E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Inadequately controlled partial onset seizures |
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E.1.1.1 | Medical condition in easily understood language |
Control of abnormal brain activity that can cause uncontrollable movements |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the short-term effect of perampanel on cognition to placebo by using the Cognitive Drug Research (CDR) System when administered as an adjunctive therapy in adolescents (12 to less than 18 years of age) with inadequately controlled partial-onset seizures (with or without secondarily generalized seizures) |
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E.2.2 | Secondary objectives of the trial |
- To assess the short-term effect of perampanel in adolescents on each of the CDR System 5 core cognitive domains of: Power of Attention, Continuity of Attention, Quality of Episodic Memory, Quality of Working Memory, and Speed of Memory
To evaluate
- the short- and long-term safety and tolerability of perampanel
- the long-term effect of perampanel in adolescents on cognition by using the CDR System
- the short- and long-term effects of perampanel on language by using the Controlled Oral Word Association Test
- the short- and long-term effects of perampanel on visuomotor skills by using the Lafayette Grooved Pegboard Test
- the long-term effect of perampanel on growth and development, including sexual development using Tanner Staging
- the pharmacokinetics of perampanel using a population PK approach and to explore the PK/pharmacodynamic relationship
- the efficacy of perampanel as determined by percent (%) change in seizure frequency and responder rate |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Core Study:
- Considered reliable and willing to be available for the study duration and is able to record seizures and report adverse events (AEs) themselves or have a legal guardian or a caregiver who can record seizures and report AEs for them
- Understand the requirements of the CDR System tests and able to perform the tests appropriately at Visit 1
- Male or female, 12 to less than 18 years of age at the time of consent/assent
- Have a diagnosis of epilepsy with partial-onset seizures with or without secondarily generalized seizures according to the International League Against Epilepsy’s (ILAE) Classification of Epileptic Seizures (1981). Diagnosis should have been established at least 6 months prior to Visit 1, by clinical history and an EEG that is consistent with localization-related epilepsy; normal interictal EEGs will be allowed provided that the subject meets the other diagnosis criterion (ie, clinical history)
- Have had a brain imaging (eg, magnetic resonance imaging [MRI] scan or computed tomography[CT]) within the 5 years prior to Visit 1 that ruled out a progressive cause of epilepsy
- Must have had at least 1 partial-onset seizure during the 4 weeks prior to Visit 1 despite a stable regimen of 1 to 3 concomitant AEDs
- Are currently being treated with stable doses of 1-3 AEDs. Only 1 inducer AED (either carbamazepine or phenytoin) out of the maximum of 3 AEDs is allowed
- Are on a stable dose of the same concomitant AED(s) for at least 4 weeks prior to Visit 1; in the case where a new AED regimen has been initiated for a subject, the dose must be stable for at least 8 weeks prior to Visit 1
- Female subjects of childbearing potential must have a negative serum human chorionic gonadotropin (β-hCG) at Visit 1 and a negative urine pregnancy test prior to randomization at Visit 2. Female subjects of childbearing potential must agree for the duration of the study and for a period of at least 60 days following administration of the last dose of study medication to commit to the consistent and correct use of a medically acceptable method of birth control (eg, a double-barrier method [condom + spermicide, condom + diaphragm with spermicide]). Abstinence will be considered an acceptable method of contraception on a case by case basis upon prior approval by the Medical Monitor
- Have an intelligence quotient (IQ) of ≥70, using the Kaufman Brief Intelligence Test, second edition (KBIT-2)
Extension Phase:
- Have completed all scheduled visits up to and including Visit 8 in the Core Study Randomization Phase
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E.4 | Principal exclusion criteria |
Core Study
- With a diagnosis of primary generalized epilepsies or seizures such as absences and/or myoclonic epilepsies
- Have current or a history of pseudo-seizures (psychogenic non-epileptic seizures [PNES]) within approximately 5 years prior to Visit 1
- Have a diagnosis of Lennox-Gastaut syndrome
- Have seizure clusters where individual seizures cannot be counted
- Have a history of status epilepticus that required hospitalization during the 12 months prior to the Visit 1
- Have an unstable psychiatric diagnosis that may confound the investigator’s ability to conduct the study or that may prevent completion of the protocol specified tests (eg, significant suicide risk, including suicidal behavior and ideation 6 months prior to Visit 1, current psychotic disorder, or acute mania)
- Have any concomitant illnesses/co-morbidities (eg, autism, attention-deficit hyperactivity disorder [ADHD]) at Visit 1 that could severely affect cognitive function during the course of the study
- Have previously participated in a clinical trial involving perampanel
- Have chronically or routinely use benzodiazepines and who have not discontinued use at least 4 weeks prior to Visit 1
Extension phase
- Those who, for any reason, discontinued early from the preceding double-blind study
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary Safety Analysis - Cognitive Function:
Change from baseline in the CDR System Global Cognition Score will be summarized by visit during the Randomization Phase and Extension Phase Part A.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The primary endpoint of change from baseline in the CDR System Global Cognition Score at Week 19 will be analyzed using analysis of covariance (ANCOVA) with baseline (Visit 2) as a covariate, and region, gender and treatment as factors in the Full Analysis Set for cognition. If the Week 19 score is missing for a subject, the last non-missing score will be used in lieu of the Week 19 score for that subject. A 95% 2-sided confidence interval (CI) will be created for the difference between the perampanel and placebo groups.
Change from the randomized baseline to the last visit (LOCF) of the Extension Phase Part A will be summarized. |
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E.5.2 | Secondary end point(s) |
To assess the short-term effect of perampanel in adolescents on each of the CDR System 5 core cognitive domains of: Power of Attention, Continuity of Attention, Quality of Episodic Memory, Quality of Working Memory,
and Speed of Memory.
- To evaluate the short- and long-term safety and tolerability of perampanel in adolescents
- To evaluate the long-term effect of perampanel in adolescents on cognition by using the CDR System
- To evaluate the short- and long-term effects of perampanel in adolescents on language by using the Controlled Oral Word Association (COWAT)
- To evaluate the short- and long-term effects of perampanel in adolescents on visuomotor skills by using the Lafayette Grooved Pegboard Test
- To evaluate the long-term effect of perampanel on growth and development in adolescents, including sexual development using Tanner Staging
- To evaluate the pharmacokinetics (PK) of perampanel in adolescents using a population PK approach and to explore the PK/pharmacodynamic (PD) relationship
- To evaluate the efficacy of perampanel in adolescents as determined by percent (%) change in seizure frequency and responder rate |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
See protocol section 8.5.2.2 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Double-blind with open label extensions |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
Czech Republic |
Hungary |
India |
Korea, Republic of |
Latvia |
Poland |
Spain |
Thailand |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Last patient last visit but for subjects who roll over into the Extension Phases, the last visit of the Maintenance Period of Core Study will be the first visit of the Extension Phase. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |