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    Summary
    EudraCT Number:2022-001256-42
    Sponsor's Protocol Code Number:YKP509C003
    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:2023-01-31
    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 number2022-001256-42
    A.3Full title of the trial
    A Randomized, Double-blind, Placebo-Controlled Study to Investigate the Efficacy and Safety of Carisbamate (YKP509) as Adjunctive Treatment for Seizures Associated with Lennox-Gastaut Syndrome in Children and Adults, with Optional Open- Label Extension
    Studio randomizzato, in doppio cieco, controllato con placebo per valutare l'efficacia e la sicurezza di Carisbamato (YKP509) come trattamento aggiuntivo per le crisi convulsive associate alla sindrome di Lennox-Gastaut in adulti e bambini, con estensione in aperto facoltativa
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical study to evaluate safety and efficacy of Caribasmate
    uno studio clinico per valutare sicurezza ed efficacia di carisbamato
    A.3.2Name or abbreviated title of the trial where available
    YKP509C003
    YKP509C003
    A.4.1Sponsor's protocol code numberYKP509C003
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT05219617
    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 SponsorSk Life Science Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportSK Life Science, Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationSK Life Science, Inc
    B.5.2Functional name of contact pointExecutive Medical Director
    B.5.3 Address:
    B.5.3.1Street Address461 From Road, 5th Floor Paramus
    B.5.3.2Town/ cityNJ
    B.5.3.3Post code07652
    B.5.3.4CountryUnited States
    B.5.4Telephone number0012014318768
    B.5.5Fax number0012014318768
    B.5.6E-mailjschiemann@sklsi.com
    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 No
    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 nameCarisbamate
    D.3.2Product code [YKP509]
    D.3.4Pharmaceutical form Powder for oral suspension
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCARISBAMATE
    D.3.9.2Current sponsor codeYKP509
    D.3.9.3Other descriptive nameCarisbamate (S)-2-O-carbamoyl-1-o-chlorophenyl-ethanol
    D.3.9.4EV Substance CodeSUB130483
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboPowder for oral suspension
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Lennox-Gastaut syndrome (LGS)
    Sindrome di Lennox-Gestaut (LGS)
    E.1.1.1Medical condition in easily understood language
    Lennox-Gastaut syndrome (LGS)
    Sindrome di Lennox-Gestaut (LGS)
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level PT
    E.1.2Classification code 10048816
    E.1.2Term Lennox-Gastaut syndrome
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy of carisbamate (YKP509) as adjunctive treatment in reducing the number of drop seizures (tonic, atonic, tonicclonic) compared with placebo in pediatric and adult subjects (age 4-55 years) diagnosed with Lennox Gastaut Syndrome (LGS)
    Valutare l'efficacia di carisbamato (YKP509) come trattamento aggiuntivo nel ridurre il numero delle crisi convulsive con caduta (toniche, atoniche, tonico-cloniche) rispetto al placebo in soggetti pediatrici e adulti (età 4-55 anni) con diagnosi di sindrome di Lennox-Gastaut (Lennox-Gastaut Syndrome, LGS)
    E.2.2Secondary objectives of the trial
    • To evaluate the efficacy of carisbamate (YKP509) as adjunctive treatment in reducing the total number of seizures compared with placebo in pediatric and adult subjects diagnosed with Lennox Gastaut Syndrome (LGS)
    • Assess subject's Quality of Life (QOL)
    • Evaluate the safety, tolerability of carisbamate in the LGS population
    • Evaluate steady-state pharmacokinetics of carisbamate in subjects with Lennox Gastaut.
