Epilepsy
Conditions
Keywords
Epilepsy, pediatric, intravenous, children, Lacosamide, VIMPAT®, seizure
Brief summary
EP0060 is a multicenter, open-label study to evaluate the safety and tolerability of intravenous (iv) Lacosamide (LCM) in pediatric subjects \>= 1 month to \< 17 years of age with epilepsy.
Interventions
DRUGLacosamide
Pharmaceutical form: solution for infusion Concentration: 10 mg/ml Route of Administration: intravenous
Sponsors
UCB BIOSCIENCES, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Months to 16 Years
Healthy volunteers
No
Inclusion criteria
* Male or female from \>=1 month to \<17 years of age * Subject has a diagnosis of epilepsy with partial-onset seizures or primary generalized tonic-clonic seizures * Subject meets 1 of the following criteria: 1. Open-label lacosmide (OLL) subject: Subject is currently receiving oral lacosmide (LCM) as adjunctive or monotherapy as participants in an open label long-term study (SP848, EP0034, or other pediatric study); OR, 2. Prescription lacosamide (RxL) subject: Subject is currently receiving prescribed oral LCM from commercial supply (eg, VIMPAT) as adjunctive or monotherapy; OR, 3. Initiating intravenous lacosamide (IIL) subject: Subject is not currently receiving LCM and will receive intravenous (iv) LCM as adjunctive treatment in EP0060. Initiation of LCM monotherapy is not permitted in IIL subjects. * Subject is an OLL or RxL subject and meets both of the following criteria: 1. Subject has been administered LCM for the treatment of epilepsy for at least 2 weeks prior to Screening; AND 2. Subject has been administered (OLL) or prescribed (RxL) oral LCM at a dose of 2 mg/kg/day to 12 mg/kg/day (for subjects \<50 kg) or 100 mg/day to 600 mg/day (for subjects \>=50 kg). Open-label study drug LCM (OLL) or prescribed oral LCM dose (RxL) must be stable for at least 3 days prior to first LCM infusion; OR, * Subject is an ILL subject and is on a stable dosage regimen of at least 1 antiepileptic drug (AED). The daily dosage regimen of concomitant AED therapy must be kept constant for a period of at least 2 weeks prior to Screening. * Subject is an acceptable candidate for venipuncture and iv infusion * Subject is, in the opinion of the investigator, able to comply with all study requirements. Subject (or parent\[s\] or legal representative) is willing to comply with all study requirements * Subject weighs \>=4 kg
Exclusion criteria
* Subject has previously received intravenous (iv) lacosamide (LCM) in this study * Subject has any medical, neurological, or psychiatric condition that, in the opinion of the investigator, could jeopardize the subject's health or compromise the subject's ability to participate in EP0060 * Subject has clinically significant hypotension or bradycardia in the opinion of the investigator * Subject \>=6 years of age 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 positive responses (Yes) to either Question 4 or Question 5 of the Columbia-Suicide Severity Rating Scale (C-SSRS) at Screening For open-label lacosamide (OLL) subjects, enrollment in EP0060 is not permitted if any of the following additional criteria are met: \- Subject has any ongoing Adverse Event (AE) in their long-term, open-label study that, in the opinion of the investigator, could jeopardize or would compromise the subject's ability to participate EP0060 or the subject meets any of the criteria for required withdrawal from the long-term open-label study For prescription lacosamide (RxL) and initiating intravenous lacosamide (IIL) subjects, enrollment in EP0060 is not permitted if any of the following additional criteria are met: * Subject has a medical condition that could reasonably be expected to interfere with drug absorption distribution, metabolism, or excretion * Subject is a female of childbearing potential and does not practice an acceptable method of contraception for the duration of participation in EP0060 * Subject has creatinine clearance less than 30 mL/min * Subject has a clinically relevant electrocardiogram (ECG) abnormality, in the opinion of the principal investigator (ie, second or third degree heart block at rest or a QT prolongation greater than 450 ms) * Subject has hemodynamically significant heart disease (eg, heart failure) * Subject has an arrhythmic heart condition requiring medical therapy, known cardiac sodium channelopathy, such as Brugada syndrome * Subject has a known history of severe anaphylactic reaction or serious blood dyscrasias * Subject has an acute or subacutely progressive central nervous system disease. * Subject has epilepsy secondary to a progressing cerebral disease or any other progressive or neurodegenerative disease (malignant brain tumor or Rasmussen syndrome) * Lacosamide is intended for treatment of generalized convulsive status epilepticus * Subject has diagnosis of Dravet's syndrome For IIL subjects, enrollment in EP0060 is not permitted if the following additional criterion is met: \- Subject has been treated with LCM within the last 3 months prior to Screening
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With at Least One Adverse Event Reported Spontaneously by the Participant/or Caregiver (Including Parent/Legal Guardian) or Observed by the Investigator During the Study | From Screening Period (Day -7 to Day -1) up to the End-of-Study Period (up to Day 37) | 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. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. 26 adverse events are reported splitting into at least 19 occurrences of individual pre-treatment emergent adverse events and 7 treatment emergent adverse events (TEAEs). |
| Percentage of Participants That Withdrew Due to Adverse Events During the Study | From Screening Period (Day -7 to Day -1) up to the End-of-Study Period (up to Day 37) | 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 and led to the withdrawal of the participants from the study. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. |
Countries
Hungary, Italy, Poland, Ukraine, United States
Participant flow
Recruitment details
The study started to enroll participants in May 2017 and concluded in June 2019.
