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Study to Assess the Safety and Tolerability of Intravenous Carbamazepine in Adults With Epilepsy

Primary Purpose

Epilepsy

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Intravenous Carbamazepine (IV CBZ)
Sponsored by
Lundbeck LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Epilepsy focused on measuring Epilepsy, Intravenous Carbamazepine, Oral Carbamazepine

Eligibility Criteria

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

Inclusion Criteria:

  1. The patient or legal representative must be able to read, understand, sign and date the IRB approved Informed Consent Form and HIPAA Authorization prior to study participation.
  2. The patient is a man or a non-pregnant woman who is at least 18 years of age.
  3. If a woman:

    • Patient is either not of childbearing potential, defined as postmenopausal for at least 1 year or surgically sterile (bilateral tubal ligation, bilateral oophorectomay or hysterectomy), or if childbearing potential, must comply with a method of birth control acceptable to the investigator during the study, for at least 28 days prior to Day 1 and for 28 days following completion of the study.
    • Patient is not breastfeeding.
    • Patient of childbearing potential must have a negative serum pregnancy test at Day -28 and a negative urine pregnancy test or serum pregnancy test at Day -1.
  4. The patient is diagnosed with any of the approved epilepsy indications for CBZ:

    • Partial seizures with complex symptomatology (psychomotor, temporal lobe)
    • Generalised tonic clonic seizures (GTCS) (grand mal): myoclonic, clonic, tonic, tonic-clonic, atonic
    • Mixed seizure patterns that include the above, or other partial or generalised seizures (except absence seizures - please see exclusion point number 12)
  5. The patient is receiving a stable dose of oral CBZ (tablet or capsule formulation) of 1200 mg/day to 2000 mg/day, for a minimum of 14 days prior to Day -28.
  6. The patient is receiving a constant dose of all other concomitant medications used for chronic conditions, (including OTC medications and herbal supplements) for a minimum of 28 days prior to Day 1.
  7. The patient is not expected to have any change in his/her baseline AED treatment during the treatment period.
  8. The patient is able to comply with maintaining an accurate Seizure and antiepileptic drug diary.
  9. The patient is able to comply with all study procedures including complying with protocol determined dosing intervals, confinement at the investigative site for up to 6 nights and 7 days, and agrees to participate in the entire study.

Exclusion Criteria:

  1. The patient has a known hypersensitivity to CBZ, Captisol, or to any of the tricyclic compounds, such as amitriptyline, trimipramine, imipramine; oxacarbazepine, phenytoin, or their analogues or metabolites.
  2. The patient has a history of previous bone marrow depression.
  3. The patient has a history of intolerance to IV administration of medication.
  4. The patient is pregnant or lactating.
  5. The patient is being treated with a monoamine oxidase (MAO) inhibitor.
  6. The patient is using oral, intramuscular, or any other hormone delivery method as their primary form of birth control.
  7. The patient has an ECG with corrected QT interval by Fridericia's correction formula (QTcF) greater than 450 msec at Screening or Day -1.
  8. The patient has a screening ALT, AST or bilirubin >=3 times the upper limit of normal.
  9. The patient has an estimated ClCR (based of Cockcroft-Gault) of <50 ml/min.
  10. The patient has had a clinically significant illness/infection or has had any surgical procedure within 30 days prior to Screening.
  11. The patient has a significant history of cardiac, renal, neurologic (other than epilepsy), psychiatric, oncologic, endocrinologic, metabolic, or hepatic disease, which would adversely affect their participation in this study.
  12. The patient is receiving oral CBZ for absence seizures.
  13. The patient has had an episode of status epilepticus within 4 weeks of Screening.
  14. The patient has a history of severe or serious adverse reactions to CBZ (for example, aplastic anemia, agranulocytosis, SJS.
  15. The patient has taken or used any investigational drug or device in the 30 days prior to Screening.
  16. The patient has previously been administered IV CBZ in a previous clinical trial (for example OV-1015).
  17. The patient has a urine toxicology screen positive for phencyclidine, benzodiazepines (unless due to the patient's concomitant AEDs), cannabinoids, cocaine, amphetamines, opiates, barbiturates (unless due to the patient's concomitant AEDs), or alcohol at Screening or Day -1.
  18. The patient has had a diagnosis of drug or alcohol abuse within the past year prior to Screening.
  19. The patient has had significant blood loss (>500 mL) or donation within 14 days of Screening.
  20. The patient has a history of poor oral CBZ compliance.
  21. The patient is participating in a weight loss or nicotine cessation program.
  22. The patient has a history of increased intraocular pressure or is on medication for glaucoma.
  23. The patient is considered by the investigator to be an unsuitable candidate for the study, which may include an increase in the frequency, severity and duration of seizures during the Pre-Treatment Period (Days -28-0).
  24. The patient has previously participated in this study.
  25. The patient is a member of the site personnel or their immediate families.

