E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
KCNQ2 Developmental and Epileptic Encephalopathy |
encefalopatia epilettica e dello sviluppo correlata a KCNQ2 |
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E.1.1.1 | Medical condition in easily understood language |
KCNQ2 Developmental and Epileptic Encephalopathy |
encefalopatia epilettica e dello sviluppo correlata a KCNQ2 |
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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 | PT |
E.1.2 | Classification code | 10077380 |
E.1.2 | Term | Epileptic encephalopathy |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the long-term safety and tolerability of XEN496 in pediatric subjects with KCNQ2-DEE who had participated in the primary study (XPF-009-301) |
Valutare la sicurezza a lungo termine e la tollerabilità di XEN496 in soggetti pediatrici con KCNQ2-DEE che hanno partecipato allo studio primario (XPF-009-301). |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the intra-subject efficacy of XEN496 in reducing seizure frequency compared to prior placebo treatment in pediatric subjects with KCNQ2-DEE who were previously randomized to receive placebo in the primary double-blind Phase 3 study (XPF-009-301) • To assess the long-term effect of XEN496 on seizure reduction in pediatric subjects treated with XEN496 • To evaluate CaGI-S and CaGI-C scores in pediatric subjects with KCNQ2-DEE • To assess neurocognitive development and behavior after dosing with XEN496 in pediatric subjects with KCNQ2-DEE • To evaluate the investigator's global impression of the change in the subject's overall condition, assessed using the CGI-C • To evaluate the use of rescue medication and change in background antiseizure medications • To assess the impact of XEN496 on the quality of life of caregivers and subjects with KCNQ2-DEE • To evaluate the plasma concentrations of ezogabine and N-acetyl metabolite of ezogabine (NAMR) |
Valutare: - efficacia nello stesso sogg di XEN496 nel ridurre la frequenza di convulsioni rispetto al precedente trattamento con placebo, in sogg pediatrici con KCNQ2-DEE che erano stati precedentemente randomizzati a ricevere placebo nello studio primario di Fase 3 in doppio cieco(XPF-009-301). -effetto a lungo termine di XEN496 sulla riduzione delle convulsioni in sogg pediatrici trattati con XEN496. -i punteggi di CaGI-S e CaGI-C in sogg pediatrici con KCNQ2-DEE. -lo sviluppo e il comportamento neurocognitivo dopo il dosaggio con XEN496 in sogg pediatrici con KCNQ2-DEE. -l'Impressione globale di cambiamento da parte dello sperimentatore nella condizione complessiva del sogg, valutata usando la scala CGI-C. -l'uso del medicinale di salvataggio e la variazione dei medicinali anticonvulsivi di base. -impatto di XEN496 sulla qualità della vita dei caregiver e dei sogg con KCNQ2-DEE. -le concentrazioni plasmatiche di ezogabina e del metabolita N-acetile di ezogabina (NAMR). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subject completed participation in the primary study, XPF-009-301. A subject who withdraws from the primary study due to meeting protocolspecified worsening criteria will be considered as having completed participation in the primary study. 2. The caregiver is willing and able to be compliant with diary completion, visit schedule, and study drug administration. 3. Subject's caregiver achieved a minimum of 85% compliance with daily diary completion during both baseline and the double-blind period of the primary study. |
1. Il soggetto ha completato la partecipazione come definito nello studio primario, XPF 009-301. Un soggetto che si ritira dallo studio primario perché soddisfa i criteri di peggioramento specificati nel protocollo, sarà considerato come soggetto che ha completato la partecipazione allo studio primario. 2. Il caregiver accetta ed è in grado di aderire ai requisiti riguardanti il completamento del diario, i programmi delle visite e la somministrazione del farmaco in studio. 3. Il caregiver del soggetto ha raggiunto un minimo dell’85% di aderenza con il completamento del diario sia durante il periodo basale che quello in doppio cieco dello studio primario. |
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E.4 | Principal exclusion criteria |
