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    Clinical Trial Results:
    Prospective, Long-Term, Interventional, Active Extension Study to Evaluate the Safety and Tolerability of NBI-921352 as Adjunctive Therapy in Subjects with Focal Onset Seizures (FOS)

    Summary
    EudraCT number
    2021-004265-12
    Trial protocol
    CZ   FR   HU   ES   IT   BE  
    Global end of trial date
    11 Mar 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Mar 2025
    First version publication date
    27 Mar 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    NBI-921352-FOS2022
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05493293
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Neurocrine Biosciences
    Sponsor organisation address
    12780 El Camino Real, San Diego, United States, 92130
    Public contact
    Neurocrine Medical Information, Neurocrine Biosciences Inc., +1 877-641-3461, medinfo@neurocrine.com
    Scientific contact
    Neurocrine Medical Information, Neurocrine Biosciences Inc., +1 877-641-3461, medinfo@neurocrine.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    11 Mar 2024
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    11 Mar 2024
    Global end of trial reached?
    Yes
    Global end of trial date
    11 Mar 2024
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary objective for this study is evaluate the long-term safety and tolerability of NBI-921352 in participants with FOS.
    Protection of trial subjects
    This study was performed in full compliance with applicable Good Clinical Practice (GCP) and regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    08 Nov 2022
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 8
    Country: Number of subjects enrolled
    Spain: 22
    Country: Number of subjects enrolled
    Belgium: 6
    Country: Number of subjects enrolled
    Czechia: 28
    Country: Number of subjects enrolled
    France: 7
    Country: Number of subjects enrolled
    Hungary: 6
    Country: Number of subjects enrolled
    Italy: 5
    Worldwide total number of subjects
    82
    EEA total number of subjects
    74
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    82
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Participants who enrolled directly from Study NBI-921352-FOS2021 did not have a screening period. Participants who did not enroll directly had a screening period of at least 4 weeks.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    NBI-921352
    Arm description
    Participants received NBI-921352 3 times per day (TID) for up to 104 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    NBI-921352
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    NBI-921352 was administered per schedule specified in the arm description.

    Number of subjects in period 1
    NBI-921352
    Started
    82
    Received at Least 1 Dose of Study Drug
    82
    Completed
    0
    Not completed
    82
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    5
         Other Than Specified
    21
         Adverse event, non-fatal
    7
         Study Terminated by Sponsor
    48

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    NBI-921352
    Reporting group description
    Participants received NBI-921352 3 times per day (TID) for up to 104 weeks.

    Reporting group values
    NBI-921352 Total
    Number of subjects
    82 82
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    42.8 ( 10.2 ) -
    Gender categorical
    Units: Subjects
        Female
    42 42
        Male
    40 40
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    7 7
        Not Hispanic or Latino
    75 75
    Race
    Units: Subjects
        Asian
    1 1
        White
    78 78
        Other
    2 2
        Not reported
    1 1

    End points

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    End points reporting groups
    Reporting group title
    NBI-921352
    Reporting group description
    Participants received NBI-921352 3 times per day (TID) for up to 104 weeks.

    Primary: Number of Participants With Serious Treatment-emergent Adverse Events (TEAEs)

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    End point title
    Number of Participants With Serious Treatment-emergent Adverse Events (TEAEs) [1]
    End point description
    A TEAE was an adverse event (AE) with an onset date on or after first dose of study drug and within 14 days after the last dose of study drug. An AE was any untoward medical occurrence in a participant administered the study drug that did not necessarily have a causal relationship with the treatment. A serious adverse event (SAE) was any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required in-patient hospitalization/prolongation of existing hospitalization, was a congenital anomaly, was infection that required treatment parenteral antibiotics, other important medical events which might jeopardize participants, or might require medical/surgical intervention to prevent any of the above. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the ‘Reported Adverse Events’ Section. Safety analysis set included all enrolled participants who received at least 1 dose of NBI-921352.
    End point type
    Primary
    End point timeframe
    From first dose of study drug up to Week 111
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The endpoint was descriptive in nature.
    End point values
    NBI-921352
    Number of subjects analysed
    82
    Units: participants
    7
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose of study drug up to Week 111
    Adverse event reporting additional description
    Safety analysis set included all enrolled participants who received at least 1 dose of NBI-921352.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    NBI-921352
    Reporting group description
    Participants received NBI-921352 3 times per day (TID) for up to 104 weeks.

