Staccato Alprazolam and Photoparoxysmal Response
Primary Purpose
Epilepsy
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
A=Placebo
B=Inhaled Alprazolam 0.5 mg
C=Inhaled Alprazolam 1 m
D= Inhaled Alprazolam 2 mg
E=Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Epilepsy
Eligibility Criteria
Inclusion Criteria:
- Male and female subjects between the ages of 18 to 60 years, inclusive
- Body mass index (BMI) ≥18 and ≤35 kg/m2
- Able to speak, read, and understand English and willing and able to provide written informed consent on an IRB-approved form before the initiation of any study procedures
- A diagnosis and history of a photoparoxysmal response on EEG with or without a diagnosis of epilepsy for which patients are on 0-2 concomitant antiepileptic drugs
- At least 3 of the EEGs performed during the screen visit must have a reproducible IPS-induced photoparoxysmal response (PPR) on EEG of at least 3 points on a frequency assessment scale in at least one eye condition
- In otherwise good general health as determined by a complete medical history, physical examination, 12-lead ECG, blood chemistry profile, hematology, and urinalysis
- Female participants (if of child-bearing potential and sexually active) and male participants (if sexually active with a partner of child-bearing potential) who agree to use a medically acceptable and effective birth control method throughout the study and for 1 week following the end of the study. Medically acceptable methods of contraception that may be used by the participant and/or his/her partner include abstinence, birth control pills or patches, diaphragm with spermicide, intrauterine device (IUD), surgical sterilization, and progestin implant or injection. Prohibited methods include: the rhythm method, withdrawal, condoms alone, or diaphragm alone
Exclusion Criteria:
- History of non-epileptic seizures (e.g. metabolic, structural, or pseudo-seizures)
- History of seizure worsening in response to narrow spectrum drugs
- An active CNS infection, demyelinating disease, degenerative neurological disease or any CNS disease deemed to be progressive during the course of the study that may confound the interpretation of the study results
- Use of more than 2 concomitant AEDs for epilepsy treatment
- Subjects taking known inhibitors or inducers of CYP3A , including carbamazepine
- Subjects with a history of allergic reactions to alprazolam or other benzodiazepines
- Treatment with an investigational drug within 30 days (or within 5 half-lives of the investigational drug, if >30 days) before Visit 2
- A history within the past 1 year of drug or alcohol dependence or abuse
- Positive urine screen for drugs of abuse at Visit 1 - Screening
- A history of HIV-positivity
- Female subjects who have a positive pregnancy test at screening or prior to test sessions or are breastfeeding
- History of acute narrow angle glaucoma, Parkinson's disease, hydrocephalus, or history of significant head trauma
- Subjects who have a current history of asthma, chronic obstructive lung disease (COPD), or any lung disease associated with bronchospasm
- Subjects who use medications to treat airways disease, such as asthma or COPD
- Subjects who have any acute respiratory signs/symptoms (e.g., wheezing)
- Clinically significant ECG abnormality including (but not limited to) any of the following conduction abnormalities or dysrhythmias: atrial fibrillation, mean QTcF (QT interval corrected for heart rate using Fridericia's method) interval >450 msec, ventricular rate <45 beats/min, second or third degree AV block, left bundle branch block, or evidence of prior myocardial infarction (MI) or acute ischemia
- Hypotension (systolic blood pressure ≤90 mm Hg, diastolic blood pressure ≤50 mm Hg), or hypertension (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥100 mm Hg) measured while seated at screening or baseline
- Significant hepatic, renal, gastroenterologic, cardiovascular (including ischemic heart disease and congestive heart failure), endocrine, neurologic (including history of seizures or stroke), or hematologic disease
- Any other disease or condition, by history, physical examination, or laboratory abnormalities that in the investigator's opinion, would present undue risk to the subject, or may confound the interpretation of study results
Sites / Locations
- Consultants in Epilepsy & Neurology, PLLC
- New York University Epilepsy Center
- University of Pennsylvania - Penn Epilepsy Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Experimental
Experimental
Experimental
Experimental
Experimental
Arm Label
Sequence BEADC
Sequence CDAEB
Sequence DEBAC
Sequence EDBAC
Sequence CABED
Arm Description
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
Outcomes
Primary Outcome Measures
Maximum Observed Change From Pretreatment Baseline in the Standardized Photosensitivity Range (SPR)
Photosensitivity describes the presentation of an epileptiform EEG response (photoparoxysmal response) from exposure to intermittent photic stimulation (IPS). SPR is the number of frequency steps (2, 5, 8, 10, 13, 15, 18, 20, 23, 25, 30, 40, 50 and 60 Hz). between the upper and lower limits of sensitivity to IPS for that patient at that time, in order not to evoke seizures. Thus a reduction (-change) means the intervention is working (desired effect on sensitivity)
Secondary Outcome Measures
Maximum Sedation Using Visual Analog Scale (Sedated-Alert)
Maximum change (in mm) from pretreatment baseline in level of sedation reported by the patient on a 100 mm line anchored by Sedated (0) and Alert (100)
Maximum Sedation Using Visual Analog Scale (Sleepy-Awake)
Maximum change (in mm) from pretreatment baseline in level of sedation reported by each subject on a 100 mm line anchored by Sleepy (0) and Awake (100)
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Standardized Photosensitivity Range (SPR)
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on SPR (PD) for each alprazolam dose
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sedated-Alert)
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on Sedation (PD) for each alprazolam dose
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sleepy-Awake)
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on Sleepiness (PD) for each alprazolam dose
Full Information
NCT ID
NCT02351115
First Posted
January 19, 2015
Last Updated
July 19, 2021
Sponsor
Alexza Pharmaceuticals, Inc.
Collaborators
The Epilepsy Study Consortium
1. Study Identification
Unique Protocol Identification Number
NCT02351115
Brief Title
Staccato Alprazolam and Photoparoxysmal Response
Official Title
Assessment of Staccato® Alprazolam on the EEG Photoparoxysmal Response in Patients With Epilepsy
Study Type
Interventional
2. Study Status
Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alexza Pharmaceuticals, Inc.
Collaborators
The Epilepsy Study Consortium
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo.
Detailed Description
The purpose of this study is to determine whether people who usually have photosensitive epilepsy will show a reduction in epileptic activity when they take a single dose of Staccato Alprazolam as compared to placebo. People with photosensitive epilepsy have changes on their electroencephalogram (EEG) when shown flashing lights. Three dose levels of Staccato Alprazolam will be compared to placebo.
This study will also assess the level of sedation of Staccato Alprazolam compared to placebo.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
5 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Sequence BEADC
Arm Type
Experimental
Arm Description
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
Arm Title
Sequence CDAEB
Arm Type
Experimental
Arm Description
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
Arm Title
Sequence DEBAC
Arm Type
Experimental
Arm Description
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
Arm Title
Sequence EDBAC
Arm Type
Experimental
Arm Description
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
Arm Title
Sequence CABED
Arm Type
Experimental
Arm Description
A=Placebo, B=Inhaled Alprazolam 0.5 mg, C=Inhaled Alprazolam 1 mg, D= Inhaled Alprazolam 2 mg, E=Placebo
Intervention Type
Drug
Intervention Name(s)
A=Placebo
Intervention Type
Drug
Intervention Name(s)
B=Inhaled Alprazolam 0.5 mg
Intervention Type
Drug
Intervention Name(s)
C=Inhaled Alprazolam 1 m
Intervention Type
Drug
Intervention Name(s)
D= Inhaled Alprazolam 2 mg
Intervention Type
Drug
Intervention Name(s)
E=Placebo
Primary Outcome Measure Information:
Title
Maximum Observed Change From Pretreatment Baseline in the Standardized Photosensitivity Range (SPR)
Description
Photosensitivity describes the presentation of an epileptiform EEG response (photoparoxysmal response) from exposure to intermittent photic stimulation (IPS). SPR is the number of frequency steps (2, 5, 8, 10, 13, 15, 18, 20, 23, 25, 30, 40, 50 and 60 Hz). between the upper and lower limits of sensitivity to IPS for that patient at that time, in order not to evoke seizures. Thus a reduction (-change) means the intervention is working (desired effect on sensitivity)
Time Frame
SPR was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at: 10 min for alprazolam 2 mg, 1 hour for alprazolam 0.5 and 1 mg and placebo
Secondary Outcome Measure Information:
Title
Maximum Sedation Using Visual Analog Scale (Sedated-Alert)
Description
Maximum change (in mm) from pretreatment baseline in level of sedation reported by the patient on a 100 mm line anchored by Sedated (0) and Alert (100)
Time Frame
Sedation was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred at:: 30 min for alprazolam 1 mg, 1 hour for alprazolam 0.5 and 2 mg, and 4 hours for placebo
Title
Maximum Sedation Using Visual Analog Scale (Sleepy-Awake)
Description
Maximum change (in mm) from pretreatment baseline in level of sedation reported by each subject on a 100 mm line anchored by Sleepy (0) and Awake (100)
Time Frame
Sleepiness was recorded pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration The maximum change from baseline occurred: at: 30 min for alprazolam 1 mg, 1 hour for alprazolam 0.5 and 2 mg and placebo
Title
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Standardized Photosensitivity Range (SPR)
Description
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on SPR (PD) for each alprazolam dose
Time Frame
Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Title
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sedated-Alert)
Description
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on Sedation (PD) for each alprazolam dose
Time Frame
Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
Title
Correlation of Plasma Concentrations of Alprazolam With Pharmacodynamic Effects on Visual Analog Scale (Sleepy-Awake)
Description
Pearson correlation of all paired plasma concentrations of alprazolam (PK) with pharmacodynamic effect on Sleepiness (PD) for each alprazolam dose
Time Frame
Pretreatment, 2, 10, 30 min, 1, 2, 4, and 6 hr post each study drug administration
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male and female subjects between the ages of 18 to 60 years, inclusive
Body mass index (BMI) ≥18 and ≤35 kg/m2
Able to speak, read, and understand English and willing and able to provide written informed consent on an IRB-approved form before the initiation of any study procedures
A diagnosis and history of a photoparoxysmal response on EEG with or without a diagnosis of epilepsy for which patients are on 0-2 concomitant antiepileptic drugs
At least 3 of the EEGs performed during the screen visit must have a reproducible IPS-induced photoparoxysmal response (PPR) on EEG of at least 3 points on a frequency assessment scale in at least one eye condition
In otherwise good general health as determined by a complete medical history, physical examination, 12-lead ECG, blood chemistry profile, hematology, and urinalysis
Female participants (if of child-bearing potential and sexually active) and male participants (if sexually active with a partner of child-bearing potential) who agree to use a medically acceptable and effective birth control method throughout the study and for 1 week following the end of the study. Medically acceptable methods of contraception that may be used by the participant and/or his/her partner include abstinence, birth control pills or patches, diaphragm with spermicide, intrauterine device (IUD), surgical sterilization, and progestin implant or injection. Prohibited methods include: the rhythm method, withdrawal, condoms alone, or diaphragm alone
Exclusion Criteria:
History of non-epileptic seizures (e.g. metabolic, structural, or pseudo-seizures)
History of seizure worsening in response to narrow spectrum drugs
An active CNS infection, demyelinating disease, degenerative neurological disease or any CNS disease deemed to be progressive during the course of the study that may confound the interpretation of the study results
Use of more than 2 concomitant AEDs for epilepsy treatment
Subjects taking known inhibitors or inducers of CYP3A , including carbamazepine
Subjects with a history of allergic reactions to alprazolam or other benzodiazepines
Treatment with an investigational drug within 30 days (or within 5 half-lives of the investigational drug, if >30 days) before Visit 2
A history within the past 1 year of drug or alcohol dependence or abuse
Positive urine screen for drugs of abuse at Visit 1 - Screening
A history of HIV-positivity
Female subjects who have a positive pregnancy test at screening or prior to test sessions or are breastfeeding
History of acute narrow angle glaucoma, Parkinson's disease, hydrocephalus, or history of significant head trauma
Subjects who have a current history of asthma, chronic obstructive lung disease (COPD), or any lung disease associated with bronchospasm
Subjects who use medications to treat airways disease, such as asthma or COPD
Subjects who have any acute respiratory signs/symptoms (e.g., wheezing)
Clinically significant ECG abnormality including (but not limited to) any of the following conduction abnormalities or dysrhythmias: atrial fibrillation, mean QTcF (QT interval corrected for heart rate using Fridericia's method) interval >450 msec, ventricular rate <45 beats/min, second or third degree AV block, left bundle branch block, or evidence of prior myocardial infarction (MI) or acute ischemia
Hypotension (systolic blood pressure ≤90 mm Hg, diastolic blood pressure ≤50 mm Hg), or hypertension (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥100 mm Hg) measured while seated at screening or baseline
Significant hepatic, renal, gastroenterologic, cardiovascular (including ischemic heart disease and congestive heart failure), endocrine, neurologic (including history of seizures or stroke), or hematologic disease
Any other disease or condition, by history, physical examination, or laboratory abnormalities that in the investigator's opinion, would present undue risk to the subject, or may confound the interpretation of study results
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
J Isojarvi, MD
Organizational Affiliation
Engage Therapeutics, Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
Consultants in Epilepsy & Neurology, PLLC
City
Boise
State/Province
Idaho
Country
United States
Facility Name
New York University Epilepsy Center
City
New York
State/Province
New York
Country
United States
Facility Name
University of Pennsylvania - Penn Epilepsy Center
City
Philadelphia
State/Province
Pennsylvania
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD submitted to regulatory authorities. Others may contact Alexza Pharmaceuticals, Inc. Please send your request to ClinicalTrialsInfo@alexza.com
IPD Sharing Time Frame
Within 10 days of request approval
IPD Sharing Access Criteria
Approval of formal request for access
IPD Sharing URL
http://alexza.com
Learn more about this trial
Staccato Alprazolam and Photoparoxysmal Response
We'll reach out to this number within 24 hrs