Pre-assignment details
Participant Flow refers to the Safety Set iv (SS-iv).
Participants by arm
| Arm | Count |
|---|---|
| Lacosamide Age Cohort ≥ 1 Month - < 8 Years This arm consisted of participants who formed Cohort 2, were greater than or equal to (≥) 1 month to less than (\<) 8 years of age and received at least 1 dose of intravenous (iv) lacosamide (LCM). For the first 20 participants in Cohort 2, iv LCM has been infused over a duration of 30 minutes but no longer than 60 minutes whenever possible. After completion of the first 20 participants in Cohort 2, a Data Monitoring Committee (DMC) reviewed the safety and tolerability data for this Cohort and made the following recommendations: the progression of the current Cohort, including iv infusion durations to be evaluated. | 48 |
| Lacosamide Age Cohort ≥ 8 - < 17 Years This arm consisted of participants who formed Cohort 1, were ≥ 8 to \< 17 years of age and received at least 1 dose of iv LCM. For the first 20 participants in Cohort 1, iv LCM has been infused over a duration of 30 minutes but no longer than 60 minutes whenever possible. After completion of the first 20 participants in Cohort 1, a DMC reviewed the safety and tolerability data for this Cohort and made the following recommendations: the progression of the current Cohort, including iv infusion durations to be evaluated, and progression to initiate enrollment in the next Cohort (Cohort 2). | 55 |
| Total Title | 103 |
| Total | 206 |
Baseline characteristics
| Characteristic | Lacosamide Age Cohort ≥ 1 Month - < 8 Years | Lacosamide Age Cohort ≥ 8 - < 17 Years | Total Title |
|---|---|---|---|
| Age, Categorical <=18 years | 48 Participants | 55 Participants | 103 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 3.840 years STANDARD_DEVIATION 2.329 | 12.662 years STANDARD_DEVIATION 2.409 | 8.551 years STANDARD_DEVIATION 5.013 |
| Race/Ethnicity, Customized Asian | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized Black | 2 Participants | 3 Participants | 5 Participants |
| Race/Ethnicity, Customized Other/Mixed | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized White | 46 Participants | 50 Participants | 96 Participants |
| Sex: Female, Male Female | 26 Participants | 31 Participants | 57 Participants |
| Sex: Female, Male Male | 22 Participants | 24 Participants | 46 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 48 | 0 / 55 |
| other Total, other adverse events | 3 / 48 | 2 / 55 |
| serious Total, serious adverse events | 0 / 48 | 0 / 55 |
Outcome results
Primary
Percentage of Participants That Withdrew Due to Adverse Events During the Study
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 and led to the withdrawal of the participants from the study. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.
Time frame: From Screening Period (Day -7 to Day -1) up to the End-of-Study Period (up to Day 37)
Population: The Safety Set iv (SS-iv) included study participants in the Safety Set (SS) who received at least 1 dose of EP0060 study medication iv LCM.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Lacosamide Age Cohort ≥ 1 Month - < 8 Years (SS-iv) | Percentage of Participants That Withdrew Due to Adverse Events During the Study | 0 percentage of participants |
| Lacosamide Age Cohort ≥ 8 - < 17 Years (SS-iv) | Percentage of Participants That Withdrew Due to Adverse Events During the Study | 0 percentage of participants |
Primary
Percentage of Participants With at Least One Adverse Event Reported Spontaneously by the Participant/or Caregiver (Including Parent/Legal Guardian) or Observed by the Investigator During the Study
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. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. 26 adverse events are reported splitting into at least 19 occurrences of individual pre-treatment emergent adverse events and 7 treatment emergent adverse events (TEAEs).
Time frame: From Screening Period (Day -7 to Day -1) up to the End-of-Study Period (up to Day 37)
Population: The Safety Set iv (SS-iv) included study participants in the Safety Set (SS) who received at least 1 dose of EP0060 study medication iv LCM.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Lacosamide Age Cohort ≥ 1 Month - < 8 Years (SS-iv) | Percentage of Participants With at Least One Adverse Event Reported Spontaneously by the Participant/or Caregiver (Including Parent/Legal Guardian) or Observed by the Investigator During the Study | 12.5 percentage of participants |
| Lacosamide Age Cohort ≥ 8 - < 17 Years (SS-iv) | Percentage of Participants With at Least One Adverse Event Reported Spontaneously by the Participant/or Caregiver (Including Parent/Legal Guardian) or Observed by the Investigator During the Study | 14.5 percentage of participants |