1. Any AE or SAE during Study XPF-009-301, which in the opinion of the investigator and sponsor's medical monitor, would preclude the subject's entry into the OLE. 2. A clinically significant condition or illness, or symptoms other than those resulting from KCNQ2-DEE, present at screening/baseline that, in the opinion of the investigator, would pose a risk to the subject if s/he were to enter the study. 3. Any conditions that were specified as exclusion criteria in the primary study (XPF 009-301). 4. It is anticipated that the subject will require treatment with at least 1 of the disallowed medications during the study. 5. Any change in cardiac rhythm or atrioventricular conduction in the primary study that, in the investigator's opinion, is a significant risk to subject safety. |
1. Qualsiasi evento avverso (AE) o evento avverso grave (SAE) durante lo studio XPF-009-301 che, a parere dello sperimentatore e del monitor clinico dello sponsor, precluderebbe l’ingresso del soggetto nello studio OLE. 2. Una condizione o malattia clinicamente significativa, o sintomi diversi da quelli derivanti da KCNQ2-DEE, presenti allo screening/basale che, a parere dello sperimentatore, metterebbero a rischio il soggetto se dovesse entrare nello studio. 3. Qualsiasi condizione che era stata descritta come criterio di esclusione nello studio primario (XPF 009-301). 4. Si prevede che il soggetto necessiterà di trattamento con almeno uno dei medicinali non concessi durante lo studio. 5. Qualsiasi cambiamento nel ritmo cardiaco o condizione atrioventircolare nello studio primario che, a parere dello sperimentatore, sia un rischio significativo per la sicurezza del soggetto. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Severity and frequency of AEs and serious adverse events (SAEs); clinically significant changes in laboratory tests, vital signs, ECGs, physical and neurologic examinations, urological examinations, and ophthalmology examinations. |
Gravità e frequenza degli AE e SAE; variazioni clinicamente significative negli esami di laboratorio, parametri vitali, elettrocardiogrammi (ECG), esame obiettivo e neurologico, esami urologici ed esami oftalmologici. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From Screening/Baseline to the End of the Study |
Dallo screening/basale alla fine dello studio |
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E.5.2 | Secondary end point(s) |
1. Change in monthly countable motor seizure frequency, comparing the first 15 weeks of XEN496 treatment in the OLE study to the seizure frequency reported during treatment in the preceding primary study (XPF-009-301), among only those subjects who were randomized to the placebo arm in the primary study 2. Change from pre-randomization baseline in the previous study over time based on response categories (<25%, 25 to <50%, 50 to <75%, 75 to <100%, 100%), based on estimated seizure frequency every 3 months during the OLE period. 3. Percent change from baseline in countable motor seizure frequency, relative to prerandomization baseline of the previous study (XPF-009301), assessed over time every 3 months during the OLE. 4. Percent change from baseline in countable motor seizure frequency, relative to prerandomization baseline of the previous study (XPF-009301), for every 3 months based on combined data from both XPF-009301 and the OLE, by the treatment group in the previous study. 5. Change over time in CaGI-S scores for the subject's seizures and overall condition. 6. Change over time in CaGI-C scores for the subject in the following domains: overall condition, seizures, behavior, alertness, motor skills, visual function, and communication. 7. Change over time in neurocognitive development based on the Bayley Scales of Infant and Toddler Development III. 8. Change over time in adaptive behavior based on the Adaptive Behavior Assessment System, Third Edition (ABAS-3) 9. Change over time in CGI-C scores for the subject's seizures and overall condition 10. Use of rescue medication. 11. Use of concomitant medications and treatments used for seizure control 12.Change in quality of life of subjects with KCNQ2-DEE, based on the Pediatric Quality of Life Inventory. 13. Change in quality of life of subjects with KCNQ2-DEE, based on the Pediatric Quality of Life Inventory, Family Impact scale 14. Plasma concentrations of ezogabine and NAMR (for subjects treated in the OLE study only) |
