E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Seizures associated with paediatric epilepsy syndromes and partial-onset seizures |
Crisis asociadas con sindromes de epilepsia pediatrica y crisis de inicio parcial |
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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 | 21.0 |
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 |
Evaluate the efficacy of perampanel as measured by the 50% responder rate. |
Evaluar la eficacia de perampanel, determinada mediante la tasa con respuesta del 50 % |
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E.2.2 | Secondary objectives of the trial |
1. To evaluate the efficacy of perampanel as measured by the proportion of subjects who are seizure-free. 2. To evaluate the efficacy of perampanel as measured by absolute reduction and percentage of reduction in seizure frequency per 28 days. 3. To evaluate the effects of perampanel on the Clinical Global Impression (CGI). 4. To evaluate the effects of perampanel on the Subject Global Impression (SGI). 5. To evaluate the effects of perampanel on cognition, behavior, and growth and development. 6. To evaluate the efficacy of perampanel as measured by the proportion of responders. 7. To evaluate the efficacy of perampanel as measured by responder rate. 8. To characterize the PK of perampanel and explore exposure/response relationship. 9. To evaluate the safety and tolerability of perampanel. |
1. Evaluar la eficacia de perampanel, determinada mediante la proporción de sujetos que se queden sin crisis 2. Evaluar la eficacia de perampanel, determinada mediante la reducción absoluta y la reducción porcentual de la frecuencia de crisis en 28 días. 3.Evaluar los efectos de perampanel sobre la escala CGI (Impresión clínica global) 4.Evaluar los efectos de perampanel sobre la escala SGI (Impresión global del sujeto) 5.Evaluar los efectos de perampanel sobre la función cognitiva, la conducta y el crecimiento y desarrollo 6.Evaluar la eficacia de perampanel, determinada mediante la proporción de sujetos con respuesta 7.Evaluar la eficacia de perampanel, determinada mediante la tasa de sujetos con respuesta 8.Determinar la farmacocinética (FC) de perampanel y explorar posibles relaciones entre exposición/respuesta 9.Evaluar la seguridad y tolerabilidad de perampanel. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects must meet all of the following criteria to be included in this study: 1. Male or female subject, from age 1 month to less than 18 years. 2. Have a diagnosis of epilepsy with a pediatric epileptic syndrome or epilepsy with POS with or without secondary generalization. 3. Subjects must have had equal or greater than 4 seizures over the 4-week interval prior to Visit 2. 4. Have had brain imaging before Visit 1 that ruled out a progressive cause of epilepsy. 5. Are currently being treated with stable doses of 1 to a maximum of 4 approved AEDs. Doses must be stable for at least 4 weeks (at least 2 weeks for subjects <6 months old) before Visit 1; only 1 EIAED out of the maximum of 4 AEDs is allowed. |
1. Sujetos de cualquier sexo y de entre un mes y menos de 18 años. 2.Diagnóstico de epilepsia, con un síndrome epiléptico pediátrico o epilepsia con CIP con o sin generalización secundaria 3.Presencia de 4 o más crisis durante el intervalo de 4 semanas previo a la visita 2. 4.Estudio de imagen cerebral realizado antes de la visita 1 que descarte una causa progresiva de la epilepsia. 5. Tratamiento activo con dosis estables de entre uno y un máximo de 4 antiepilépticos aprobados. Las dosis deberán permanecer estables durante al menos 4 semanas (2 semanas en los sujetos menores de 6 meses) antes de la visita 1; solo se permitirá un antiepiléptico inductor enzimático (AEIE) entre los 4 antiepilépticos como máximo. |
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E.4 | Principal exclusion criteria |
Subjects who meet any of the following criteria will be excluded from this study: 1. Females who are breastfeeding or pregnant at Screening or Baseline. 2. Females of childbearing potential who: Within 28 days before study entry, did not use a combination of a barrier method with a highly effective method of contraception. Do not agree to use a combination of a barrier method with a highly effective method of contraception. 3. Current or history of pseudo-seizures (psychogenic nonepileptic seizures) within approximately 5 years before Visit 1. 4. Have a history of status epilepticus that required hospitalization during the 6 months before to Visit 1. 