E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Epilepsy with partial onset seizures |
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E.1.1.1 | Medical condition in easily understood language |
Epilepsy with partial onset seizures |
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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 | 18.0 |
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 primary objective of this study is to evaluate the efficacy of LCM administered concomitantly with 1 to 3 AEDs in subjects ≥1 month to <4 years of age with epilepsy who currently have uncontrolled partial-onset seizures. |
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E.2.2 | Secondary objectives of the trial |
The secondary objective is to evaluate the safety and tolerability of LCM in subjects ≥1 month to <4 years of age with epilepsy who currently have uncontrolled partial-onset seizures. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subject is male or female from ≥1 month (ie, 4 weeks after full term [37 weeks gestational age]) to <4 years of age.
• Subject has a diagnosis of epilepsy with partial-onset seizures. The results of ≥1 prior EEG and ≥1 magnetic resonance imaging/computerized tomography scan should be consistent with this diagnosis.
• Subject weighs ≥4kg to <30kg at Visit 1.
• Subject has uncontrolled partial-onset seizures after an adequate course of treatment (in the opinion of the investigator) with ≥2 AEDs (concurrently or sequentially).
• Subject has experienced ≥2 partial-onset seizures with or without secondary generalization during each consecutive 7-day period during the 2 weeks prior to Visit 1.
• Subject has ≥2 partial-onset seizures with or without secondary generalization during the 72-hour Baseline video-EEG.
• Subject is on a stable (concurrently or sequentially) dosage regimen of 1 to 3 AEDs. The dosage regimen of concomitant AED therapy must be kept constant for a period of ≥2 weeks prior to Visit 1. A stable daily dosage regimen of a concomitant benzodiazepine (BZD) will be considered as a concomitant AED.
• Vagus nerve stimulation is allowed and will not be counted as a concomitant AED. The VNS device must have been implanted for ≥6 months prior to Visit 1; device settings must be kept stable for ≥2 weeks prior to Visit 1 and kept stable during the Baseline, Treatment, and Transition Periods. Use of the VNS device magnet is allowed.
• Subject is an acceptable candidate for venipuncture |
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E.4 | Principal exclusion criteria |
Subject has experienced febrile seizures exclusively. The occurrence of febrile seizures in addition to partial-onset seizures is not exclusionary.
• Subject is on a ketogenic or other specialized diet for the treatment of epilepsy. If the subject was on a ketogenic or other specialized diet in the past, they must be off this diet for ≥2 months prior to Visit 1.
• Subject has an alanine aminotransferase (ALT), aspartate aminotransferase (AST), or total bilirubin level ≥2 times the upper limit of normal (ULN), or creatinine clearance <30mL/minute.
• Subject has a clinically relevant ECG abnormality, in the opinion of the investigator (eg, second or third degree heart block at rest or a corrected QT interval [QTc] ≥450ms).
• Subject has a hemodynamically significant congenital heart disease.
• Subject has an arrhythmic heart condition requiring medical therapy.
• Subject has a known history of severe anaphylactic reaction secondary to medication intake or serious blood dyscrasias.
• Subject has nonepileptic events that could be confused with seizures. Subjects may be included if epileptic events can be clearly distinguished and the frequency meets the study inclusion criteria.
• Subject has a current diagnosis of Lennox-Gastaut syndrome, epilepsia partialis continua, primary generalized epilepsy, or seizures that are not of partial-onset origin.
• Subject has a history of status epilepticus ≤2 months prior to Screening (Visit 1).
• Subject has been treated with ethosuximide.
• Subject is currently being treated with vigabatrin or has discontinued use <12 months prior to Visit 1. Subjects who were previously treated with vigabatrin and have discontinued use >12 months prior to Visit 1 are eligible.
• Subject has been treated with felbamate and has experienced any serious toxicity issues (defined as liver failure, aplastic anemia) with this treatment. Subjects treated with felbamate for <12 months are excluded. Subjects treated with felbamate for ≥12 months prior to Visit 1 and who have not experienced serious toxicity issues are eligible.
• Subject has an acute or subacutely progressive central nervous system disease. Subject has epilepsy secondary to a progressing cerebral disease or any other progressively neurodegenerative disease (malignant brain tumor or Rasmussen Syndrome).
• Subject has a known sodium channelopathy, such as Brugada syndrome. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1) The primary efficacy variable will be the proportion of responders where a responder is a subject experiencing a 50% or greater reduction in their ADF of electrographic partial-onset seizures recorded on the 72-hour End-of-Maintenance Period video-EEG compared to the 72-hour End-of-Baseline Period video-EEG.
2) Adverse events reported spontaneously by the subject’s parent(s) and/or legal representative(s)/caregiver(s) (in accordance with local regulation) or observed by the investigator
3) Subject withdrawals due to AEs |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1) End-of-Maintenance Period video-EEG (Visit 6) compared to the 72-hour End-of-Baseline Period video-EEG (Visits 2 and 3)
2) From Baseline to End-of-Treatment
3) From Baseline to End-of-Treatment |
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E.5.2 | Secondary end point(s) |
1) Percent and absolute change in ADF of electrographic partial-onset seizures from the End-of-Baseline Period video-EEG to the End-of-Maintenance Period video-EEG
2) Proportion of subjects who achieved “seizure-free” status (yes/no) for subjects who completed at least 48 hours of interpretable video-EEG recording during the End-of-Maintenance Period video-EEG
3) Proportion of subjects experiencing a ≥25% to <50%, 50% to 75%, or >75% reduction in ADF of electrographic partial-onset seizures from the end-of-Baseline Period video-EEG to the End-of-Maintenance Period video-EEG
4) Proportion of subjects experiencing no change in ADF of electrographic partial-onset seizures (between <25% reduction and <25% increase) from the End-of-Baseline Period video-EEG to the End-of-Maintenance Period video-EEG
5) Proportion of subjects experiencing an increase in ADF of electrographic partial-onset seizures of ≥25% from the End-of-Baseline Period video-EEG to the End-of-Maintenance Period video-EEG |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) From the end-of-Baseline Period video-EEG (Visits 2 and 3) to the End-of-Maintenance Period video-EEG (Visit 6)
2) During the the end-of-Baseline Period video-EEG (Visit 6)
3) From the end-of-Baseline Period video-EEG (Visits 2 and 3) to the End-of-Maintenance Period video-EEG (Visit 6)
4) From the end-of-Baseline Period video-EEG (Visits 2 and 3) to the End-of-Maintenance Period video-EEG (Visit 6)
5) From the end-of-Baseline Period video-EEG (Visits 2 and 3) to the End-of-Maintenance Period video-EEG (Visit 6) |
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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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 87 |
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 |
Argentina |
Australia |
Brazil |
Bulgaria |
Canada |
Chile |
Colombia |
Croatia |
Czech Republic |
France |
Georgia |
Germany |
Greece |
Hungary |
Israel |
Italy |
Korea, Republic of |
Mexico |
Moldova, Republic of |
Poland |
Romania |
Serbia |
Spain |
Taiwan |
Thailand |
Ukraine |
United Kingdom |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | 14 |
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 | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |