Clinical Trial Results:
A Multicenter, Double-blind, Randomized, Placebo-controlled, Parallel-group Study to Investigate the Efficacy and Safety of Lacosamide as Adjunctive Therapy in Subjects with Epilepsy >=4 Years to <17 Years of Age with Partial-Onset Seizures
Summary
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EudraCT number |
2012-004996-38 |
Trial protocol |
HU SK BE IT LV EE CZ ES PL GB LT BG RO Outside EU/EEA SI HR FR |
Global end of trial date |
24 Jan 2017
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Results information
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Results version number |
v2(current) |
This version publication date |
01 Apr 2018
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First version publication date |
09 Aug 2017
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Other versions |
v1 |
Version creation reason |
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Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
SP0969
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01921205 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
UCB BIOSCIENCES Inc.
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Sponsor organisation address |
8010 Arco Corporate Drive, Raleigh, United States, NC 27617
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Public contact |
Clin Trial Reg & Results Disclosure, UCB BIOSCIENCES GmbH, clinicaltrials@ucb.com
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Scientific contact |
Clin Trial Reg & Results Disclosure, UCB BIOSCIENCES GmbH, clinicaltrials@ucb.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
13 Feb 2017
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
24 Jan 2017
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To evaluate the efficacy of Lacosamide (LCM) administered concomitantly with 1 to <=3 antiepileptic drugs (AEDs) in subjects with epilepsy >=4 years to <17 years of age who currently have uncontrolled partial-onset seizures.
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Protection of trial subjects |
During the conduct of the study all subjects were closely monitored.
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Background therapy |
Background therapy was permitted as defined in the study protocol. Patients were treated with 1-3 concomitant antiepileptic drugs (AEDs). | ||
Evidence for comparator |
Not applicable. | ||
Actual start date of recruitment |
29 Aug 2013
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Long term follow-up planned |
Yes
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Long term follow-up rationale |
Safety | ||
Long term follow-up duration |
2 Years | ||
Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Argentina: 9
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Country: Number of subjects enrolled |
Australia: 8
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Country: Number of subjects enrolled |
Belgium: 5
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Country: Number of subjects enrolled |
Bulgaria: 3
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Country: Number of subjects enrolled |
Colombia: 3
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Country: Number of subjects enrolled |
Croatia: 16
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Country: Number of subjects enrolled |
Czech Republic: 8
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Country: Number of subjects enrolled |
Estonia: 3
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Country: Number of subjects enrolled |
Georgia: 29
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Country: Number of subjects enrolled |
Hungary: 29
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Country: Number of subjects enrolled |
Israel: 6
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Country: Number of subjects enrolled |
Italy: 8
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Country: Number of subjects enrolled |
Latvia: 13
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Country: Number of subjects enrolled |
Lithuania: 4
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Country: Number of subjects enrolled |
Mexico: 8
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Country: Number of subjects enrolled |
Montenegro: 2
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Country: Number of subjects enrolled |
Poland: 36
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Country: Number of subjects enrolled |
Romania: 15
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Country: Number of subjects enrolled |
Russian Federation: 16
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Country: Number of subjects enrolled |
Serbia: 12
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Country: Number of subjects enrolled |
Slovakia: 16
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Country: Number of subjects enrolled |
Slovenia: 3
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Country: Number of subjects enrolled |
Korea, Republic of: 12
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Country: Number of subjects enrolled |
Taiwan: 15
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Country: Number of subjects enrolled |
Thailand: 33
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Country: Number of subjects enrolled |
Ukraine: 17
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Country: Number of subjects enrolled |
United Kingdom: 2
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Country: Number of subjects enrolled |
United States: 12
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Worldwide total number of subjects |
343
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EEA total number of subjects |
161
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
182
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Adolescents (12-17 years) |
161
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
The study started to enroll patients in August 2013 and concluded in January 2017. | |||||||||||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
The Participant Flow refers to the Safety Set which included all randomized subjects who took at least 1 dose of study medication. | |||||||||||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||||||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator, Carer, Assessor | |||||||||||||||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Placebo | |||||||||||||||||||||||||||||||||||||||
Arm description |
This arm includes subjects with epilepsy, who received a flexible dose of Placebo oral solution or tablets, administered twice a day. Appearance of Placebo oral solution and tablets matched the Lacosamide oral solution and tablets. | |||||||||||||||||||||||||||||||||||||||
Arm type |
Placebo | |||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo - solution
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Investigational medicinal product code |
PBO - solution
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Other name |
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Pharmaceutical forms |
Oral solution
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Routes of administration |
Oral use
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Dosage and administration details |
Placebo solution matching LCM solution.