Sites / Locations

  • Mayo Clinic Arizona
  • Clinical Trials Incorporated
  • Collaborative Neuroscience Network, Inc.
  • Denver Health and Hospital Authority
  • University of South Florida
  • University of Illinois at Chicago
  • Southern illinois University School of Medicine
  • Central DuPage Hospital
  • Via Christi Epilepsy Center
  • Leonard J. Chabert Medical Center
  • Louisiana Research Associates
  • Ochsner Clinic Foundation
  • Mid-Atlantic Epilepsy and Sleep Center
  • Beth Israel Deaconess Medical Center
  • University of Minnesota & Prism Research
  • The Comprehensive Epilepsy Care Center for Children and Adults
  • Montefiore Medicical Center
  • Langone Medical Center NYU Comprehensive Epilepsy Center
  • Columbia University Medical Center: Dept of Neurology
  • University of Rochester
  • SUNY Upstate Medical University
  • Wake Forest University Health Sciences
  • Cleveland Clinic
  • Temple University Health systems
  • Medical University of South Carolina
  • Neurological Clinic of Texas, P.A.
  • Scott & White Memorial Hospital
  • University of Virginia
  • VCU Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intravenous Carbamazepine (IV CBZ)

Arm Description

Outcomes

Primary Outcome Measures

Adverse Events

Secondary Outcome Measures

Full Information

First Posted
May 21, 2010
Last Updated
December 14, 2017
Sponsor
Lundbeck LLC
Collaborators
Ligand Pharmaceuticals, ICON Clinical Research, Quintiles, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01128959
Brief Title
Study to Assess the Safety and Tolerability of Intravenous Carbamazepine in Adults With Epilepsy
Official Title
Open-Label Study to Assess the Safety and Tolerability of Intravenous Carbamazepine as Short-Term Replacement of Oral Carbamazepine in Adult Patients With Epilepsy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
January 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lundbeck LLC
Collaborators
Ligand Pharmaceuticals, ICON Clinical Research, Quintiles, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and tolerability of intravenous (IV) carbamazepine (CBZ) administered as multiple 15 minute infusions and a single 5 minute infusion to adult patients with epilepsy on stable higher doses of oral CBZ.
Detailed Description
This was a phase III, multicenter, open-label study designed to assess the safety and tolerability of intravenously administered CBZ in adult patients with epilepsy. This study included a 28 day Lead-in Period, a Confinement Period (up to 7 days and 6 nights) and a 28 day Follow-up Period. Patients began confinement on Day -1 of the trial, continuing to take their oral CBZ as prescribed by the investigator. On the morning of Day 0, Day 4, and Day 17, patients began the 24hr urine collection for evaluation of urinary biomarkers. All patients temporarily discontinued their prescribed oral CBZ and begin IV CBZ administration on the morning of Day 1, continuing administrations every 6 hours (Q6h) through the morning of Day 4.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy
Keywords
Epilepsy, Intravenous Carbamazepine, Oral Carbamazepine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
108 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intravenous Carbamazepine (IV CBZ)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Intravenous Carbamazepine (IV CBZ)
Intervention Description
10 mg/mL of IV CBZ dissolved in 250 mg/mL of Captisol® (sulfobutylether-beta-cyclodextrin) dosed at 70% of the patient's daily maintenance dose of oral CBZ administered after suitable dilution with D5W by IV infusion every 6 hours.
Primary Outcome Measure Information:
Title
Adverse Events
Time Frame
Baseline to after last iv dose on day 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient or legal representative must be able to read, understand, sign and date the IRB approved Informed Consent Form and HIPAA Authorization prior to study participation. The patient is a man or a non-pregnant woman who is at least 18 years of age. If a woman: Patient is either not of childbearing potential, defined as postmenopausal for at least 1 year or surgically sterile (bilateral tubal ligation, bilateral oophorectomay or hysterectomy), or if childbearing potential, must comply with a method of birth control acceptable to the investigator during the study, for at least 28 days prior to Day 1 and for 28 days following completion of the study. Patient is not breastfeeding. Patient of childbearing potential must have a negative serum pregnancy test at Day -28 and a negative urine pregnancy test or serum pregnancy test at Day -1. The patient is diagnosed with any of the approved epilepsy indications for CBZ: Partial seizures with complex symptomatology (psychomotor, temporal lobe) Generalised tonic clonic seizures (GTCS) (grand mal): myoclonic, clonic, tonic, tonic-clonic, atonic Mixed seizure patterns that include the above, or other partial or generalised seizures (except absence seizures - please see exclusion point number 12) The patient is receiving a stable dose of oral CBZ (tablet or capsule formulation) of 1200 mg/day to 2000 mg/day, for a minimum of 14 days prior to Day -28. The patient is receiving a constant dose of all other concomitant medications used for chronic conditions, (including OTC medications and herbal supplements) for a minimum of 28 days prior to Day 1. The patient is not expected to have any change in his/her baseline AED treatment during the treatment period. The patient is able to comply with maintaining an accurate Seizure and antiepileptic drug diary. The patient is able to comply with all study procedures including complying with protocol determined dosing intervals, confinement at the investigative site for up to 6 nights and 7 days, and agrees to participate in the entire study. Exclusion Criteria: The patient has a known hypersensitivity to CBZ, Captisol, or to any of the tricyclic compounds, such