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A Prospective, Observational Study On The Effectiveness Of New Antiepileptic Drugs As First Bitherapy In The Daily Clinical Practice

Primary Purpose

Focal Epilepsy

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Gabapentin, Lamotrigine, Levetiracetam, Pregabalin, Oxcarbacepine, Tiagabine, Topiramate, Zonisamide
Sponsored by
Pfizer's Upjohn has merged with Mylan to form Viatris Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Focal Epilepsy focused on measuring epilepsy antiepileptic biotherapy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Aged 18 years or older.
  • Diagnosis of focal epilepsy.
  • Previous failure of one or more AEDs used in monotherapy.
  • Background treatment with an antiepileptic drug.
  • The investigator has considered that the patient must start treatment with some of the seven new AEDs in combination therapy: lamotrigine, levetiracetam, gabapentin, oxcarbazepine, pregabalin, tiagabine and/or topiramate.
  • History of seizures in the patient in the past 3 months.
  • The patient or legal guardian must be able to understand the characteristics of the study and fill in the seizure diaries.
  • Written informed consent.

Exclusion Criteria:

  • Inability to comply with the study requirements.
  • Diagnosis of generalized epilepsy or inability to establish if focal or generalized.
  • Presence of serious or uncontrolled systemic disease, serious psychiatric disease or progressive neurological disease.
  • History of alcoholism, drug addiction, or abuse of medicines in the past two years.
  • Psychogenic seizures in the two years prior to inclusion in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Other

    Arm Label

    1.0

    Arm Description

    Outcomes

    Primary Outcome Measures

    Percent of Participants Classified as Responders
    Responder = decrease in number of seizures by >=50 percent (%) during the last 3 months of treatment before discontinuation (assessed at Month 3 and Month 6) versus the number of seizures that occurred during the 3 months before the baseline visit (baseline).