    • Valutare l'efficacia di carisbamato (YKP509) come trattamento aggiuntivo nel ridurre il numero totale di crisi convulsive rispetto al placebo in soggetti pediatrici e adulti con diagnosi di sindrome di Lennox-Gastaut (LGS)
    • Valutare la qualità della vita (QOL) del soggetto
    • Valutare la sicurezza, la tollerabilità di carisbamato nella popolazione con LGS
    • Valutare la farmacocinetica allo stato stazionario di carisbamato in soggetti con sindrome di Lennox-Gastaut
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Subject must have a documented history of Lennox-Gastaut syndrome by:
    a. Evidence of more than one type of seizure, of which at least one should be an atonic or tonic seizure
    b. History of an electroencephalogram (EEG) reporting diagnostic criteria for LGS (abnormal background activity accompanied by slow, spike and wave pattern <3.0 Hz)
    c. History of developmental delay
    2. Male or female subjects
    3. Subjects must be age 4-55 years at the time of consent/assent
    4. Must have been <11 years old at the onset of LGS
    5. Subjects must have experienced at least 2 drop seizures with potential to fall (tonic, atonic, tonic-clonic) each week during the 4-week Baseline period preceding randomization. Drop seizures are defined as aseizure involving the entire body, trunk, or head that led or could have led to a fall, injury, slumping in a chair, or hitting the subject's head on a surface. For seizures that occur in clusters: if countable, an exact seizure count should be used; if uncountable, the caregiver should estimate the number of seizures.
    6. Subjects must have been receiving 1 to 4 concomitant anti-seizure medications (ASMs) at a stable dose for at least 4 weeks before Visit 1
    7. If not taking Epidiolex, subjects may take other approved cannabidiol or over the counter cannabidiol products. If taking cannabidiol other than Epidiolex, consult Medical Monitor to determine if it counts as a
    concomitant ASM.
    8. Dietary therapy and any CNS stimulator settings must be stable for 4 weeks prior to baseline and maintain stable regimen throughout the study. The dietary therapy and CNS stimulators are not counted as an ASM.
    9. Parents or caregivers must be able to keep accurate seizure diaries
    10. Subject is either not of childbearing potential, defined as premenarchal, postmenopausal for at least 1 year or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), if of
    childbearing potential, must comply with an acceptable method of birth control during the study, for at least 4 weeks prior to study entry and for 2 weeks after dose of study drug.
    11. Subject and/or parent(s)/legal representative must be willing and able to give informed assent/consent for participation in the study
    12. Subject and their caregiver must be willing and able (in the
    investigator's opinion) to comply with all study requirements
    13. History of COVID-19 vaccination is permitted.
    1. Il soggetto deve avere un'anamnesi di sindrome di Lennox-Gastaut documentata mediante:
    a. evidenza di più di un tipo di crisi convulsiva, di cui almeno una deve essere atonica o tonica
    b. storia di un elettroencefalogramma (EEG) che riporta criteri diagnostici per LGS (attività di fondo anomala accompagnata da un pattern di picchi e onde lente <3,0 Hz)
    c. storia di ritardo dello sviluppo
    2. Soggetti maschili o femminili
    3. I soggetti devono avere un'età compresa tra 4 e 55 anni al momento del consenso/assenso
    4. I soggetti devono aver avuto meno di 11 anni all'insorgenza della LGS
    5. I soggetti devono aver sperimentato almeno 2 crisi convulsive con potenziale di caduta (toniche, atoniche, tonico-cloniche) ogni settimana durante il periodo basale di 4 settimane precedente la randomizzazione. Le crisi convulsive con caduta sono definite come una crisi che coinvolge l'intero corpo, il tronco o la testa che ha portato o avrebbe potuto portare a una caduta, lesioni, accasciamento su una sedia o a colpire una superficie con la testa. Per le crisi convulsioni che si verificano in cluster: se possono essere contate, deve essere utilizzato un conteggio esatto delle crisi; se non possono essere contate, il caregiver deve stimare il numero di crisi convulsive.
    6. I soggetti devono aver ricevuto da 1 a 4 farmaci antiepilettici (ASM) concomitanti a una dose stabile per almeno 4 settimane prima della Visita 1
    7. Se non assumono Epidiolex, i soggetti possono assumere altri prodotti a base di cannabidiolo approvati o da banco. Se si assume un cannabidiolo diverso da Epidiolex, consultare il Medical Monitor per determinare se il farmaco è considerato un ASM concomitante.
    8. La terapia alimentare e qualsiasi impostazione dello stimolatore del SNC devono essere stabili da 4 settimane prima del basale ed essere mantenuti a un regime stabile per tutto lo studio. La terapia alimentare e gli stimolatori del SNC non sono considerati ASM.
    9. I genitori o i caregiver devono essere in grado di tenere diari accurati delle crisi convulsive.
    10. Il soggetto non è in età fertile, definito come in fase premenarcale, in postmenopausa da almeno 1 anno o chirurgicamente sterile (legatura bilaterale delle tube, ovariectomia bilaterale o isterectomia); se in età fertile, deve rispettare un metodo anticoncezionale accettabile durante lo studio, per almeno 4 settimane prima dell'ingresso nello studio e per 2 settimane dopo l'ultima dose del farmaco in studio.
    11. Il soggetto e/o il genitore/rappresentante legale devono essere disposti e in grado di fornire il consenso/assenso informato per la partecipazione allo studio
    12. Il soggetto e il suo caregiver devono essere disposti e in grado (secondo il parere dello sperimentatore) di rispettare tutti i requisiti dello studio
    13. Anamnesi di vaccinazione per COVID-19 è consentita
    E.4Principal exclusion criteria
    1. Etiology of subject's seizures is a progressive neurologic disease. Subjects with tuberous sclerosis will not be excluded from study participation, unless there is a progressive brain tumor
    2. Evidence of clinically significant disease (e.g., cardiac, respiratory, gastrointestinal, renal disease, hepatic disease) that in the opinion of the investigator(s) could affect the subject's safety or study conduct
    3. Subjects who were on adrenocorticotropic hormone (ACTH) therapy in the 6 months prior to baseline
    4. Subject on dietary therapy for less than 4 weeks prior to screening visit (Visit 1) or suffers from frequent stooling
    5. Current use of felbamate with less than 12 months of continuous exposure
    6. Subjects who took vigabatrin in the past must have discontinued it at least 5 months before Visit 1. Subjects taking vigabatrin should have documentation showing no evidence of a vigabatrin-associated visual field abnormality.
    7. Subject who had a history of hypoxia which needed emergency resuscitation within 12 months prior to baseline
    8. Status epilepticus within 12 weeks of Visit 1
    9. Any clinically significant illness (including COVID-19) in the 4 weeks prior to Visit 1, as determined by the Investigator
    10. Subject has clinically significant abnormal laboratory values, in the investigator's opinion, at Visit 1 or time of randomization (Visit 2)
    11. Subject has a history of any serious drug-induced hypersensitivity, e.g., toxic epidermal necrolysis, or Drug Reaction with Eosinophilia and Systemic Symptoms [DRESS]) or any drug-related rash requiring
    hospitalization
    12. Vagus Nerve Stimulation (VNS), Deep Brain Stimulation (DBS), Responsive Neurostimulator System (RNS) or other neurostimulation forepilepsy device implanted or activated <5 months prior to enrollment.
    Stimulation parameters that have been stable for <4 weeks, or Battery life of unit not anticipated to extend for duration of trial.
    13. Subject is pregnant, may be pregnant, lactating or planning to be pregnant
    14. Any suicidal ideation with intent, with or without a plan within 6 months before Visit 2 (i.e., answering "Yes" to questions 4 or 5 in the Suicidal Ideation section of the agespecific Columbia-Suicide Severity
    Rating Scale (C-SSRS) in subjects aged 6 and above who are able to be evaluated
    15. Any suicidal behavior within 2 years before Visit 2 (i.e., answering YES to any question in the Suicidal behavior section of the age-specific Columbia-Suicide Severity Rating Scale (C-SSRS) in subjects aged 6 and above who are able to be evaluated.
    16. Evidence of significant active hepatic disease. Stable elevations of liver enzymes (alanine aminotransferase (ALT), and aspartate aminotransferase (AST)) due to concomitant medication(s) will be
    allowed if they are <3 x ULN
    17. Subject with total bilirubin [TBL] >2 x ULN (except for Gilbert's syndrome).
    18. Active viral hepatitis (B or C) as demonstrated by positive serology at the Screening visit (Visit 1)
    19. History of positive antibody/antigen test for human immunodeficiency virus (HIV)
    20. If taking Epidiolex, subject may not use other approved cannabidiol or over the counter cannabidiol products
    21. Scheduled for epilepsy-related surgery, VNS insertion, or any other stimulators/surgery during the projected course of the study
    22. Subject who has participated in any clinical study of an investigational product or device in the 30 days prior to the screening visit (Visit 1)
    23. Concomitant use of medications known to be strong inducers of cytochrome UGT enzymes including, but not limited to: phenobarbital, phenytoin, carbamazepine, primidone, rifampin, troglitazone, St. John's
    Wort, efavirenz, nevirapine, glucocorticoids (other than topical usage), modafinil, pioglitazone, and rifabutin
    24. Evidence of cardiac disease, including unstable angina, myocardial infarction, within the past 2 years, uncontrolled heart failure, major arrhythmias, congenital short QT syndrome
    25. Subject with a short QTc interval (<340 msec) or long QTc interval (>460 msec) as confirmed by a repeated electrocardiogram (ECG)
    26. Intermittent benzodiazepine rescue administered more than four times in the 28 days prior to Visit 1 (1 to 2 doses in a 24-hour period is considered as one rescue).
