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Levetiracetam to Prevent Post-Traumatic Epilepsy

Primary Purpose

Epilepsy, Post-traumatic Epilepsy

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Levetiracetam
Sponsored by
Pavel Klein
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Epilepsy focused on measuring Post-Traumatic epilepsy, Traumatic brain injury, Epilepsy prevention, Levetiracetam

Eligibility Criteria

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

Inclusion Criteria:

  • Acute head injury associated with one of the following:

Intracranial hemorrhage, including epidural, subdural and intracerebral hemorrhage or with cerebral contusion(s) of any size; Penetrating (foreign body) head injury; Skull fracture and dural tear; Seizure within 8 hours of head injury

  • Onset of head injury within 8-hours of proposed treatment initiation.
  • Glasgow Coma Scale 6-15.

Exclusion Criteria:

  • Clinical contraindications:

    • Previous epilepsy or status epilepticus.
    • Any systemic illness or unstable medical condition that might pose additional risk, including: renal insufficiency, other unstable metabolic or endocrine disturbances, and active systemic cancer.
    • Psychosis within six months of enrollment as determined by history of hospitalization for psychosis or medications for psychosis.
    • Moderate to severe mental retardation (IQ< 55 or>2 school grade levels below the expected for age [expected age = grade level +5]).
  • Clinical/Laboratory Indicators:

    • Serum creatinine > 1.5 on the day of treatment initiation for adults.
    • Serum creatinine ≥1.5 for subjects ≥17 years old, ≥1.0 for subjects 13-17 years old and ≥0.7 for subjects 6-12 years old.
    • Pregnancy
    • Use of any CNS-active investigational drugs within 3 months of enrollment.
    • Use of Antiepileptic Drugs (AEDs) within two months of enrollment, for any indication.
    • Allergy/sensitivity to study drugs or their formulations:
    • Active drug or alcohol dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements:
    • Inability or unwillingness of subject or legal guardian/representative to give written informed consent.

Sites / Locations

  • Children's National Medical Center
  • MedStar Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

No Intervention

Arm Label

Levetiracetam

No Intervention Control

Arm Description

66 subjects with acute head injury with a high risk for developing post-traumatic epilepsy will receive levetiracetam 55 mg/kg/day in a b.i.d. schedule. Treatment will commence within 8 hours of the acute head injury and will last for 30 days. In addition, subjects will receive phenytoin for 1 week following head injury as standard clinical care.

60 subjects with acute head injury with a high risk for developing post-traumatic epilepsy enrolled 8-24 hours after injury will not receive levetiracetam. Subjects will receive phenytoin for 1 week following head injury as standard clinical care.

Outcomes

Primary Outcome Measures

Post-Traumatic Epilepsy
occurrence of PTE (Post-Traumatic Epilepsy)

Secondary Outcome Measures

Adverse Events
The 66 subjects with acute head injury with a high risk for developing post-traumatic epilepsy that received levetiracetam 55 mg/kg/day in a b.i.d. were monitored for adverse events through the 30 day treatment period.

Full Information

First Posted
October 12, 2011
Last Updated
December 11, 2015
Sponsor
Pavel Klein
Collaborators
Medstar Health Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT01463033
Brief Title
Levetiracetam to Prevent Post-Traumatic Epilepsy
Official Title
Pilot: Levetiracetam to Prevent Post-Traumatic Epilepsy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
April 2005 (undefined)
Primary Completion Date
June 2008 (Actual)
Study Completion Date
February 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Pavel Klein
Collaborators
Medstar Health Research Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Head injury is the cause of approximately 5% of all epilepsy in the US. Past attempts at preventing epilepsy by treatment with older antiepileptic drugs have been unsuccessful. Levetiracetam is a novel AED with potent antiepileptogenic properties in animal models of epilepsy. It has a favorable side effect and pharmacokinetic profile. It is therefore a strong candidate for a clinical trial of epilepsy prevention following traumatic brain injury (TBI). However, there has been no experience in administering levetiracetam rapidly to individuals with acute TBI. The investigators propose to initiate the evaluation of levetiracetam in prevention of post-traumatic epilepsy by determining the safety, tolerability, pharmacokinetics and feasibility of acute and chronic administration of levetiracetam to individuals with head injury with a high risk for developing post-traumatic epilepsy. Further, the investigators will follow subjects for 2 years after injury in order to obtain pilot data about effect of levetiracetam on PTE. This pilot study is the first step in evaluation of levetiracetam in prevention of post-traumatic epilepsy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy, Post-traumatic Epilepsy
Keywords
Post-Traumatic epilepsy, Traumatic brain injury, Epilepsy prevention, Levetiracetam

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
126 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Levetiracetam
Arm Type
Active Comparator
Arm Description
66 subjects with acute head injury with a high risk for developing post-traumatic epilepsy will receive levetiracetam 55 mg/kg/day in a b.i.d. schedule. Treatment will commence within 8 hours of the acute head injury and will last for 30 days. In addition, subjects will receive phenytoin for 1 week following head injury as standard clinical care.
Arm Title
No Intervention Control
Arm Type
No Intervention
Arm Description
60 subjects with acute head injury with a high risk for developing post-traumatic epilepsy enrolled 8-24 hours after injury will not receive levetiracetam. Subjects will receive phenytoin for 1 week following head injury as standard clinical care.
Intervention Type
Drug
Intervention Name(s)
Levetiracetam
Other Intervention Name(s)
Keppra (brand name)
Intervention Description
55 mg/kg/day given in 2 divided doses 12 hours apart
Primary Outcome Measure Information:
Title
Post-Traumatic Epilepsy
Description
occurrence of PTE (Post-Traumatic Epilepsy)
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Adverse Events
Description
The 66 subjects with acute head injury with a high risk for developing post-traumatic epilepsy that received levetiracetam 55 mg/kg/day in a b.i.d. were monitored for adverse events through the 30 day treatment period.
Time Frame
30 day treatment period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Acute head injury associated with one of the following: Intracranial hemorrhage, including epidural, subdural and intracerebral hemorrhage or with cerebral contusion(s) of any size; Penetrating (foreign body) head injury; Skull fracture and dural tear; Seizure within 8 hours of head injury Onset of head injury within 8-hours of proposed treatment initiation. Glasgow Coma Scale 6-15. Exclusion Criteria: Clinical contraindications: Previous epilepsy or status epilepticus. Any systemic illness or unstable medical condition that might pose additional risk, including: renal insufficiency, other unstable metabolic or endocrine disturbances, and active systemic cancer. Psychosis within six months of enrollment as determined by history of hospitalization for psychosis or medications for psychosis. Moderate to severe mental retardation (IQ< 55 or>2 school grade levels below the expected for age [expected age = grade level +5]). Clinical/Laboratory Indicators: Serum creatinine > 1.5 on the day of treatment initiation for adults. Serum creatinine ≥1.5 for subjects ≥17 years old, ≥1.0 for subjects 13-17 years old and ≥0.7 for subjects 6-12 years old. Pregnancy Use of any CNS-active investigational drugs within 3 months of enrollment. Use of Antiepileptic Drugs (AEDs) within two months of enrollment, for any indication. Allergy/sensitivity to study drugs or their formulations: Active drug or alcohol dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements: Inability or unwillingness of subject or legal guardian/representative to give written informed consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pavel Klein, M.D.
Organizational Affiliation
Children's National Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's National Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
MedStar Research Institute
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23876024
Citation
Pearl PL, McCarter R, McGavin CL, Yu Y, Sandoval F, Trzcinski S, Atabaki SM, Tsuchida T, van den Anker J, He J, Klein P. Results of phase II levetiracetam trial following acute head injury in children at risk for posttraumatic epilepsy. Epilepsia. 2013 Sep;54(9):e135-7. doi: 10.1111/epi.12326. Epub 2013 Jul 22.
Results Reference
result
PubMed Identifier
22771222
Citation
Klein P, Herr D, Pearl PL, Natale J, Levine Z, Nogay C, Sandoval F, Trzcinsky S, Atabaki SM, Tsuchida T, van den Anker J, Soldin SJ, He J, McCarter R. Results of phase II pharmacokinetic study of levetiracetam for prevention of post-traumatic epilepsy. Epilepsy Behav. 2012 Aug;24(4):457-61. doi: 10.1016/j.yebeh.2012.05.011. Epub 2012 Jul 7.
Results Reference
result
PubMed Identifier
22777131
Citation
Klein P, Herr D, Pearl PL, Natale J, Levine Z, Nogay C, Sandoval F, Trzcinski S, Atabaki SM, Tsuchida T, van den Anker J, Soldin SJ, He J, McCarter R. Results of phase 2 safety and feasibility study of treatment with levetiracetam for prevention of posttraumatic epilepsy. Arch Neurol. 2012 Oct;69(10):1290-5. doi: 10.1001/archneurol.2012.445.
Results Reference
result

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Levetiracetam to Prevent Post-Traumatic Epilepsy

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