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Investigational medicinal product name |
Placebo - tablet
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Investigational medicinal product code |
PBO - tablet
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Placebo tablets matching LCM tablets.
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Arm title
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Lacosamide | |||||||||||||||||||||||||||||||||||||||
Arm description |
This arm includes subjects with epilepsy, who received a flexible dose of Lacosamide (LCM) oral solution or tablets, administered twice a day. Subjects weighing <30kg received 8mg/kg/day to 12mg/kg/day Lacosamide (LCM) oral solution; subjects weighing >=30kg to <50kg received 6mg/kg/day to 8mg/kg/day LCM oral solution; and subjects weighing >=50kg received 300mg/day to 400mg/day LCM tablets, or if unable or unwilling to swallow tablets may have received LCM oral solution, however, they were not permitted to exceed the maximum dose of LCM 400mg/day. The subject’s body weight at Baseline (Visit 2) was used to determine the dose throughout the study. | |||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Lacosamide - solution
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Investigational medicinal product code |
LCM - solution
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Other name |
Vimpat
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Pharmaceutical forms |
Oral solution
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Routes of administration |
Oral use
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Dosage and administration details |
6mg/kg/day to 12 mg/kg/day determined by subject´s body weight at Baseline.
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Investigational medicinal product name |
Lacosamide - tablet
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Investigational medicinal product code |
LCM - tablet
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Other name |
Vimpat
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
300mg/day to 400mg/day determined by subject´s body weight at Baseline.
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Baseline characteristics reporting groups
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Reporting group title |
Placebo
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Reporting group description |
This arm includes subjects with epilepsy, who received a flexible dose of Placebo oral solution or tablets, administered twice a day. Appearance of Placebo oral solution and tablets matched the Lacosamide oral solution and tablets. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Lacosamide
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Reporting group description |
This arm includes subjects with epilepsy, who received a flexible dose of Lacosamide (LCM) oral solution or tablets, administered twice a day. Subjects weighing <30kg received 8mg/kg/day to 12mg/kg/day Lacosamide (LCM) oral solution; subjects weighing >=30kg to <50kg received 6mg/kg/day to 8mg/kg/day LCM oral solution; and subjects weighing >=50kg received 300mg/day to 400mg/day LCM tablets, or if unable or unwilling to swallow tablets may have received LCM oral solution, however, they were not permitted to exceed the maximum dose of LCM 400mg/day. The subject’s body weight at Baseline (Visit 2) was used to determine the dose throughout the study. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Placebo
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Reporting group description |
This arm includes subjects with epilepsy, who received a flexible dose of Placebo oral solution or tablets, administered twice a day. Appearance of Placebo oral solution and tablets matched the Lacosamide oral solution and tablets. | ||
Reporting group title |
Lacosamide
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Reporting group description |
This arm includes subjects with epilepsy, who received a flexible dose of Lacosamide (LCM) oral solution or tablets, administered twice a day. Subjects weighing <30kg received 8mg/kg/day to 12mg/kg/day Lacosamide (LCM) oral solution; subjects weighing >=30kg to <50kg received 6mg/kg/day to 8mg/kg/day LCM oral solution; and subjects weighing >=50kg received 300mg/day to 400mg/day LCM tablets, or if unable or unwilling to swallow tablets may have received LCM oral solution, however, they were not permitted to exceed the maximum dose of LCM 400mg/day. The subject’s body weight at Baseline (Visit 2) was used to determine the dose throughout the study. | ||
Subject analysis set title |
Placebo (FAS)
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
This arm includes subjects with epilepsy, who received a flexible dose of Placebo oral solution or tablets, administered twice a day. Appearance of Placebo oral solution and tablets matched the Lacosamide oral solution and tablets.