    Serious adverse events
    NBI-921352
    Total subjects affected by serious adverse events
         subjects affected / exposed
    7 / 82 (8.54%)
         number of deaths (all causes)
    1
         number of deaths resulting from adverse events
    Nervous system disorders
    Epilepsy
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Generalised tonic-clonic seizure
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seizure cluster
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Death
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Hepatobiliary disorders
    Hepatitis acute
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    COVID-19
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hyponatraemia
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    NBI-921352
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    41 / 82 (50.00%)
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    15 / 82 (18.29%)
         occurrences all number
    27
    Headache
         subjects affected / exposed
    12 / 82 (14.63%)
         occurrences all number
    12
    Somnolence
         subjects affected / exposed
    5 / 82 (6.10%)
         occurrences all number
    6
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    10 / 82 (12.20%)
         occurrences all number
    11
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    6 / 82 (7.32%)
         occurrences all number
    8
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    5 / 82 (6.10%)
         occurrences all number
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    22 Oct 2021
    • Inclusion criterion was revised to indicate that hormonal contraception is considered an acceptable method of contraception when used with effective nonhormonal contraception and to clarify that male participants with bilateral orchiectomy are required to use a condom with spermicide. • Specified that known potent inhibitors or inducers of cytochrome P3A4 (CYP3A4) enzymes (other than antiseizure medications [ASMs]) are not permitted during the study. • A statement was added that participants should avoid exposure to excessive sunlight or artificial ultraviolet light during the study and be advised to use sunscreen/sunblock and/or wear protective clothing when exposure could not be avoided. • Added that study treatment discontinuation was required for corrected QT interval using Fridericia’s formula (QTcF) change from baseline >60 millisecond (msec) (cardiologist verified) and confirmed with repeated electrocardiogram (ECG) measure. • Added that study treatment discontinuation was required for QTcF of >500 msec (cardiologist verified) on any ECG tracing. • Added a statement that the electronic data capture (EDC) and study-specific electronic case report forms (eCRFs) will comply with European Union General Data Protection Regulation.
    18 May 2022
    The protocol was revised to allow enrollment of participants who did not enroll directly from FOS2021. A Screening Period of up to 8 weeks and a 1-week open label (OL) Dose Titration Period was added. • Removed statement that participants should avoid excessive sunlight and ultraviolet light exposure during the study. • Added a statement that the Sponsor will store biosamples in a manner compliant with applicable national and local regulations and the requirements of the European Union General Data Protection Regulation. • Added that entries into the daily seizure diary will be reviewed with the participant by qualified study staff personnel who have completed the study-specific training. • Revised methods for measuring body temperature. • Added a statement that study visits may be conducted remotely if in-person visits were not possible for COVID-19-related reasons. • Updated to state that SAEs must be reported immediately and no later than 24 hours of knowledge of the event under any circumstances. • Added that pregnancies in partners of male participants must be reported to Neurocrine Biosciences, Inc (NBI) and that NBI will ask to follow the partner’s pregnancy. • Updated Sponsor contact information for reporting SAEs and pregnancies. • Removed the requirement for postbaseline safety data from the definition of the safety analysis set.
    04 May 2023
    • The secondary objective was recategorized as an ‘other’ objective. • Changes were made to the study endpoints, and the safety and efficacy analyses were updated to reflect the changes to the endpoints. • Clarified that a Taper Visit is not applicable for participants who withdraw from the study if they have dose de-escalation before the Early Termination Visit. • Increased the frequency of pregnancy testing for female participants of childbearing potential during the OL treatment period and removed the requirement for a confirmatory serum pregnancy test to be conducted at the study center. • Added that the local regulatory authority will be notified if urgent safety measures are required. • Updated statements about the security of information technology systems and Sponsor compliance with applicable laws and regulations for disclosure of study results. • Updated the Schedule of Assessments to clarify timing of seizure diary collection and dispensation.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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