E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Epilepsy, partial onset seizures |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10015037 |
E.1.2 | Term | Epilepsy |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 |
The objectives of this study are:
•To evaluate the safety, tolerability, and PK of Lacosamide when added to 1 to 3 concomitant AEDs in children aged 1 month to 17 years with a diagnosis of uncontrolled partial-onset seizures
•To obtain preliminary efficacy data on seizure frequency
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. A signed informed consent has been obtained from the parent/legal guardian and assent has been obtained from the subject (when possible or as required according to local Institutional Review Boards/Independent Ethics Committees).
2. Subject and caregiver (which may be a parent, a legal guardian, or other caregiver) are willing and able to comply with all study requirements including maintaining a daily seizure diary.
3. Subject is male or female between 1 month (ie, 4 weeks after full term [37 weeks gestational age]) and 17 years of age inclusive. For preterm infants <1 year old, the corrected gestational age should be used when determining eligibility. The generally accepted definition of corrected gestational age, which is calculated by subtracting the number of weeks born before 37 weeks of gestation from the chronological age, will be used for this study.
4. Subject’s BMI is within the 5th to 95th percentile for his/her age group (subjects ≥2 years of age only; see Section 16.2), and subject must be a minimum of 5kg (11.0 pounds) in body weight.
5. Subject has a diagnosis of epilepsy with partial-onset seizures.
a. The results of at least 1 prior electroencephalogram (EEG) AND 1 prior magnetic resonance imaging/computerized tomography scan should be consistent with the above diagnosis.
6. Subject has been observed to have uncontrolled partial-onset seizures after an adequate course of treatment (in the opinion of the investigator) with at least 2 AEDs (concurrently or sequentially).
7. Subject has been observed to have at least 2 countable seizures in the 4 week period prior to Screening.
a. In the case of simple partial seizures, only those with motor signs will be counted towards meeting the inclusion criteria (only partial seizures with a recognizable and countable manifestation).
8. Subject is on a stable dosage regimen of 1 to 3 AEDs, which should remain stable throughout the course of the study. The daily dosage regimen of concomitant AED therapy must be kept constant for a period of at least 1 week prior to Screening. Vagal nerve stimulation is not counted as medical therapy; however, VNS settings must be kept constant for a period of at least 1 week prior to Screening and during the study.
9.Subject is an acceptable candidate for venipuncture. |
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E.4 | Principal exclusion criteria |
Subjects are not permitted to enroll in the study if any of the following criteria are met:
1.Subject is currently participating or has participated within the last 2 months in any study of
an investigational drug or experimental device
2.Subject has ever received LCM
3.Subject has any medical or psychiatric condition that could jeopardize the subject’s health,
compromise the subject’s ability to participate in this study, and/or confound the planned
assessments of the study. Subject has any medical condition that would affect renal or
hepatic clearance of LCM
4.Subject with seizures that are uncountable due to clustering (ie, an episode lasting less than
30 minutes in which several seizures occur with such frequency that the initiation and
completion of each individual seizure cannot be distinguished) during the 8-week period
prior to study entry for subjects ≥1 year of corrected age or the 4-week period prior to study
entry for subjects <1 year of corrected age)
5.Subject has a known hypersensitivity to any component of the investigational medicinal
product
6.Subject is a female of childbearing potential or the subject achieves menarche during the
study and does not practice an acceptable method of contraception for the duration of the
study
Medically acceptable contraceptive method includes oral or depot contraceptive
treatment with at least 30μg ethinylestradiol per intake (or 50μg if associated with
carbamazepine [or other strong enzyme inducers, eg, phenobarbital, primidone,
oxcarbazepine]) which must be used in conjunction with a barrier method. Sexual
abstinence is also an acceptable method of contraception.