    Secondary Outcome Measures

    Percent of Participants With Reduction in Number of Seizures >=25% and >=75% During the Last 3 Months of Treatment
    Percent of participants with reduction in number of seizures >=25% and >=75% during the last 3 months of treatment before discontinuation (assessed at Month 3 and Month 6) versus the 3 month period before the baseline visit.
    Percent of Seizure-free Participants During the Last 3 Months Before Discontinuation
    Percent Change From Baseline in the Median Number of Seizures During the Last 3 Months of Treatment
    Percent of Days Without Crisis During the Study
    Crisis was defined as the total number of seizures during the study, the seizures at month 3 plus the seizures at month 6. The percent of days without crisis is number of days of study (date of last visit minus date of baseline visit) without crisis divided by number of days of study, multiplied by 100.
    Time to First Seizure
    Number of days to first seizure after baseline.
    Percent of Participants Who Continued on Study Medication to Month 6
    Retention rate: percent of participants who continued on study medication throughout the 6 Month period after inclusion in the study.
    Time to Discontinuation Due to Lack of Efficacy
    Time to Discontinuation Due to Safety, Tolerability, or Treatment Compliance
    Time to Discontinuation Due to Other Reasons
    Treatment Satisfaction Evaluated by Patient Global Impression of Change Visual Analog Scale (VAS)
    Patient Global Impression of Change VAS: subject rated instrument to measure subject's change in overall status; range from 0 (much better) to 10 (much worse).
    Percent of Participants Reaching Monotherapy
    Percent of participants who started on more than one treatment (bitherapy) and reached monotherapy by end of study.
    Percent of Participants That Reduced, Maintained and Increased Their Doses of New Antiepileptic Drugs (AED)
    Percent of Participants That Reduced, Maintained and Increased the Doses of the Initial Treatment Administered in Monotherapy
    Change From Baseline to Month 6 in the Hospital Anxiety and Depression Scale (HADS)
    HADS: subject rated questionnaire with 2 subscales. HADS-A assesses state of generalized anxiety (anxious mood, restlessness, anxious thoughts, panic attacks); HADS-D assesses state of lost interest and diminished pleasure response (lowering of hedonic tone). Each subscale comprised of 7 items with range 0 (no presence of anxiety or depression) to 3 (severe feeling of anxiety or depression). Total score 0 to 21 for each subscale; higher score indicates greater severity of anxiety and depression symptoms.
    Change From Baseline to Month 6 in Quality of Life 10 Domains (QOLIE-10)
    QOLIE-10: 10-item questionnaire evaluates health-related quality of life in individuals with epliepsy. Comprised of 7 components: seizure worry, overall quality of life, emotional well-being, energy, cognitive functioning, medication effects (physical and mental effects), and social function (work, driving, social function). Total score rated 0 to 100; higher score = higher quality of life.
    Change From Baseline to Months 3 and 6 in Health Condition: Euro Quality of Life Scale (EQ-5D) Visual Analog Scale (VAS)
    Assessment of the health condition of the subjects using the EQ-5D VAS: subject rated questionnaire to assess health-related quality of life in terms of a single index value. Using the VAS subjects rated current health state on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state.
    Change in Sleep Disturbances From Baseline to Month 6: Medical Outcomes Study Sleep Scale (MOS-SS)
    Subject rated instrument to assess key constructs of sleep; assesses sleep quality and quantity. Consists of a 6-item and 9-item overall sleep problems index measuring time to fall asleep and sleep duration in past 4 weeks; 5 subscales rated 1 (all the time) to 6 (none of the time): sleep disturbance, snoring, awaken short of breath, somnolence, and adequacy. Transformed scores range = 0 to 100; higher score indicates greater intensity of attribute. Two additional subscales = sleep quantity (range 0-24 hours) and optimal sleep (number of participants with optimal sleep 7-8 hours per night).
    Percent of Participants Indicating Optimal Sleep on the Optimal Sleep Subscale: Medical Outcomes Study Sleep Scale (MOS-SS)
    MOS-SS: subject rated instrument used to assess the key constructs of sleep; assesses sleep quantity and quality and is comprised of 12 items yielding 7 subscale scores and 2 composite index scores. Optimal sleep subscale is derived from sleep quantity average hours of sleep over the past 4 weeks; percent of participants with response YES (optimal) if sleep quantilty was 7-8 hours of sleep per night.
    Change From Baseline to Month 6 in Visits to a Specialist or the Emergency Room Because of Epilepsy
    Numerical assessment of change in the number of visits to a specialist or the emergency room because of epilepsy needed during the study.
    Change From Baseline to Month 6 in Total Number of Days Hospitalized Because of Epilepsy
    Numerical assessment of change in total number of days hospitalized because of epilepsy during the study.
    Percent of Participants With Cessation of Occupation, Requirement of Caregiver, or Admission to Intensive Care Unit
    Percent of participants with cessation of usual occupation, requirement of an informal caregiver, and who required admission to the intensive care unit (ICU).

    Full Information

    First Posted
    March 3, 2009
    Last Updated
    January 21, 2021
    Sponsor
    Pfizer's Upjohn has merged with Mylan to form Viatris Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00855738
    Brief Title
    A Prospective, Observational Study On The Effectiveness Of New Antiepileptic Drugs As First Bitherapy In The Daily Clinical Practice
    Official Title
    Liceo Study: A Prospective, Observational Study On The Effectiveness Of New Antiepileptic Drugs As First Bitherapy In The Daily Clinical Practice
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2010
    Overall Recruitment Status
    Completed
    Study Start Date
    May 2007 (undefined)
    Primary Completion Date
    June 2009 (Actual)
    Study Completion Date
    June 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Pfizer's Upjohn has merged with Mylan to form Viatris Inc.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Assessment of the efficacy under daily clinical conditions of the new antiepileptic drugs (AEDs) gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, tiagabine and topiramate, used as first-choice combination therapy (bitherapy) in patients with focal epilepsy.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Focal Epilepsy
    Keywords
    epilepsy antiepileptic biotherapy