    27. Previous exposure to carisbamate or sensitivity/allergy to components of the oral suspension.
    1. L'eziologia delle crisi convulsive del soggetto è una malattia neurologica progressiva. I soggetti con sclerosi tuberosa non saranno esclusi dalla partecipazione allo studio, a meno che non vi sia un tumore cerebrale progressivo
    2. Evidenza di una malattia significativa (ad es. cardiaca, respiratoria, gastrointestinale, renale, epatica) che, secondo il parere del PI, potrebbe influire sulla sicurezza del soggetto o sulla conduzione dello studio
    3. Soggetti che erano in terapia con l'ormone adrenocorticotropo (ACTH) nei 6 mesi precedenti il basale
    4. Soggetto in terapia alimentare da meno di 4 sett prima della visita di screening (Visita 1) o che soffre di evacuazioni frequenti
    5. Uso corrente di felbamato con meno di 12 mesi di esposizione continua
    6. I soggetti che hanno assunto vigabatrin in passato devono averlo interrotto da almeno 5 mesi prima della Visita 1. I soggetti che assumono vigabatrin devono avere una documentazione che non mostri alcuna evidenza di un'anomalia del campo visivo associata a vigabatrin.
    7. Soggetto con storia di ipossia che necessitava di rianimazione di emergenza nei 12 mesi prima del basale
    8. Stato epilettico nelle 12 sett dalla Visita 1
    9. Qualsiasi malattia clinicamente significativa (inclusa COVID-19) nelle 4 sett precedenti la Visita 1 come determinato dal PI
    10. soggetto con valori di lab anomali clinicamente significativi alla Visita 1 o al momento della randomizzazione (Visita 2) secondo l'opinione del PI
    11. Il soggetto ha un'anamnesi di grave ipersensibilità indotta da farmaci, es., necrolisi epidermica tossica o reazione da farmaco con eosinofilia e sintomi sistemici (Drug Reaction with Eosinophilia and Systemic Symptoms, DRESS) o eruzione cutanea correlata al farmaco che richieda il ricovero
    12. Stimolazione del nervo vago (Vagus Nerve Stimulation, VNS), stimolazione cerebrale profonda (Deep Brain Stimulation, DBS), sistema di neurostimolazione reattiva (Responsive Neurostimulator System, RNS) o altro dispositivo di neurostimolazione per l'epilessia impiantato o attivato entro 5 mesi dall'arruolamento. Parametri di stimolazione stabili da <4 settimane o durata della batteria dell'unità che non si prevede duri per la durata della sperimentazione.
    13. Il soggetto è in gravidanza, si sospetta una gravidanza, la sta pianificando o sta allattando con latte materno
    14. Qualsiasi ideazione suicidaria con intenzione, con o senza un piano nei 6 mesi prima della Visita 2 (cioè, risposta affermativa alle domande 4 o 5 nella sezione Ideazione suicidaria della scala (C-SSRS) specifica per età in soggetti di età pari o superiore a 6 anni che possono essere valutati
    15. Qualsiasi comportamento suicidario nei 2 anni prima della Visita 2 (cioè, risposta affermativa a qualsiasi domanda nella sezione Comportamento suicidario della scala della Columbia University per la valutazione della gravità del rischio di suicidio (C-SSRS) specifica per età in soggetti di età pari o superiore a 6 anni che possono essere valutati.
