Secondary Outcome Measures
NameTimeMethod
participant/family acceptability of this trial design116 days

to be measured via post-study questionnaire, open-ended questions asked, no specific scale is used.

Quality of Life reported by adult participant/family116 days

Quality of Life in Epilepsy Inventory (QOLIE-31) tool for adult participants. Changes from baseline to maintenance phase will be compared to measure the outcome.

health resource utilization and changes176 days

A trial-specific Health Resource Utilization Questionnaire (HRUQ) is used to collect epilepsy participants' healthcare resource usage and out-of-pocket healthcare expenses during trial participation. The data will be analyzed descriptively to measure direct and indirect healthcare resource utilization related to the intervention from baseline phase to 60-day follow up post study protocolized treatment.

changes in work and activity impairment affected by seizure116 days

WPAI (Work Productivity and Activity Impairment Questionnaire) asks about the effect of participant's seizure on their/their caregivers' ability to work and perform regular activities. Changes reported from baseline to maintenance phase will be compared.

Quality of Life reported by pediatric participants and family116 days

Quality of Life in Childhood Epilepsy (QOLCE-55) tool for pediatric participants (4 - 17 yrs). Changes from baseline to maintenance phase will be compared to measure the outcome.

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