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    111 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    1.0
    Arm Type
    Other
    Intervention Type
    Drug
    Intervention Name(s)
    Gabapentin, Lamotrigine, Levetiracetam, Pregabalin, Oxcarbacepine, Tiagabine, Topiramate, Zonisamide
    Other Intervention Name(s)
    Neurontin, Lamictal, Lyrica, Keppra, Topamax, Gabatril, Episen, Zonegran
    Intervention Description
    Gabapentin: up to 3.600 mg/d Lamotrigine: up to 400 mg/d Levetiracetam: up to 3.000 mg/d Pregabalin: up to 600 mg/d Oxcarbazepine: up to 2.400 mg/d Tiagabine: up to 30 mg/d Topiramate: up to 400 mg/d Zonisamide: up to 500 mg/d
    Primary Outcome Measure Information:
    Title
    Percent of Participants Classified as Responders
    Description
    Responder = decrease in number of seizures by >=50 percent (%) during the last 3 months of treatment before discontinuation (assessed at Month 3 and Month 6) versus the number of seizures that occurred during the 3 months before the baseline visit (baseline).
    Time Frame
    Baseline, Month 3, Month 6 (last 3 months of treatment)
    Secondary Outcome Measure Information:
    Title
    Percent of Participants With Reduction in Number of Seizures >=25% and >=75% During the Last 3 Months of Treatment
    Description
    Percent of participants with reduction in number of seizures >=25% and >=75% during the last 3 months of treatment before discontinuation (assessed at Month 3 and Month 6) versus the 3 month period before the baseline visit.
    Time Frame
    Baseline, Month 3, Month 6 (last 3 months of treatment)
    Title
    Percent of Seizure-free Participants During the Last 3 Months Before Discontinuation
    Time Frame
    Baseline, Month 3, Month 6 (last 3 months of treatment)
    Title
    Percent Change From Baseline in the Median Number of Seizures During the Last 3 Months of Treatment
    Time Frame
    Baseline, Month 3, Month 6 (last 3 months of treatment)
    Title
    Percent of Days Without Crisis During the Study
    Description
    Crisis was defined as the total number of seizures during the study, the seizures at month 3 plus the seizures at month 6. The percent of days without crisis is number of days of study (date of last visit minus date of baseline visit) without crisis divided by number of days of study, multiplied by 100.
    Time Frame
    Baseline through Month 6 (or end of treatment)
    Title
    Time to First Seizure
    Description
    Number of days to first seizure after baseline.
    Time Frame
    Baseline to Month 6 (or end of treatment)
    Title
    Percent of Participants Who Continued on Study Medication to Month 6
    Description
    Retention rate: percent of participants who continued on study medication throughout the 6 Month period after inclusion in the study.
    Time Frame
    Baseline to Month 6
    Title
    Time to Discontinuation Due to Lack of Efficacy
    Time Frame
    Baseline, Month 3, Month 6
    Title
    Time to Discontinuation Due to Safety, Tolerability, or Treatment Compliance
    Time Frame
    Baseline, Month 3, Month 6
    Title
    Time to Discontinuation Due to Other Reasons
    Time Frame
    Baseline, Month 3, Month 6
    Title
    Treatment Satisfaction Evaluated by Patient Global Impression of Change Visual Analog Scale (VAS)
    Description
    Patient Global Impression of Change VAS: subject rated instrument to measure subject's change in overall status; range from 0 (much better) to 10 (much worse).
    Time Frame
    Baseline, Month 3, Month 6
    Title
    Percent of Participants Reaching Monotherapy
    Description
    Percent of participants who started on more than one treatment (bitherapy) and reached monotherapy by end of study.
    Time Frame
    Baseline through Month 6 (or end of study)
    Title
    Percent of Participants That Reduced, Maintained and Increased Their Doses of New Antiepileptic Drugs (AED)
    Time Frame
    Baseline to Month 6 (or end of treatment)
    Title
    Percent of Participants That Reduced, Maintained and Increased the Doses of the Initial Treatment Administered in Monotherapy
    Time Frame
    Baseline through Month 6 (or end of treatment)
    Title
    Change From Baseline to Month 6 in the Hospital Anxiety and Depression Scale (HADS)
    Description
    HADS: subject rated questionnaire with 2 subscales. HADS-A assesses state of generalized anxiety (anxious mood, restlessness, anxious thoughts, panic attacks); HADS-D assesses state of lost interest and diminished pleasure response (lowering of hedonic tone). Each subscale comprised of 7 items with range 0 (no presence of anxiety or depression) to 3 (severe feeling of anxiety or depression). Total score 0 to 21 for each subscale; higher score indicates greater severity of anxiety and depression symptoms.
    Time Frame
    Baseline to Month 6
    Title
    Change From Baseline to Month 6 in Quality of Life 10 Domains (QOLIE-10)
    Description
    QOLIE-10: 10-item questionnaire evaluates health-related quality of life in individuals with epliepsy. Comprised of 7 components: seizure worry, overall quality of life, emotional well-being, energy, cognitive functioning, medication effects (physical and mental effects), and social function (work, driving, social function). Total score rated 0 to 100; higher score = higher quality of life.
    Time Frame
    Baseline to Month 6
    Title
    Change From Baseline to Months 3 and 6 in Health Condition: Euro Quality of Life Scale (EQ-5D) Visual Analog Scale (VAS)
    Description
    Assessment of the health condition of the subjects using the EQ-5D VAS: subject rated questionnaire to assess health-related quality of life in terms of a single index value. Using the VAS subjects rated current health state on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state.
    Time Frame
    Baseline, Month 3, Month 6
    Title
    Change in Sleep Disturbances From Baseline to Month 6: Medical Outcomes Study Sleep Scale (MOS-SS)
    Description
    Subject rated instrument to assess key constructs of sleep; assesses sleep quality and quantity. Consists of a 6-item and 9-item overall sleep problems index measuring time to fall asleep and sleep duration in past 4 weeks; 5 subscales rated 1 (all the time) to 6 (none of the time): sleep disturbance, snoring, awaken short of breath, somnolence, and adequacy. Transformed scores range = 0 to 100; higher score indicates greater intensity of attribute. Two additional subscales = sleep quantity (range 0-24 hours) and optimal sleep (number of participants with optimal sleep 7-8 hours per night).
    Time Frame
    Baseline to Month 6
    Title
    Percent of Participants Indicating Optimal Sleep on the Optimal Sleep Subscale: Medical Outcomes Study Sleep Scale (MOS-SS)
    Description
    MOS-SS: subject rated instrument used to assess the key constructs of sleep; assesses sleep quantity and quality and is comprised of 12 items yielding 7 subscale scores and 2 composite index scores. Optimal sleep subscale is derived from sleep quantity average hours of sleep over the past 4 weeks; percent of participants with response YES (optimal) if sleep quantilty was 7-8 hours of sleep per night.
    Time Frame
    Baseline, Month 6
    Title
    Change From Baseline to Month 6 in Visits to a Specialist or the Emergency Room Because of Epilepsy
    Description
    Numerical assessment of change in the number of visits to a specialist or the emergency room because of epilepsy needed during the study.
    Time Frame
    Baseline to Month 6
    Title
    Change From Baseline to Month 6 in Total Number of Days Hospitalized Because of Epilepsy
    Description
    Numerical assessment of change in total number of days hospitalized because of epilepsy during the study.
    Time Frame
    Baseline to Month 6
    Title
    Percent of Participants With Cessation of Occupation, Requirement of Caregiver, or Admission to Intensive Care Unit
    Description
    Percent of participants with cessation of usual occupation, requirement of an informal caregiver, and who required admission to the intensive care unit (ICU).
    Time Frame
    Month 6