    16. Evidenza di epatopatia attiva significativa. Saranno consentiti aumenti stabili degli enzimi epatici (alanina aminotransferasi (ALT) e aspartato aminotransferasi (AST)) dovuti a farmaci concomitanti, se sono <3 x ULN
    17. Soggetto con bilirubina totale [TBL] >2 x ULN (eccetto sindrome di Gilbert).
    18. Epatite virale attiva (B o C) come dimostrato dalla sierologia positiva alla visita di screening (Visita 1)
    19. Anamnesi di test positivo per l'anticorpo/antigene del virus dell'immunodeficienza umana (HIV)
    20. Se assume Epidiolex, il soggetto può non utilizzare altri prodotti a base di cannabidiolo approvati o da banco
    21. Programmato per un intervento chirurgico correlato all'epilessia, inserimento di VNS o altri stimolatori/interventi chirurgici durante il corso previsto dello studio
    22. Soggetto che ha partecipato a qualsiasi studio clinico su un prodotto o dispositivo in sperimentazione nei 30 giorni precedenti la visita di screening (Visita 1)
    23. Uso concomitante di farmaci noti per essere forti induttori degli enzimi UGT inclusi, a titolo esemplificativo ma non esaustivo: fenobarbital, fenitoina, carbamazepina, primidone, rifampicina, troglitazone, iperico, efavirenz, nevirapina, glucocorticoidi (diversi dall'uso topico), modafinil, pioglitazone e rifabutina
    24. Evidenza di cardiopatia, tra cui angina instabile, infarto miocardico, negli ultimi 2 anni, insufficienza cardiaca non controllata, aritmie maggiori, sindrome congenita del QT corto
    25. Soggetto con intervallo QTc breve (<340 msec) o intervallo QTc lungo (>460 msec) come confermato da un elettrocardiogramma (ECG) ripetuto
    26. Terapia di salvataggio intermittente con benzodiazepine somministrata più di 4vve nei 28gg precedenti la Visita 1 (da 1 a 2 dosi in un periodo di 24 ore è considerato come una terapia di salvataggio).
    27. Precedente esposizione al carisbamato o sensibilità/allergia ai componenti della sospensione orale.
    E.5 End points
    E.5.1Primary end point(s)
    The primary outcome will be the percentage change from baseline in the total frequency (average per 28 days) of drop seizures with potential to fall (tonic, atonic, tonic-clonic) during thethe double-blind treatment period.
    L'esito primario sarà la variazione percentuale rispetto al basale della frequenza totale (media per 28 giorni) delle crisi convulsive con potenziale di caduta (toniche, atoniche, tonico-cloniche) durante il periodo di trattamento in doppio cieco.
    E.5.1.1Timepoint(s) of evaluation of this end point
    During the double-blind treatment period.
    Durante il periodo di trattamento in doppio cieco
    E.5.2Secondary end point(s)
    1. The percentage of subjects with at least a 50% reduction from baseline in the total frequency of drop seizures (tonic, atonic, tonicclonic) during the double-blind treatment period.
    2. Percentage change from baseline in the frequency of all types of seizures (total seizures) during the double-blind treatment period.
    3. Subject/Caregiver Global Impression of Change in overall condition (S/CGIC) score
    at the last visit.

    Other Secondary Endpoints:
    1. Percentage change from baseline in the 28-day frequency of
    a. drop seizures (tonic, atonic, tonic-clonic),
    b. non-drop seizures (myoclonic seizures, atypical absence),
    c. total seizures during the maintenance phase of the double-blind treatment period.
    2. Percentage change from baseline in non-drop seizures (myoclonic seizures, atypical absence) frequency per 28 days during the doubleblind treatment period.
    3. The percentage of subjects with at least a 50% reduction from baseline in the total frequency of drop seizures (tonic, atonic, tonicclonic) during the maintenance phase of the double-blind treatment period.
    4. Proportion of subjects with a 75%, 90% and 100% response rate for drop seizures (tonic, atonic, tonic-clonic), non-drop seizures, and total seizures during the double-blind treatment period.
    5. Proportion of subjects with a 75%, 90% and 100% response rate for drop seizures (tonic, atonic, tonic-clonic), non-drop seizures, and total seizures during the maintenance phase of the double-blind treatment period.
    6. Quality of Life (QOL) based on standardized measures such as:
    a. Vineland Adaptive Behavior Scale, for pediatric and adult subjects, when able to be assessed and only in English.
    b. Behavior Rating Inventory of Executive Function scale (BRIEF) – aged 5 to 18 years old, when able to be assessed and only in English.