5. Have an unstable psychiatric diagnosis that may confound subjects’ ability to participate in the study or that may prevent completion of the protocol specified tests. 6. Any suicidal ideation with intent with or without a plan within 6 months before Visit 2. 7. Are scheduled or confirmed or both to have epilepsy surgery within 6 months after Visit 1. 8. Evidence of clinically significant disease that in the opinion of the investigator could affect the subject’s safety or interfere with the study assessments. 9. Evidence of moderate or severe renal insufficiency as defined by estimated glomerular filtration rates (eGFRs). 10. Evidence of significant active hepatic disease. 11. Evidence of significant active hematological disease. 12. Clinically significant ECG abnormality, including Fridericia prolonged corrected QT interval (QTcF) defined as greater than 450 msec. 13. Have a progressive central nervous system (CNS) disease, including degenerative CNS diseases and progressive tumors. 14. Multiple drug allergies or a severe drug reaction to AEDs, including dermatological (eg, Stevens-Johnson syndrome), hematological, or organ toxicity reactions. 15. Concomitant use of felbamate as an AED for less than 2 years or where the dose has not been stable for at least 8 weeks before Visit 1. 16. Concomitant or recent (within last 5 months before Visit 1) use of vigabatrin or any evidence of vigabatrin-associated clinically significant vision abnormality. 17. Benzodiazepines for any indications other than epilepsy prohibited from 1 month before Visit 1 and during the study. 18. A vagal nerve stimulator (VNS), responsive neurostimulator (RNS), or deep brain stimulator (DBS) implanted less than 5 months before Visit 1 or changes in parameter less than 4 weeks before Visit 1 (or thereafter during the study). 19. On a ketogenic diet for which the diet is not stable regimen for at least 4 weeks before to Visit 1. 20. History of or a concomitant medical condition that in the opinion of the investigator would preclude the subject’s participation in a clinical study or compromise the subject’s ability to safely complete the study. 21. Use of perampanel within 30 days before Visit 1, or perampanel was discontinued due to adverse reactions (perampanel-related) or lack of efficacy in case of previous exposure. 22. Subjects with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. 23. Have participated in a study involving administration of an investigational drug or device within 4 weeks before Visit 1. 24. Hypersensitivity to the active substance or to any of the excipients of the study drug |
1. Mujeres en período de lactancia o embarazadas en el período de selección o basal. 2. Mujeres en edad fértil que: •En los 28 días previos a la incorporación al estudio no hayan utilizado un método anticonceptivo muy eficaz •No se comprometan a utilizar un método anticonceptivo muy eficaz 3. Presencia o antecedentes de seudocrisis (crisis no epilépticas psicógenas) aproximadamente en los 5 años previos a la visita 1. 4.Antecedentes de estado epiléptico con necesidad de hospitalización en los 6 meses previos a la visita 1. 5.Diagnóstico psiquiátrico inestable que pueda confundir la capacidad del sujeto para participar en el estudio o que pueda impedir la realización de las pruebas especificadas en el protocolo . 6.Ideación suicida con intención, con o sin un plan, en los 6 meses previos a la visita 2 7.Cita prevista o confirmada para una intervención quirúrgica por epilepsia en los 6 meses siguientes a la visita 1; 8. Signos de enfermedad de importancia clínica que, en opinión del investigador, pueda afectar a la seguridad del sujeto o interferir en las evaluaciones del estudio. 9.Signos de insuficiencia renal moderada o grave, definida por una filtración glomerular estimada (FGe) 10.Signos de hepatopatía activa importante. 11.Signos de enfermedad hematológica activa importante; 12.Alteración clínicamente significativa en el electrocardiograma (ECG), como un intervalo QT corregido (QTc) prolongado, definido como mayor de 450 ms. 13.Enfermedad progresiva del sistema nervioso central (SNC), como enfermedades degenerativas y tumores progresivos. 14.Múltiples alergias a medicamentos o reacción grave a un antiepiléptico, incluidas reacciones dermatológicas (p. ej., síndrome de Stevens-Johnson), hematológicas o de toxicidad orgánica. 15.Uso concomitante de felbamato como antiepiléptico durante menos de 2 años o, en caso de que la dosis no haya sido estable, durante al menos 8 semanas antes de la visita 1. 16.Uso concomitante o reciente (en los 5 meses previos a la visita 1) de vigabatrina o cualquier signo de una anomalía visual clínicamente importante asociada a vigabatrina. 