-Variazione nella frequenza mensile delle convulsioni motorie numerabili, confrontando le prime 15 settimane di trattamento con XEN496 nello studio OLE, rispetto alla frequenza di convulsioni riportata durante il trattamento nel precedente studio primario (XPF-009-301), solo tra quei soggetti che erano randomizzati al braccio placebo nello studio primario. -Variazione dal basale pre-randomizzazione nel tempo nello studio precedente, in base a categorie di risposta (<25%, da 25 a <50%, da 50 a <75%, da 75 a <100%, 100%), basata su frequenza stimata delle convulsioni ogni 3 mesi durante il periodo OLE. -Percentuale di variazione dal basale nella frequenza delle convulsioni motorie numerabili, relative al basale pre-randomizzazione dello studio precedente (XPF 009 301), valutata nel tempo ogni 3 mesi durante lo studio OLE. -Percentuale di variazione dal basale nella frequenza delle convulsioni motorie numerabili, relative al basale pre-randomizzazione dello studio precedente (XPF 009 301), ogni 3 mesi basata sui dati combinati di XPF 009-301 e OLE, per gruppo di trattamento nello studio precedente. -Variazione nel tempo dei punteggi CaGI-S per le convulsioni del soggetto e condizione complessiva. -Variazione nel tempo dei punteggi CaGI-C per il soggetto nei seguenti domini: condizione complessiva, convulsioni, comportamento, allerta, capacità motorie, funzione visiva e comunicazione. -Variazione nel tempo dello sviluppo neurocognitivo basato sulle Scale Bayley III dello Sviluppo del neonato e del bambino. -Variazione nel tempo del comportamento adattativo basato sul Sistema di valutazione del comportamento adattativo, terza edizione. -Variazione nel tempo dei punteggi CGI-C per le convulsioni del soggetto e la condizione generale. -Uso del medicinale di salvataggio. -Uso di tutti i medicinali concomitanti compresi i trattamenti usati per il controllo delle convulsioni. -Variazione della qualità della vita di soggetti con KCNQ2-DEE, basato sull’Inventario della qualità della vita pediatrica. -Variazione della qualità della vita di soggetti con KCNQ2-DEE, basato sull’Inventario della qualità della vita pediatrica, Scala dell’impatto sulla famiglia. -Concentrazioni plasmatiche di ezogabine e NAMR (per soggetti trattati solo nello studio OLE). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Screening to first 15 weeks (up to Visit 10) 2. From screening through to the end of the study 3. From screening through to the end of the study 4. From screening through to the end of the study 5. Study days: 1, 24, 67, 109, 182, 273 and 364 6. Study days: 24, 67, 109, 182, 273 and 364 7. Study days: 1, 109 and 364 8. Study days: 1, 109, 182 and 364 9. Study days: 67, 109, 182 and 364 10. From screening through to the end of the study 11. From screening through to the end of the study 12. Study days: 1, 67, 109, 182 and 364 13. Study days: 1, 67, 109, 182 and 364 14. Study days: 1, 16, 32, 67, 109, 182 and 364; 1. Screening alle prime 15 settimane (fino alla visita 10) 2. Dallo screening fino alla fine dello studio 3. Dallo screening fino alla fine dello studio 4. Dallo screening fino |
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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 | Yes |
E.6.13.1 | Other scope of the trial description |
long-term; tolerability |
lungo termine, tollerabilità |
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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 | No |
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 | Yes |
E.8.1.7.1 | Other trial design description |
estensione in aperto |
open label extension |
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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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
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 | Information not present in EudraCT |
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 |
Australia |
Canada |
China |
United States |
Belgium |
France |
Germany |
Italy |
Poland |
Spain |
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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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The end of the study is defined as completion of the last visit for the last subject in this study. |
La fine dello studio è definita come completamento dell'ultima visita per l'ultimo soggetto nello studio. |
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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 | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 4 |
E.8.9.2 | In all countries concerned by the trial days | 14 |