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Safety and Pharmacokinetics Study of E2007 to Treat Partial and Generalised Seizures in People With Epilepsy

Primary Purpose

Epilepsy

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
E2007
E2007
Placebo
Sponsored by
Eisai Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Epilepsy focused on measuring Epilepsy, E2007, partial seizures, generalized seizures

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

A patient who met the following inclusion criteria was eligible to participate in the study:

  1. Males or females with simple or complex partial seizures with or without secondary generalization, or primary generalized tonic-clonic seizures according to the International League against Epilepsy classification. Patient records were to document the frequency of seizure.
  2. Age: 18 to 65 years.
  3. Race: any.
  4. Patients receiving up to two additional anti-epileptic medications at doses that were stable for at least the four weeks immediately preceding baseline.
  5. Patients willing and able to co-operate with the study procedures including completion of patient diaries.
  6. Patients living at home with a partner or carer able to monitor compliance.
  7. Patients giving informed consent to participate in the study.

Exclusion Criteria

A patient who met the following exclusion criteria was not eligible to participate in the study:

  1. Pregnant or lactating women.
  2. Women of childbearing potential unless (1) surgically sterile or (2) practicing effective contraception (eg, abstinence, IUD or barrier method plus hormonal method) and having a negative serum beta-HCG result at screening and being willing to remain on the current form of contraception for the duration of the study. Postmenopausal women could be included but were to have been amenorrhoeic for at least 12 months to be considered as not being of child-bearing potential.
  3. Fertile men not willing to use reliable contraception or with partners not willing to use reliable contraception.
  4. Patients with status epilepticus within the past 24 months.
  5. Patients with unstable abnormalities of the hepatic, renal, cardiovascular, respiratory, abdominal, haematological, endocrine or metabolic systems which might complicate assessment of the tolerability of the study medication.
  6. Patients with significantly elevated liver enzymes (abnormal bilirubin level, or serum transaminase levels more than 1.5 times the upper limit of normal).
  7. Patients taking drugs other than anti-epileptic agents which induce the enzyme cytochrome P450 3A4 (since these might reduce the plasma concentration of E2007), including dexamethasone, rifabutin, rifampacin, St John's Wort.
  8. Patients with past or present drug or alcohol abuse.
  9. Patients with unstable psychiatric illness.
  10. Patients who had received an investigational drug within the three months before baseline.
  11. Patients without a reliable partner or carer.
  12. Patients with any condition which would make the patient, in the opinion of the investigator, unsuitable for the study.

Sites / Locations

  • 3ClinicalResearch AG

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

E2007 1 mg

E2007 2 mg

Placebo

Arm Description

Tablet, once daily to be taken in the morning by mouth, one hour before breakfast, with a glass of water.

Tablet, once daily to be taken in the morning by mouth, one hour before breakfast, with a glass of water.

Tablet, once daily to be taken in the morning, one hour before breakfast, with a glass of water.

Outcomes

Primary Outcome Measures

Number of participants with Treatment Emergent Adverse Events (TEAEs)
The TEAEs were defined as those Adverse Events (AEs) that start on or after the first dose of the treatment until the end of the study. AEs were classified by the investigator as 'not related', 'possibly related' or 'probably related'.
Clinical Global Impression of Tolerability (CGIT)
The investigator's global impressions of the tolerability of the study treatment was based on a five point scale: 1 - very good, 2 - good, 3 - moderate, 4 - poor, and 5 - very poor.
Pharmacokinetic Parameter: Area Under the Curve (AUC)(0-24hr) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. A measure of systemic drug exposure over 24 hours, which is obtained by collecting a series of blood samples and measuring the concentrations of drug in each sample.
Pharmacokinetic Parameter: Cmax (Maximum Observed Plasma Concentration) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. The maximum concentration of a drug observed after its administration.
Pharmacokinetic Parameter: Tmax (Time to Maximum Concentration) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. The time after dosing when a drug attains its highest measurable concentration (Cmax).
Pharmacokinetic Parameter: Css,min (Minimum Steady State Plasma Concentration) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. Lowest plasma concentration within a steady-state dosing interval.
Pharmacokinetic Parameter: Cav (Average Plasma Concentration) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants.
Pharmacokinetic Parameter: Peak-to-trough Fluctuation (PTF) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants.
Pharmacokinetic Parameter: Observed Accumulation Ratio (Rac) of E2007
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants.

Secondary Outcome Measures

Change from Baseline of Bond and Lader Scale
The Bond and Lader visual analogue mood scale (VAMS) had a score from 0 - 100; a higher score represented worsening of the participants condition attributed to 3 factors, (1) Anxiety (e.g., calmness), (2) Sedation (e.g., alertness, (3) Dysphoria (e.g., contentedness). The change was visit minus baseline.
Change from Baseline of Peak Saccadic Velocity (PSV)
Saccadic velocity is the rate of eye movement in response to stimulus. The saccadic eye movement was used to allow comparison of any sedative effects seen.
Number of Particpants receiving other Anti-epileptic agents During Treatment
Percent Change from Baseline of Failed Saccades
Failed saccades is stimulus resulting in no eye movement above a defined threshold within a specified time.
Mean trough concentrations of E2007
Number of seizures
The Clinical Global Impression of Change

Full Information

First Posted
July 31, 2015
Last Updated
December 17, 2018
Sponsor
Eisai Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03780907
Brief Title
Safety and Pharmacokinetics Study of E2007 to Treat Partial and Generalised Seizures in People With Epilepsy
Official Title
A Randomised, Double-Blind, Placebo-Controlled Study of the Tolerability, Safety and Pharmacokinetics of E2007 in Epileptic Patients With Partial and Generalised Seizures
Study Type
Interventional

2. Study Status

Record Verification Date
November 2015
Overall Recruitment Status
Completed
Study Start Date
February 14, 2003 (Actual)
Primary Completion Date
August 6, 2003 (Actual)
Study Completion Date
August 6, 2003 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eisai Co., Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objectives of this study were to assess the tolerability and safety of E2007 in patients with refractory partial or generalised seizures and to assess the pharmacokinetics of E2007 in epileptic patients receiving at least one concomitant anti-epileptic drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy
Keywords
Epilepsy, E2007, partial seizures, generalized seizures

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
E2007 1 mg
Arm Type
Experimental
Arm Description
Tablet, once daily to be taken in the morning by mouth, one hour before breakfast, with a glass of water.
Arm Title
E2007 2 mg
Arm Type
Experimental
Arm Description
Tablet, once daily to be taken in the morning by mouth, one hour before breakfast, with a glass of water.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Tablet, once daily to be taken in the morning, one hour before breakfast, with a glass of water.
Intervention Type
Drug
Intervention Name(s)
E2007
Intervention Description
1 mg of E2007 was administered by mouth once daily.
Intervention Type
Drug
Intervention Name(s)
E2007
Intervention Description
2 mg of E2007 was administered by mouth once daily.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo once daily of oral tablet formulation to be taken in the morning, one hour before breakfast, with a glass of water.
Primary Outcome Measure Information:
Title
Number of participants with Treatment Emergent Adverse Events (TEAEs)
Description
The TEAEs were defined as those Adverse Events (AEs) that start on or after the first dose of the treatment until the end of the study. AEs were classified by the investigator as 'not related', 'possibly related' or 'probably related'.
Time Frame
From administration of first dose of study drug up until 42 days.
Title
Clinical Global Impression of Tolerability (CGIT)
Description
The investigator's global impressions of the tolerability of the study treatment was based on a five point scale: 1 - very good, 2 - good, 3 - moderate, 4 - poor, and 5 - very poor.
Time Frame
Day 28
Title
Pharmacokinetic Parameter: Area Under the Curve (AUC)(0-24hr) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. A measure of systemic drug exposure over 24 hours, which is obtained by collecting a series of blood samples and measuring the concentrations of drug in each sample.
Time Frame
Day 1 and Day 14
Title
Pharmacokinetic Parameter: Cmax (Maximum Observed Plasma Concentration) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. The maximum concentration of a drug observed after its administration.
Time Frame
Day 1 and Day 14
Title
Pharmacokinetic Parameter: Tmax (Time to Maximum Concentration) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. The time after dosing when a drug attains its highest measurable concentration (Cmax).
Time Frame
Day 1 and Day 14
Title
Pharmacokinetic Parameter: Css,min (Minimum Steady State Plasma Concentration) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants. Lowest plasma concentration within a steady-state dosing interval.
Time Frame
Day 14
Title
Pharmacokinetic Parameter: Cav (Average Plasma Concentration) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants.
Time Frame
Day 14
Title
Pharmacokinetic Parameter: Peak-to-trough Fluctuation (PTF) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants.
Time Frame
Day 14
Title
Pharmacokinetic Parameter: Observed Accumulation Ratio (Rac) of E2007
Description
Standard pharmacokinetic parameters for E2007 were derived from plasma drug concentrations in epileptic participants.
Time Frame
Day 14
Secondary Outcome Measure Information:
Title
Change from Baseline of Bond and Lader Scale
Description
The Bond and Lader visual analogue mood scale (VAMS) had a score from 0 - 100; a higher score represented worsening of the participants condition attributed to 3 factors, (1) Anxiety (e.g., calmness), (2) Sedation (e.g., alertness, (3) Dysphoria (e.g., contentedness). The change was visit minus baseline.
Time Frame
Baseline, Day 28 and Day 42
Title
Change from Baseline of Peak Saccadic Velocity (PSV)
Description
Saccadic velocity is the rate of eye movement in response to stimulus. The saccadic eye movement was used to allow comparison of any sedative effects seen.
Time Frame
Baseline, Day 28, Day 42
Title
Number of Particpants receiving other Anti-epileptic agents During Treatment
Time Frame
Day 1 and Day 14
Title
Percent Change from Baseline of Failed Saccades
Description
Failed saccades is stimulus resulting in no eye movement above a defined threshold within a specified time.
Time Frame
Baseline, Day 28, Day 42
Title
Mean trough concentrations of E2007
Time Frame
Day 7, Day 21, and Day 28
Title
Number of seizures
Time Frame
Baseline (Day-1) to Day 42
Title
The Clinical Global Impression of Change
Time Frame
Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria A patient who met the following inclusion criteria was eligible to participate in the study: Males or females with simple or complex partial seizures with or without secondary generalization, or primary generalized tonic-clonic seizures according to the International League against Epilepsy classification. Patient records were to document the frequency of seizure. Age: 18 to 65 years. Race: any. Patients receiving up to two additional anti-epileptic medications at doses that were stable for at least the four weeks immediately preceding baseline. Patients willing and able to co-operate with the study procedures including completion of patient diaries. Patients living at home with a partner or carer able to monitor compliance. Patients giving informed consent to participate in the study. Exclusion Criteria A patient who met the following exclusion criteria was not eligible to participate in the study: Pregnant or lactating women. Women of childbearing potential unless (1) surgically sterile or (2) practicing effective contraception (eg, abstinence, IUD or barrier method plus hormonal method) and having a negative serum beta-HCG result at screening and being willing to remain on the current form of contraception for the duration of the study. Postmenopausal women could be included but were to have been amenorrhoeic for at least 12 months to be considered as not being of child-bearing potential. Fertile men not willing to use reliable contraception or with partners not willing to use reliable contraception. Patients with status epilepticus within the past 24 months. Patients with unstable abnormalities of the hepatic, renal, cardiovascular, respiratory, abdominal, haematological, endocrine or metabolic systems which might complicate assessment of the tolerability of the study medication. Patients with significantly elevated liver enzymes (abnormal bilirubin level, or serum transaminase levels more than 1.5 times the upper limit of normal). Patients taking drugs other than anti-epileptic agents which induce the enzyme cytochrome P450 3A4 (since these might reduce the plasma concentration of E2007), including dexamethasone, rifabutin, rifampacin, St John's Wort. Patients with past or present drug or alcohol abuse. Patients with unstable psychiatric illness. Patients who had received an investigational drug within the three months before baseline. Patients without a reliable partner or carer. Patients with any condition which would make the patient, in the opinion of the investigator, unsuitable for the study.
Facility Information:
Facility Name
3ClinicalResearch AG
City
Hennigsdorf
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
35305920
Citation
Maguire M. Response to "Perampanel and pregnancy: Could experience be a gloomy lantern that does not even illuminate its bearer?". Epilepsy Behav. 2022 Apr;129:108654. doi: 10.1016/j.yebeh.2022.108654. Epub 2022 Mar 16. No abstract available.
Results Reference
derived

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Safety and Pharmacokinetics Study of E2007 to Treat Partial and Generalised Seizures in People With Epilepsy

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