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Subject analysis set title |
Lacosamide (FAS)
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
This arm includes subjects with epilepsy, who received a flexible dose of Lacosamide (LCM) oral solution or tablets, administered twice a day. Subjects weighing <30kg received 8mg/kg/day to 12mg/kg/day Lacosamide (LCM) oral solution; subjects weighing >=30kg to <50kg received 6mg/kg/day to 8mg/kg/day LCM oral solution; and subjects weighing >=50kg received 300mg/day to 400mg/day LCM tablets, or if unable or unwilling to swallow tablets may have received LCM oral solution, however, they were not permitted to exceed the maximum dose of LCM 400mg/day. The subject’s body weight at Baseline (Visit 2) was used to determine the dose throughout the study.
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End point title |
Change in partial onset seizure (POS) frequency per 28 days from Baseline to the Maintenance Period | |||||||||||||||
End point description |
The POS frequency is standardized to a 28-day duration. Negative values indicate improvement from Baseline.
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End point type |
Primary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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Statistical analysis title |
Statistical Analysis 1 | |||||||||||||||
Comparison groups |
Placebo (FAS) v Lacosamide (FAS)
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Number of subjects included in analysis |
338
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Analysis specification |
Pre-specified
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Analysis type |
superiority | |||||||||||||||
P-value |
= 0.0003 | |||||||||||||||
Method |
ANCOVA | |||||||||||||||
Parameter type |
Percent reduction over Placebo | |||||||||||||||
Point estimate |
31.72
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Confidence interval |
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level |
95% | |||||||||||||||
sides |
2-sided
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lower limit |
16.342 | |||||||||||||||
upper limit |
44.277 |
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End point title |
Proportion of responders where a responder is defined as a participant with >= 50% reduction in partial onset seizure frequency per 28 days from Baseline to the Maintenance Period | |||||||||||||||
End point description |
Proportion of responders is presented as percentage of participants. A responder is a subject experiencing a 50 % or greater reduction in partial onset seizure frequency per 28 days from Baseline to the Maintenance Period.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Proportion of subjects experiencing a >=25 % to <50 %, 50 % to 75 %, or >75 % reduction in partial onset seizure frequency per 28 days from Baseline to the end of Maintenance Period | |||||||||||||||||||||
End point description |
Proportion of subjects is presented as percentage of participants.
A >=25%-<50% response in the Maintenance Period is defined as >=25% to <50% reduction in POS frequency per 28 days from Baseline to end of Maintenance Period. A >=50%-<=75% response in the Maintenance Period is defined as >=50% to <=75% reduction in POS frequency per 28 days from Baseline to end of Maintenance Period. A 75% response in the Maintenance Period is defined as >75% reduction in POS frequency per 28 days from Baseline to end of Maintenance Period.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Change in partial onset seizure frequency per 28 days from Baseline to the entire treatment (ie, Titration+Maintenance Periods) | |||||||||||||||
End point description |
The POS frequency is standardized to a 28-day duration. Negative values indicate improvement from Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Proportion of subjects experiencing a >=25 % to <50 %, 50 % to 75 %, or >75 % reduction in partial onset seizure frequency per 28 days from Baseline to the entire treatment (ie, Titration+Maintenance Periods) | |||||||||||||||||||||
End point description |
Proportion of subjects is presented as percentage of participants.
A >=25%-<50% response in the Treatment Period is defined as >=25% to <50% reduction in POS frequency per 28 days from Baseline to end of Treatment Period. A >=50%-<=75% response in the Treatment Period is defined as >=50% to <=75% reduction in POS frequency per 28 days from Baseline to end of Treatment Period. A 75% response in the Treatment Period is defined as >75% reduction in POS frequency per 28 days from Baseline to end of Treatment Period.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Proportion of subjects experiencing no change in partial onset seizure frequency (between <25 % reduction and <25 % increase) per 28 days from Baseline to the entire treatment (ie, Titration+Maintenance Periods) | |||||||||||||||
End point description |
Proportion of subjects is presented as percentage of participants.
No change is defined as between <25% reduction and <25% increase in POS frequency per 28 days from Baseline to the entire Treatment Period, otherwise not between <25% reduction and <25% increase is defined as a change.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Proportion of subjects experiencing an increase in partial onset seizure frequency per 28 days of >=25 % from Baseline to the entire treatment (ie, Titration+Maintenance Periods) | |||||||||||||||
End point description |
Proportion of subjects is presented as percentage of participants.
