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    Summary
    EudraCT Number:2013-004396-12
    Sponsor's Protocol Code Number:02
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2014-01-31
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2013-004396-12
    A.3Full title of the trial
    Efficacy of ketamine in refractory convulsive status epilepticus in children: a multicenter, randomized, controlled, open-label, no-profit, with sequential design study.
    Efficacia della ketamina nello stato di male epilettico convulsivo refrattario in età pediatrica: uno studio multicentrico, randomizzato, controllato, in aperto, no profit, con disegno sequenziale.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Efficacy of ketamine in refractory convulsive status epilepticus in children: a multicenter, randomized, controlled, open-label, no-profit, with sequential design study.
    Efficacia della ketamina nello stato di male epilettico convulsivo refrattario in età pediatrica: uno studio multicentrico, randomizzato, controllato, in aperto, no profit, con disegno sequenziale.
    A.3.2Name or abbreviated title of the trial where available
    KETASER01
    KETASER01
    A.4.1Sponsor's protocol code number02
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorAzienda Ospedaliero-Universitaria Meyer
    B.1.3.4CountryItaly
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportL. Molteni & C. Dei Alitti Società di Esercizio S.p.A.
    B.4.2CountryItaly
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAnna Rosati
    B.5.2Functional name of contact pointDirigente medico
    B.5.3 Address:
    B.5.3.1Street AddressViale Pieraccini 24
    B.5.3.2Town/ cityFirenze
    B.5.3.3Post code50139
    B.5.3.4CountryItaly
    B.5.4Telephone number00390555662573
    B.5.5Fax number00390555662329
    B.5.6E-maila.rosati@meyer.it
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Ketamina
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameKetamina
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnestetico dissociativo
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Midazolam
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameMidazolam
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeAnestetico convenzionale
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Propofol
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePropofol
    D.3.4Pharmaceutical form Emulsion for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeanestetico convenzionale
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Tiopentale
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTiopentale
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeanestetico convenzionale
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Refractory convulsive status epilepticus, defined as the recurrence of crisis for more than 60 minutes and / or drug-resistant I l and II line.
    Stato di male epilettico convulsivo refrattario, definito come il ripetersi di crisi per oltre 60 minuti e/o resistente ai farmaci di I e II linea.
    E.1.1.1Medical condition in easily understood language
    Refractory convulsive status epilepticus, defined as the recurrence of crisis for more than 60 minutes and / or drug-resistant I and II line.
    Stato di male epilettico convulsivo refrattario, definito come il ripetersi di crisi per oltre 60 minuti e/o resistente ai farmaci di I e II linea.
    E.1.1.2Therapeutic area Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 17.1
    E.1.2Level LLT
    E.1.2Classification code 10057955
    E.1.2Term Convulsive status epilepticus
    E.1.2System Organ Class 100000004852
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy of intravenous administration of KE in the treatment of refractory convulsive status epilepticus compared to administration of MDZ at high doses (TPS and / or PR).
    Valutare l'efficacia della somministrazione per via endovenosa della KE nel trattamento dello stato di male epilettico convulsivo refrattario rispetto alla somministrazione di MDZ ad alte dosi e (TPS e/o PR).
    E.2.2Secondary objectives of the trial
    To evaluate the efficacy of intravenous administration of KE in the treatment of refractory convulsive status epilepticus compared to administration of MDZ at high doses (TPS and / or PR).
    Valutare l'efficacia della somministrazione per via endovenosa della KE nel trattamento dello stato di male epilettico convulsivo refrattario rispetto alla somministrazione di MDZ ad alte dosi e (TPS e/o PR).
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1) Patients 1 month to 18 years old.
    2) Diagnosis and clinical EEGrafica of refractory convulsive status epilepticus
    3) Refractoriness of the drug I and II line
    4) Written informed consent from parents or legal guardian.