as amitriptyline, trimipramine, imipramine; oxacarbazepine, phenytoin, or their analogues or metabolites. The patient has a history of previous bone marrow depression. The patient has a history of intolerance to IV administration of medication. The patient is pregnant or lactating. The patient is being treated with a monoamine oxidase (MAO) inhibitor. The patient is using oral, intramuscular, or any other hormone delivery method as their primary form of birth control. The patient has an ECG with corrected QT interval by Fridericia's correction formula (QTcF) greater than 450 msec at Screening or Day -1. The patient has a screening ALT, AST or bilirubin >=3 times the upper limit of normal. The patient has an estimated ClCR (based of Cockcroft-Gault) of <50 ml/min. The patient has had a clinically significant illness/infection or has had any surgical procedure within 30 days prior to Screening. The patient has a significant history of cardiac, renal, neurologic (other than epilepsy), psychiatric, oncologic, endocrinologic, metabolic, or hepatic disease, which would adversely affect their participation in this study. The patient is receiving oral CBZ for absence seizures. The patient has had an episode of status epilepticus within 4 weeks of Screening. The patient has a history of severe or serious adverse reactions to CBZ (for example, aplastic anemia, agranulocytosis, SJS. The patient has taken or used any investigational drug or device in the 30 days prior to Screening. The patient has previously been administered IV CBZ in a previous clinical trial (for example OV-1015). The patient has a urine toxicology screen positive for phencyclidine, benzodiazepines (unless due to the patient's concomitant AEDs), cannabinoids, cocaine, amphetamines, opiates, barbiturates (unless due to the patient's concomitant AEDs), or alcohol at Screening or Day -1. The patient has had a diagnosis of drug or alcohol abuse within the past year prior to Screening. The patient has had significant blood loss (>500 mL) or donation within 14 days of Screening. The patient has a history of poor oral CBZ compliance. The patient is participating in a weight loss or nicotine cessation program. The patient has a history of increased intraocular pressure or is on medication for glaucoma. The patient is considered by the investigator to be an unsuitable candidate for the study, which may include an increase in the frequency, severity and duration of seizures during the Pre-Treatment Period (Days -28-0). The patient has previously participated in this study. The patient is a member of the site personnel or their immediate families.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Email contact via H. Lundbeck A/S
Organizational Affiliation
LundbeckClinicalTrials@lundbeck.com
Official's Role
Study Director
Facility Information:
Facility Name
Mayo Clinic Arizona
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
Clinical Trials Incorporated
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Collaborative Neuroscience Network, Inc.
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Denver Health and Hospital Authority
City
Denver
State/Province
Colorado
ZIP/Postal Code
80204
Country
United States
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
University of Illinois at Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Southern illinois University School of Medicine
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62702
Country
United States
Facility Name
Central DuPage Hospital
City
Winfield
State/Province
Illinois
ZIP/Postal Code
60190
Country
United States
Facility Name
Via Christi Epilepsy Center
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
Facility Name
Leonard J. Chabert Medical Center
City
Houma
State/Province
Louisiana
ZIP/Postal Code
70363
Country
United States
Facility Name
Louisiana Research Associates
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70114
Country
United States
Facility Name
Ochsner Clinic Foundation
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70115
Country
United States
Facility Name
Mid-Atlantic Epilepsy and Sleep Center
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20815
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
University of Minnesota & Prism Research
City
Saint Paul
State/Province
Minnesota
ZIP/Postal Code
55114
Country
United States
Facility Name
The Comprehensive Epilepsy Care Center for Children and Adults
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63017
Country
United States
Facility Name
Montefiore Medicical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Langone Medical Center NYU Comprehensive Epilepsy Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Columbia University Medical Center: Dept of Neurology
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
SUNY Upstate Medical University
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Temple University Health systems
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Neurological Clinic of Texas, P.A.
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
Scott & White Memorial Hospital
City
Temple
State/Province
Texas
ZIP/Postal Code
76508
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Facility Name
VCU Medical Center
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298-0599
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25912051
Citation
Lee D, Kalu U, Halford JJ, Biton V, Cloyd J, Klein P, Bekersky I, Peng G, Dheerendra S, Tolbert D. Intravenous carbamazepine as short-term replacement therapy for oral carbamazepine in adults with epilepsy: Pooled tolerability results from two open-label trials. Epilepsia. 2015 Jun;56(6):906-14. doi: 10.1111/epi.12991. Epub 2015 Apr 25.
Results Reference
derived

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Study to Assess the Safety and Tolerability of Intravenous Carbamazepine in Adults With Epilepsy

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