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Aged 18 years or older. Diagnosis of focal epilepsy. Previous failure of one or more AEDs used in monotherapy. Background treatment with an antiepileptic drug. The investigator has considered that the patient must start treatment with some of the seven new AEDs in combination therapy: lamotrigine, levetiracetam, gabapentin, oxcarbazepine, pregabalin, tiagabine and/or topiramate. History of seizures in the patient in the past 3 months. The patient or legal guardian must be able to understand the characteristics of the study and fill in the seizure diaries. Written informed consent. Exclusion Criteria: Inability to comply with the study requirements. Diagnosis of generalized epilepsy or inability to establish if focal or generalized. Presence of serious or uncontrolled systemic disease, serious psychiatric disease or progressive neurological disease. History of alcoholism, drug addiction, or abuse of medicines in the past two years. Psychogenic seizures in the two years prior to inclusion in the study.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Pfizer CT.gov Call Center
    Organizational Affiliation
    Pfizer
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Links:
    URL
    https://trialinfoemail.pfizer.com/pages/landing.aspx?StudyID=A0081144&StudyName=A%20Prospective%2C%20Observational%20Study%20On%20The%20Effectiveness%20Of%20New%20Antiepileptic%20Drugs%20As%20First%20Bitherapy%20In%20The%20Daily%20Clinical%20Practice
    Description
    To obtain contact information for a study center near you, click here.

    Learn more about this trial

    A Prospective, Observational Study On The Effectiveness Of New Antiepileptic Drugs As First Bitherapy In The Daily Clinical Practice

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