The subject must understand the consequences and potential risks of inadequately
protected sexual activity, be educated about and understand the proper use of
contraceptive methods, and undertake to inform the investigator of any potential change
in status. Females of childbearing potential must have a negative pregnancy test at the
Screening Visit (Visit 1)
7.Deleted and no longer applicable beginning with Protocol Amendment 4 (see protocol
amendment details in Section 26, Section 27, and Section 28)
8.Subject has had or has a febrile illness within 2 weeks of dosing
9.Subject is on a ketogenic or other specialized diet. If the subject was on a specialized diet in
the past, they must be off the diet for at least 2 months prior to the Screening Visit
10.Subject has an alanine aminotransferase (ALT), aspartate aminotransferase (AST), or total
bilirubin level greater than or equal to 2 times the upper limit of normal (ULN), or creatinine
clearance less than 50mL/min
11.Subject has a clinically relevant ECG abnormality, in the opinion of the principal investigator
(ie, second or third degree heart block at rest or a QT prolongation greater than 450ms)
12.Subject has hemodynamically significant heart disease (eg, heart failure)
13.Subject has an arrhythmic heart condition requiring medical therapy
14.Subject has a known history of severe anaphylactic reaction or serious blood dyscrasias.
15.Subject has nonepileptic events, including psychogenic seizures, that could be confused with
seizures. If both epileptic and nonepileptic events are present, epileptic events must be
distinguished from nonepileptic phenomena
16.Subject has a history of primary generalized epilepsy. Subject <2 years of age has EEG
findings or a clinical history of primary generalized epilepsy
17.Subject ≥2 years of age has a history of status epilepticus within the 6-month period prior to
Screening. Subject <2 years of age who has a history of status epilepticus requiring
hospitalization during the 1-month period prior to Screening
18.Subject is receiving concomitant treatment with felbamate or has received previous
felbamate therapy within the last 6 months prior to Screening
19.Subject has taken or is currently taking vigabatrin
20.Subject has a progressive neurological disorder (this does not ordinarily exclude
Lennox-Gastaut, Tuberous Sclerosis, or West Syndrome)
21.Deleted and no longer applicable beginning with Protocol Amendment 5 (see protocol
amendment details in Section 29, Section 30, and Section 31)
22.Subject is taking monoamine oxidase (MAO) inhibitors or narcotic analgesics
23.Subject has epilepsy secondary to a progressing cerebral disease or any other progressively
neurodegenerative disease, such as Rasmussen syndrome
24.Subject <2 years of age has a treatable seizure etiology (eg, febrile seizures). The occurrence
of febrile seizures per se is not exclusionary
25.Subject has a known sodium channelopathy, such as Brugada syndrome
26.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 Screening |
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E.5 End points |
E.5.1 | Primary end point(s) |
Number of subjects that report at least one treatment-emergent adverse event |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
•Mean LCM plasma concentration
•Mean SPM 12809 plasma concentration
•Change in seizure frequency
•Change in Caregiver Global Impression of Change score
•Change in Caregiver Global Impression of Change
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Mean LCM plasma concentration
-Pre-dose (-1 to 0 hours)
-18-42 minutes post-dose
-48-72 minutes post-dose
-90 to 150 minutes post-dose
-210 to 270 minutes post-dose
-6 to 9 hours post-dose
-11 to 12 hours post-dose
•Mean SPM 12809 plasma concentration
-18-42 minutes post-dose
-48-72 minutes post-dose
-90 to 150 minutes post-dose
-210 to 270 minutes post-dose
-6 to 9 hours post-dose
-11 to 12 hours post-dose
Change in seizure frequency
- Baseline to End of Treatment
Change in Caregiver Global Impression of Change score
- Baseline to End of Treatment
Change in Caregiver Global Impression of Change
- Baseline to End of Treatment |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
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 | Yes |
E.6.13.1 | Other scope of the trial description |
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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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | No |
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 |
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E.8.7 | Trial has a data monitoring committee | No |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 4 |
E.8.9.2 | In all countries concerned by the trial days | 0 |