Epilepsy
Conditions
Keywords
Lacosamide, Vimpat, UCB, Epilepsy, Partial-Onset Seizures, Pediatric
Brief summary
The purpose of this study is to evaluate the long-term safety, tolerability and efficacy of lacosamide (LCM) in pediatric subjects.
Interventions
Pharmaceutical form: oral solution Concentration: 1 mg/kg - 6 mg/kg BID (2 mg/kg/day - 12 mg/ kg/day) Route of administration: oral use
Sponsors
Study design
Eligibility
Inclusion criteria
* An Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written Informed Consent form (ICF) is signed and dated by the subject or legal representative. The ICF or a specific Assent form, where required, will be signed and dated by minors * Subject has completed the Transition Period of SP0967 \[NCT02477839\] or SP0969 \[NCT01921205\] for the treatment of uncontrolled partial-onset seizures in pediatric epilepsy * Subject is expected to benefit from participation, in the opinion of the investigator * Subject/legal representative is considered reliable and capable of adhering to the protocol (eg, able to understand and complete diaries), visit schedule, and medication intake according to the judgment of the investigator * Subject is male or female aged 1 month to ≤17 years * Subject has a diagnosis of epilepsy with partial-onset seizures
Exclusion criteria
* Subject is receiving any investigational drugs or using any experimental devices in addition to lacosamide (LCM) * Subject meets a mandatory withdrawal criterion (ie, MUST withdraw criterion) for SP0967 or SP0969, or is experiencing an ongoing serious adverse event (SAE) * For subjects ≥6 years of age, subject has a lifetime history of suicide attempt (including an actual attempt, interrupted attempt, or aborted attempt), or has suicidal ideation in the past 6 months as indicated by a positive response ('Yes') to either Question 4 or Question 5 of the Columbia-Suicide Severity Rating Scale (C-SSRS) at Visit 1 * Female subject who is pregnant or nursing, and/or a female subject of childbearing potential who is not surgically sterile or does not practice 1 highly effective method of contraception
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) | From Week 0 to the End of Safety Follow-Up (up to Week 104) | An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. Treatment-emergent is defined as starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose. |
| Percentage of Participants With Serious TEAEs | From Week 0 to the End of Safety Follow-Up (up to Week 104) | A serious adverse event (SAE) must meet 1 or more of the following criteria: • Death, • Life-threatening (Life-threatening does not include a reaction that might have caused death had it occurred in a more severe form.), • Significant or persistent disability/incapacity, • Congenital anomaly/birth defect (including that occurring in a fetus), • Important medical event that, based upon appropriate medical judgment, may jeopardize the patient or participant and may require medical or surgical intervention to prevent 1 of the other outcomes listed in the definition of serious., • Initial inpatient hospitalization or prolongation of hospitalization. Treatment-emergent is defined as starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose. |
| Percentage of Participants With TEAEs Leading to Study Discontinuation | From Week 0 to the End of Safety Follow-Up (up to Week 104) | An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. AEs leading to study discontinuation. Treatment-emergent is defined as starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Seizure-free Days During the Study | From Week 0 to End of Treatment (up to Week 96) | The number of seizure-free days was the total number of days within an interval for which daily diary data were available and no seizures were reported. The percentage of seizure-free days was computed as 100 times the number of seizure-free days in the interval divided by the number of days in the interval for which daily diary data were available. Percentage of seizure-free days was measured using data obtained from participant diaries from EP0034 and is presented for the overall Treatment only. |
Countries
Argentina, Australia, Belgium, Brazil, Bulgaria, China, Colombia, Croatia, Czechia, Estonia, France, Georgia, Greece, Hungary, Israel, Italy, Latvia, Lithuania, Mexico, Moldova, Montenegro, Philippines, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, South Korea, Taiwan, Thailand, Ukraine, United Kingdom, United States
Participant flow
Recruitment details
The study started to enroll participants in August 2014 and concluded in April 2022.
Pre-assignment details
The Participant Flow refers to the Safety Set (SS). The SS included all enrolled study participants who took at least 1 dose of lacosamide (LCM) in this long-term extension study.
Participants by arm
| Arm | Count |
|---|---|
| Lacosamide (All Subjects) Participants who participated in primary study \[SP0967 (NCT02477839) or SP0969 (NCT01921205)\] consented and met requirements to participate in current study received LCM 10 milligram/kilogram/day (mg/kg/day) as an oral solution for study participants weighing \<30 kg, LCM 6 mg/kg/day as an oral solution for study participants weighing \>=30 kg to \<50 kg, and LCM 300 mg/day as tablets for study participants weighing \>=50 kg. LCM was administered twice daily (bid) up to Week 96. After 1 week the investigator might adjust the LCM dose during the Treatment based on clinical judgment within a range of 2 mg/kg/day to 12 mg/kg/day for the oral solution and 100 mg/day to 600 mg/day for the tablets. | 540 |
| Total | 540 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 23 |
| Overall Study | Lack of Efficacy | 46 |
| Overall Study | Lost to Follow-up | 4 |
| Overall Study | Participant moved to another country | 1 |
| Overall Study | Patient and Investigator choice | 1 |
| Overall Study | Patient was prescribed CBD | 1 |
| Overall Study | Protocol deviation | 2 |
| Overall Study | Seizures appeared resolved with epilepsy surgery | 1 |
| Overall Study | Surgery | 1 |
| Overall Study | Surgery-hemispherotomy | 1 |
| Overall Study | Withdrawal by Subject | 64 |
Baseline characteristics
| Characteristic | Lacosamide (All Subjects) |
|---|---|
| Age, Continuous | 7.486 years STANDARD_DEVIATION 5.415 |
| Age, Customized >=12 - <18 years | 150 Participants |
| Age, Customized >=24 months - <12 years | 287 Participants |
| Age, Customized >=28 days - <24 months | 103 Participants |
| Race/Ethnicity, Customized American Indian/Alaskan native | 18 Participants |
| Race/Ethnicity, Customized Asian | 83 Participants |
| Race/Ethnicity, Customized Black | 4 Participants |
| Race/Ethnicity, Customized Hispanic or Latino | 68 Participants |
| Race/Ethnicity, Customized Not Hispanic or Latino | 472 Participants |
| Race/Ethnicity, Customized Other/mixed | 21 Participants |
| Race/Ethnicity, Customized White | 414 Participants |
| Sex: Female, Male Female | 236 Participants |
| Sex: Female, Male Male | 304 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 7 / 540 |
| other Total, other adverse events | 289 / 540 |
| serious Total, serious adverse events | 111 / 540 |
Outcome results
Percentage of Participants With Serious TEAEs
A serious adverse event (SAE) must meet 1 or more of the following criteria: • Death, • Life-threatening (Life-threatening does not include a reaction that might have caused death had it occurred in a more severe form.), • Significant or persistent disability/incapacity, • Congenital anomaly/birth defect (including that occurring in a fetus), • Important medical event that, based upon appropriate medical judgment, may jeopardize the patient or participant and may require medical or surgical intervention to prevent 1 of the other outcomes listed in the definition of serious., • Initial inpatient hospitalization or prolongation of hospitalization. Treatment-emergent is defined as starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose.
Time frame: From Week 0 to the End of Safety Follow-Up (up to Week 104)
Population: The SS included all enrolled study participants who took at least 1 dose of LCM in this long-term extension study.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Lacosamide (All Subjects) | Percentage of Participants With Serious TEAEs | 20.6 percentage of participants |
Percentage of Participants With TEAEs Leading to Study Discontinuation
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. AEs leading to study discontinuation. Treatment-emergent is defined as starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose.
Time frame: From Week 0 to the End of Safety Follow-Up (up to Week 104)
Population: The SS included all enrolled study participants who took at least 1 dose of LCM in this long-term extension study. Here, only those participants who discontinued the study due to TEAEs starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose of LCM are reported.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Lacosamide (All Subjects) | Percentage of Participants With TEAEs Leading to Study Discontinuation | 4.1 percentage of participants |
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. Treatment-emergent is defined as starting on or after the date of first dose of LCM in EP0034, and within 30 days of last dose.
Time frame: From Week 0 to the End of Safety Follow-Up (up to Week 104)
Population: The Safety Set (SS) included all enrolled study participants who took at least 1 dose of LCM in this long-term extension study.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Lacosamide (All Subjects) | Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) | 77.2 percentage of participants |
Percentage of Seizure-free Days During the Study
The number of seizure-free days was the total number of days within an interval for which daily diary data were available and no seizures were reported. The percentage of seizure-free days was computed as 100 times the number of seizure-free days in the interval divided by the number of days in the interval for which daily diary data were available. Percentage of seizure-free days was measured using data obtained from participant diaries from EP0034 and is presented for the overall Treatment only.
Time frame: From Week 0 to End of Treatment (up to Week 96)
Population: The Full Analysis Set (FAS) was used for the analysis of seizure data and included all study participants in the SS who had at least 1 completed post-Baseline seizure diary. Study participants whose efficacy data could not be source verified were excluded from the FAS. Here, Number of participants analyzed included those participants who were evaluable for the assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Lacosamide (All Subjects) | Percentage of Seizure-free Days During the Study | 66.96 percentage of seizure free days | Standard Deviation 36.18 |