17.Uso intermitente de benzodiacepinas por indicaciones distintas de la epilepsia (p. ej., ansiedad o trastorno del sueño) en el mes previo a la visita 1. Se permite el uso de benzodiacepinas como medicación de rescate para controlar las crisis. 18.Implantación de un estimulador del nervio vago (ENV), neuroestimulador reactivo (NER) o estimulador cerebral profundo (ECP) menos de 5 meses antes de la visita 1 o cambios de los parámetros menos de 4 semanas antes de la visita 1 (o posteriormente durante el estudio). 19.Seguimiento de una dieta cetogénica que no se haya mantenido estable durante al menos 4 semanas antes de la visita 1. 20.Antecedentes o presencia de una enfermedad concomitante que, en opinión del investigador, impida la participación del sujeto en un estudio clínico o comprometa su capacidad de completar el estudio de forma segura. 21.Uso de perampanel en los 30 días previos a la visita 1 o suspensión de perampanel por reacciones adversas (relacionadas con perampanel) o falta de eficacia en caso de exposición previa. 22.Problemas hereditarios de intolerancia a la galactosa, alactasia lapona o malabsorción de glucosa-galactosa. 23.Participación en un estudio en el que se haya administrado un fármaco o producto sanitario en investigación en las 4 semanas previas a la visita 1, o en el período equivalente a unas 5 semividas del compuesto en investigación anterior, lo que suponga más tiempo. 24. Hipersensibilidad a sustancias activas o a cualquier excipiente del farmaco del estudio |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of 50% responders for all seizures. |
Proporción de sujetos con respuesta del 50 % en todas las crisis |
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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) |
1. Proportion of subjects who are seizure-free. 2. Absolute and Percent Change from baseline in seizure frequency for all seizures. 3. CGI of Change. 4. SGI of Change. 5. Change from baseline in CDR. 6. Change from baseline in CBCL. 7. Proportion of responders for all seizures. 8. Changes from baseline in growth and development parameters. 9. Proportion of subjects with any treatment-emergent reports of suicidal ideation and behavior on the C-SSRS and intensity of these behaviors assessed using C-SSRS scores. 10. Change from baseline in number of seizures recorded on EEG. 11. Safety and tolerability |
1.Proporción de sujetos que se queden sin crisis . 2.Variación absoluta y porcentual con respecto al período basal de la frecuencia de todas las crisis 3. Puntuación CGI-C (según el investigador) al final del período de tratamiento del estudio principal y al final de la fase de extensión. 4. Puntuación SGI-C (según el sujeto) al final del período de tratamiento del estudio principal y al final de la fase de extensión. 5. Variación de la puntuación CDR entre el período basal . 6.Variación de la puntuación CBCL entre el período basal . 7.Proporción de sujetos con respuesta en todas las crisis . 8.Variaciones de los parámetros de crecimiento y desarrollo entre el periodo basal. 9.Proporción de sujetos con cualquier notificación de ideación y comportamiento suicidas en la escala C SSRS surgidos durante el tratamiento e intensidad de estos comportamientos evaluada mediante las puntuaciones C-SSRS . 10.Variación del número de crisis registradas en el EEG entre el período basal. 11. Seguridad y tolerabilidad |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. 23 & 52 weeks 2. 23 & 52 weeks 3. 23 & 52 weeks 4. 23 & 52 weeks 5. 23 & 52 weeks 6, 23 & 52 weeks 7. 23 & 52 weeks 8. Continuous 9. 23 & 52 weeks 10. 23 & 52 weeks 11. Continuous |
1. 23 & 52 semanas 2. 23 & 52 semanas 3. 23 & 52 semanas 4. 23 & 52 semanas 5. 23 & 52 semanas 6, 23 & 52 semanas 7. 23 & 52 semanas 8. Continuo 9. 23 & 52 semanas 10. 23 & 52 semanas 11. Continuo |
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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) | 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 | 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 | 1 |
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 | 50 |
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 |
Belgium |
Czech Republic |
Denmark |
France |
Germany |
Spain |
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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Last visit of the last subject. |
Ultima visita del ultimo paciente |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 11 |
E.8.9.1 | In the Member State concerned days | |
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 | 1 |