An increase is defined as a >=25% increase in POS frequency per 28 days from Baseline to the entire Treatment Period, otherwise <25% increase is defined as no increase.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Change in partial onset seizure frequency per 28 days from Baseline to the entire treatment (ie, Titration+Maintenance Periods) for Simple Partial Seizures | |||||||||||||||
End point description |
The POS frequency is standardized to a 28-day duration. Negative values indicate improvement from Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Change in partial onset seizure frequency per 28 days from Baseline to the entire treatment (ie, Titration+Maintenance Periods) for Complex Partial Seizures | |||||||||||||||
End point description |
The POS frequency is standardized to a 28-day duration. Negative values indicate improvement from Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Change in partial onset seizure frequency per 28 days from Baseline to the entire treatment (ie, Titration+Maintenance Periods) for Secondary Generalized Seizures | |||||||||||||||
End point description |
The POS frequency is standardized to a 28-day duration. Negative values indicate improvement from Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 16 (or last value on treatment)
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No statistical analyses for this end point |
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End point title |
Proportion of seizure free days during the Maintenance Period for subjects who completed the Maintenance Period | |||||||||||||||
End point description |
The proportion of seizure free days is calculated as (days with number of seizures = 0) divided by (days with recorded data in the subject diary), where 'days with recorded data in the subject diary' excludes any days where 'Not Done' is recorded.
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End point type |
Secondary
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End point timeframe |
Week 7 to Week 16
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No statistical analyses for this end point |
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End point title |
Proportion of subjects who achieved “seizure free” status (yes/no) for subjects who completed the Maintenance Period | |||||||||||||||
End point description |
The proportion of seizure free days is calculated as (days with number of seizures = 0) divided by (days with recorded data in the subject diary), where 'days with recorded data in the subject diary' excludes any days where 'Not Done' is recorded.
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End point type |
Secondary
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End point timeframe |
Week 7 to Week 16
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events were collected from Visit 1 until Safety Follow-Up Visit up to week 24.
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Assessment type |
Non-systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
16.1
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Reporting groups
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Reporting group title |
Placebo
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Reporting group description |
This arm includes subjects with epilepsy, who received a flexible dose of Placebo oral solution or tablets, administered twice a day. Appearance of Placebo oral solution and tablets matched the Lacosamide oral solution and tablets. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Lacosamide
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Reporting group description |
This arm includes subjects with epilepsy, who received a flexible dose of Lacosamide (LCM) oral solution or tablets, administered twice a day. Subjects weighing <30kg received 8mg/kg/day to 12mg/kg/day Lacosamide (LCM) oral solution; subjects weighing >=30kg to <50kg received 6mg/kg/day to 8mg/kg/day LCM oral solution; and subjects weighing >=50kg received 300mg/day to 400mg/day LCM tablets, or if unable or unwilling to swallow tablets may have received LCM oral solution, however, they were not permitted to exceed the maximum dose of LCM 400mg/day. The subject’s body weight at Baseline (Visit 2) was used to determine the dose throughout the study. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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05 Mar 2015 |
The main purpose of this substantial amendment was to add details to the statistics section regarding sample size re-estimation and statistical evaluation of secondary and other efficacy variables based on the clarifications made by the South Korean Ministry of Health and align the wording with the SP0967 protocol (a double-blind, randomized, placebo-controlled, parallel-group study to investigate the efficacy and safety of LCM as adjunctive therapy in subjects with epilepsy >=1 month to <4 years of age with partial-onset seizures).
Based on recommendations made by the US FDA, the creatinine clearance was changed from less than 50mL/min to less than 30mL/min in Exclusion Criterion number 10. In addition, as per request from the Swedish Ministry of Health, Exclusion Criterion number 20 (excluding subjects with epilepsy secondary to a progressing cerebral disease or any other progressively neurodegenerative disease, such as Rasmussen Syndrome) was removed because it was considered to be a duplicate of Exclusion Criterion number 23 (Section 3.3.2).
Exclusion Criterion number 22 was reworded to clarify that the excluded sodium channelopathies were cardiac. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |