E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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 | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10000331 |
E.1.2 | Term | Absence seizure |
E.1.2 | System Organ Class | 100000014665 |
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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 |
To evaluate the efficacy and safety of lamotrigine monotherapy in newly diagnosed typical absence seizures in pediatric patients in Japan and South Korea [initial dose 0.3 mg/kg/day, maintenance dose 1.2-10.2 mg/kg/day or 400 mg/day (whichever was less)] administered orally once daily (when the number of tablets taken at a time increases, the dose can be administered in two divided doses per day). |
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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. Target disease: Subjects with newly diagnosed and untreated typical absence seizure which is classifiable by the International Classification of Seizures.
2. Diagnosis of typical absence seizures is established by at least one of two 4-minute hyperventilation tests as supported by clinical signs and EEG findings.
The following criteria will be used to define a typical absence seizure on the EEG: a discharge of generalized spike-and-wave or multiple spike-and-wave activity lasting ≥3 seconds during the awake state. The frequency of the spike-and-wave should be between 2.5-4.5 Hz.
3. Age (at the time of obtaining consent):
• 2 to 15 years of age in Japan
• 2 to 12 years of age in South Korea
4. Subjects must weigh at least 7 kg
5. Outpatients
6. Parent/guardian must have given written informed consent. Subjects who are intellectually able to understand the concepts and procedures of the protocol must give assent by also signing the consent.
7. Gender: Male or female
8. QTc<450 millisecond (msec) or <480msec for subjects with Bundle Branch Block – values based on either single ECG values or triplicate ECG averaged QTc values obtained over a brief recording period. |
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E.4 | Principal exclusion criteria |
1. Subjects with partial seizure or generalized seizures other than typical absence.
2. Subjects with a history of rash associated with other treatment.
3. Subjects with any clinically significant chronic cardiac, renal, or hepatic medical condition. Any patient with these conditions will be excluded from the study even if these conditions are being controlled with chronic therapy.
4. Subjects with an acute or chronic illness likely to impair drug absorption, distribution, metabolism or excretion or with any unstable physical symptoms likely to require hospitalization during participation in the study.
5. Subjects with a psychiatric disorder requiring medication, or who had psychiatric conditions in the past that was both judged to be severe and required hospitalization.
6. Subjects with an acute or progressive neurological disorder or an organic disease.
7. Subjects with currently taking any psychoactive drugs to treat hyperactivity disorder or attention deficit disorder.
8. Subjects with an unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminaemia, oesophageal or gastric varices or persistent jaundice), cirrhosis, known biliary abnormalities (with the exception of Gilbert’s syndrome or asymptomatic gallstones).
9. Female subjects who are pregnant or lactating, who may be pregnant, or who plan for pregnancy during the study.
10. Children in foster care: A child who has been placed under the control or protection of an agency, organisation, institution or entity by the courts, the government or a government body, acting in accordance with powers conferred on them by law or regulation. This can include a child cared for by foster parents or living in a care home or institution, provided that the arrangement falls within the definition above. The definition of a child in care does not include a child who is adopted or who has an appointed legal guardian.
11. Subjects taking inducers of lamotrigine glucuronidation (i.e., rifampicin, lopinavir/ritonavir), atazanavir/ritonavir, risperidone, oral contraceptives or hormone drug which includes estrogen.
12. Subjects having participated in other clinical study in the past 3 months before the start of investigational product.
13. Subjects who have active suicidal plan/intent or have had active suicidal thoughts in the past 3 months before the start of investigational product or who have history of suicide attempt in the last 1 year before the start of investigational product or more than 1 lifetime suicide attempt.
14. Subjects whom the investigator (or subinvestigator) considers ineligible for the study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of subjects seizure-free confirmed by HV-EEG at the end of the maintenance phase [Maintenance-Visit 3 (M-V3)]: [Number of subjects seizure-free confirmed by HV-EEG at the end of the maintenance phase (M-V3) / Number of subjects who have received the investigational product |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The end point was assessed at the end of the maintenance phase of the study- Week 16 |
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E.5.2 | Secondary end point(s) |
Proportion of subjects seizure-free confirmed by HV-EEG at the two consecutive visits in the escalation phase
• Proportion of subjects seizure-free confirmed by HV-clinical signs at each visit during the escalation phase
• Proportion of subjects seizure-free confirmed by HV-clinical signs during the maintenance phase
• Number of days with seizure episodes on seizure diary per week (fixed escalation phase, escalation phase, maintenance phase, fixed escalation phase + escalation phase + maintenance phase) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Endnotes were assessed through out the course of the study- Week 16 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
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 | 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 | 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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
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.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
Will this trial be conducted at a single site globally?
| No |
E.8.4 | Will this trial be conducted at multiple sites globally? | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.2 | Trial being conducted completely outside of the EEA | Yes |
E.8.6.3 | Specify the countries outside of the EEA 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.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 0 |