    Principali endpoint secondari:
    1. La percentuale di soggetti con una riduzione di almeno il 50% rispetto al basale della frequenza totale delle crisi convulsive con caduta (toniche, atoniche, tonico-cloniche) durante il periodo di trattamento in doppio cieco.
    2. Variazione percentuale rispetto al basale della frequenza di tutti i tipi di crisi convulsive (crisi totali) durante il periodo di trattamento in doppio cieco.
    3. Punteggio della scala S/CGIC (Subject/Caregiver Global Impression of Change, impressione globale di cambiamento da parte del soggetto/caregiver) all'ultima visita dello studio.

    Altri endpoint secondari:
    1. Variazione percentuale rispetto al basale nell'intervallo di 28 giorni di
    a. crisi convulsive con caduta (toniche, atoniche, tonico-cloniche),
    b. crisi convulsive senza caduta (crisi miocloniche, assenza atipica),
    c. crisi convulsive totali
    durante la fase di mantenimento del periodo di trattamento in doppio cieco.
    2. Variazione percentuale rispetto al basale della frequenza delle crisi convulsive senza caduta (crisi miocloniche, assenza atipica) per 28 giorni durante il periodo di trattamento in doppio cieco.
    3. La percentuale di soggetti con una riduzione di almeno il 50% rispetto al basale della frequenza totale delle crisi convulsive con caduta (toniche, atoniche, tonico-cloniche) durante la fase di mantenimento del periodo di trattamento in doppio cieco.
    4. Percentuale di soggetti con un tasso di risposta del 75%, 90% e 100% per crisi convulsive con caduta (toniche, atoniche, tonico-cloniche), crisi convulsive senza caduta e crisi convulsive totali durante il periodo di trattamento in doppio cieco.
    5. Percentuale di soggetti con un tasso di risposta del 75%, 90% e 100% per crisi convulsive con caduta (toniche, atoniche, tonico-cloniche), crisi convulsive senza caduta e crisi convulsive totali durante la fase di mantenimento del periodo di trattamento in doppio cieco.6. Qualità della vita (QOL) basata su misure standardizzate quali:
    a. Vineland Adaptive Behavior Scale (scala Vineland per il comportamento adattivo), per soggetti pediatrici e adulti, quando valutabili e solo in lingua inglese.
    b. Scala Behavior Rating Inventory of Executive Function (BRIEF, Inventario di valutazione del comportamento della funzione esecutiva) – dai 5 ai 18 anni, quando valutabili e solo in inglese.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. During the double-blind treatment period
    2. During the double-blind treatment period
    3. At last visit
    Other Secondary Endpoints:
    1. During the maintenance phase of the double-blind treatment period
    2. During the double-blind treatment period
    3. During the maintenance phase of the double-blind treatment period
    4. During the double-blind treatment period
    5. During the maintenance phase of the double-blind treatment period
    6. Screening, maintenance phase and EoT/EoS
    1. Durante il periodo di trattamento in doppio cieco
    2. Durante il periodo di trattamento in doppio cieco
    3. All'ultima visita
    Altri endpoint secondari:
    1. Durante la fase di mantenimento del periodo di trattamento in doppio cieco
    2. Durante il periodo di trattamento in doppio cieco
    3. Durante la fase di mantenimento del periodo di trattamento in doppio cieco
    4. Durante il periodo di trattamento in doppio cieco
    5. Durante la fase di mantenimento del periodo di trattamento in doppio cieco
    6. Screening, fase di mantenimento e EoT/EoS
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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
    fase di estensione in aperto opzionale
    Optional open-Label extension
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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 concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA25
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Colombia
    Israel
    Korea, Republic of
    Mexico
    Taiwan
    United States
    Poland
    Spain
    Germany
    Greece
    Italy
    Hungary
    Portugal
    Serbia
    E.8.7Trial 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
    last Visit Last subject (LVLS)
    ultima visita dell'ultimo paziente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months1
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    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) No
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 102
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 66
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 84
    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 No
    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 No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state21
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 92
    F.4.2.2In the whole clinical trial 252
    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)
    Expanded Access Programs will be provided following the Open-label Extension.
    Verranno istituiti programmi di accesso esteso in seguito all'estensione open-label.
    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 Decision2023-04-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-02-08
    P. End of Trial
    P.End of Trial StatusOngoing
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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
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