    5) Administration of rating scales in the risk of mortality (PIM III) and severity of SE (stess, status epilepticusseverity score) to be performed prior to randomization.
    1) Pazienti da 1 mese a 18 anni di età.
    2) Diagnosi clinico-EEGrafica di stato di male epilettico convulsivo refrattario
    3) Refrattarietà ai farmaci di I e II linea
    4) Consenso informato scritto da parte dei genitori o tutore legale.
    5) Somministrazione di scale di valutazione del rischio di mortalità (PIM III) e di gravità dello SE (STESS, status epilepticusseverity score) da eseguire prima della randomizzazione.
    E.4Principal exclusion criteria
    1) contraindications to the use of the medication/s in the study.
    2) pregnant or suspected pregnant.
    1) controindicazioni all'uso del/i farmaco/i in studio.
    2) stato di gravidanza presunta o accertata.
    E.5 End points
    E.5.1Primary end point(s)
    Resolution of refractory convulsive status epilepticus
    Risoluzione dello stato di male epilettico convulsivo refrattario
    E.5.1.1Timepoint(s) of evaluation of this end point
    seven days
    sette giorni
    E.5.2Secondary end point(s)
    1) Frequency of electro-medical crisis during treatment;
    2) Frequency of crisis from outcome at hospital discharge;
    3) Proportion of patients requiring intubation during treatment with KE;
    4) Proportion of patients for whom it is necessary to support the use of cardiovascular drugs (amine) for heart failure secondary to ongoing therapy;
    5) Proportion of subjects who respond to alternative therapy given after the registration of a therapeutic failure in the arm allocation;
    6) Proportion of patients requiring discontinuation of study treatment for adverse events;
    7) Proportion of treatment failures due to death (within 24 hours after discontinuation of therapy);
    8) in-hospital mortality;
    9) time to assisted ventilation
    1) Frequenza delle crisi elettro-cliniche durante il trattamento a partire dal raggiungimento della dose massima dei farmaci in studio fino all’accertamento dell’outcome;
    2) Frequenza delle crisi dall’accertamento dell’outcome alla dimissione dall’ospedale;
    3) Proporzione di pazienti richiedenti intubazione in corso di trattamento con KE;
    4) Proporzione di pazienti per i quali si rende necessario il ricorso a farmaci di supporto cardiovascolare (amine) per scompensi secondari alla terapia in corso;
    5) Proporzione di soggetti che rispondono alla terapia alternativa somministrata dopo la registrazione di un insuccesso terapeutico nel braccio di allocazione;
    6) Proporzione di pazienti che richiedono l’interruzione del trattamento in studio per comparsa di eventi avversi;
    7) Proporzione di insuccessi terapeutici per decesso (entro le 24 ore dalla sospensione della terapia);
    8) Mortalità intraospedaliera;
    9) Durata del tempo di ventilazione assistita
    E.5.2.1Timepoint(s) of evaluation of this end point
    seven days
    sette giorni
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Multicentrico e sequenziale con test triangolare
    Multicenter and sequential triangular test
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned9
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial 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
    Resolution of refractory convulsive status epilepticus
    Risoluzione dello stato di male epilettico convulsivo refrattario
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 57
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) Yes
    F.1.1.4.1Number of subjects for this age range: 10
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 20
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 27
    F.1.2Adults (18-64 years) No
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception For clinical trials recorded in the database before the 10th March 2011 this question read: "Women of childbearing potential" and did not include the words "not using contraception". An answer of yes could have included women of child bearing potential whether or not they would be using contraception. The answer should therefore be understood in that context. This trial was recorded in the database on 2014-01-31. Yes
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation Yes
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Patients inconscience
    Patients under 18 years of age
    Pazienti privi di coscienza e minorenni
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state57
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    clinical-epidemiology follow-up
    Follow-up clinico-epidemiologico.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2015-01-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-02-03
    P. End of Trial
    P.End of Trial StatusOngoing
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