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Epidiolex in Typical Absence Seizures

Primary Purpose

Study the Efficacy of Epidiolex for Typical Absence Seizures

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Cannabidiol (Epidiolex)
Sponsored by
University of South Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Study the Efficacy of Epidiolex for Typical Absence Seizures

Eligibility Criteria

6 Years - undefined (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

10.1 Existing clinical patients diagnosed with Genetic (Idiopathic) Generalized Epilepsy will be reviewed and asked if they are willing to participate.

10.2 Signed informed consent form (ICF) indicating that the subject has been informed of the procedures to be followed, the experimental nature of the therapy, alternatives, potential benefits, side effects, risks, and discomforts.

Men or non-pregnant, non-breastfeeding women 16 to 55 years of age who are able to read and understand the written and spoken local language.

Clinical diagnosis of IGE (including, but not limited to, CAE, JAE, juvenile myoclonic epilepsy, or Jeavons syndrome) with absence seizures consistent with the International League against Epilepsy Revised Classification of Seizures (2017).

Absence seizures, by history on average once per hour, persisting despite standard of care (SOC) treatment, defined as treatment with at least 2 AEDs appropriate for the patient's epilepsy syndrome. SOC failure, per investigator discretion, will be defined as insufficient clinical response or intolerable side effects, which precludes use of the appropriate AED.

Observation of at least 3 instances of generalized discharges of approximately 2.5 - 4 Hz lasting >2 seconds via 24-hr ambulatory EEG

On stable doses of one or more antiepileptic medication(s) for at least 30 days. If a subject is not on medication, adequate documentation justifying lack of therapy may be acceptable for the subject after Greenwich Biosciences review. Ketogenic, modified Atkins diet (MAD), or low glycemic diet with stable carbohydrate ratio for at least 30 days before screening is an acceptable antiepileptic therapy. Vagal nerve stimulation at stable settings (for at least 30 days before screening), without use of the magnet, is also acceptable.

Subjects with reproductive capability, including all males and WOCBP, must agree to practice continuous abstinence or adequate contraception methods (appropriate double barrier method or oral, patch, implant, or injectable contraception) from as soon as feasible during screening period until at least 30 days after the last dose (i.e., intermittent abstinence based on "rhythm," temperature monitoring, or other means of timing is not acceptable). WOCBP include any woman who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, and/or bilateral oophorectomy) or is not postmenopausal. Postmenopausal is defined as amenorrhea for ≥12 consecutive months without another cause, and a documented serum follicle stimulating hormone (FSH) level ≥35 mIU/mL.

Able and willing to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

10.3 Subjects will be excluded from the study if any of the following conditions apply.

History of surgical intervention for treatment of epilepsy.

Additional seizure (clinical and electrographic) types, including, but not limited to, epileptic spasms, generalized tonic seizures, atonic seizures, or focal seizures. Subjects with GTCS or myoclonic seizures are eligible for the study.

Inadequately treated psychotic or mood disorder (e.g., schizophrenia, major depression, bipolar disorder).

Presence of severe intellectual disability, severe autism spectrum disorder, or severe developmental disorder such that the subject cannot sign the ICF or cannot cooperate with the study procedures.

Presence of positive urine drug screen for drugs of abuse, except if this is explained by use of an allowed prescription medicine.

Significant hepatic (AST/ALT or bilirubin ≥2 × ULN) or renal disease (creatinine clearance

≤39 mL/min).

A current C-SSRS score of 4 or 5 at screening or history of suicide attempt within the past year. Study team members have been trained on the administration of this assessment.

Any other condition and/or situation that causes the investigator to deem a subject unsuitable for the study.

Treatment with an investigational agent within 30 days prior to the first dose of CBD (Epidiolex) or planning to receive an investigational agent during the study.

Concurrent legal use of CBD obtained from state dispensaries.

10.5 Students, Employees, those that are socially and/or economically disadvantaged and Wards of the state will not be included in this research population.

Sites / Locations

  • University of South Florida

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Absence Seizures Treated with Epidiolex

Arm Description

This is a pilot, open-label study consisting of a screening period of up to 28 Days, a 4-week dose-titration treatment period to dose of up to 20 mg/kg/day BID of CBD (EPIDIOLEX ), and a 30-day safety follow-up period following the last dose of study medication.

Outcomes

Primary Outcome Measures

Amount of epileptiform activity.
The EEG epileptiform activity will be measured in seconds per 24 hours period.

Secondary Outcome Measures

Full Information

First Posted
May 19, 2021
Last Updated
July 9, 2023
Sponsor
University of South Florida
Collaborators
Jazz Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04899050
Brief Title
Epidiolex in Typical Absence Seizures
Official Title
Safety and Efficacy of CBD (Epidiolex) in Idiopathic Generalized Epilepsy With Typical Absence Seizures
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
July 30, 2021 (Actual)
Primary Completion Date
May 27, 2023 (Actual)
Study Completion Date
May 27, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of South Florida
Collaborators
Jazz Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Pilot study, open-label study consisting of a screening period of up to 4 weeks, a 4-week dose-titration treatment period to dose of up to 20 mg/kg/day BID of CBD (Epidiolex), and a 30 day safety follow-up period following the last dose of study medication.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Study the Efficacy of Epidiolex for Typical Absence Seizures

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Absence Seizures Treated with Epidiolex
Arm Type
Experimental
Arm Description
This is a pilot, open-label study consisting of a screening period of up to 28 Days, a 4-week dose-titration treatment period to dose of up to 20 mg/kg/day BID of CBD (EPIDIOLEX ), and a 30-day safety follow-up period following the last dose of study medication.
Intervention Type
Drug
Intervention Name(s)
Cannabidiol (Epidiolex)
Intervention Description
Use of Epidiolex to control absence seizures.
Primary Outcome Measure Information:
Title
Amount of epileptiform activity.
Description
The EEG epileptiform activity will be measured in seconds per 24 hours period.
Time Frame
From baseline EEG to the EEG after 90 days of treatment.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participants are eligible to be included in the study only if all of the following criteria apply: Participant is willing to sign the informed consent form (ICF) indicating that the subject has been informed of the procedures to be followed, the experimental nature of the therapy, alternatives, potential benefits, side effects, risks, and discomforts. Participant is male or female 6 years of age and older, with diagnosis of uncontrolled Genetic (Idiopathic) Generalized Epilepsy with Typical Absence Seizures. Clinical diagnosis of GGE (including, but not limited to, CAE, JAE, juvenile myoclonic epilepsy, or Jeavons syndrome) with absence seizures consistent with the International League against Epilepsy Revised Classification of Seizures (2017). Absence seizures, by history on average once per hour, persisting despite standard of care (SOC) treatment, defined as treatment with at least 2 AEDs appropriate for the patient's epilepsy syndrome. SOC failure, per investigator discretion, will be defined as insufficient clinical response or intolerable side effects, which precludes use of the appropriate AED. Observation of at least 3 instances of generalized discharges of approximately 2.5 - 4 Hz lasting >2 seconds via 24-hr ambulatory EEG. On stable doses of one or more antiepileptic medication(s) for at least 30 days. If a subject is not on medication, adequate documentation justifying lack of therapy may be acceptable for the subject after Greenwich Biosciences review. Ketogenic, modified Atkins diet (MAD), or low glycemic diet with stable carbohydrate ratio for at least 30 days before screening is an acceptable antiepileptic therapy. Vagal nerve stimulation at stable settings (for at least 30 days before screening), without use of the magnet, is also acceptable. Subjects with reproductive capability, including all males and WOCBP, must agree to practice continuous abstinence or adequate contraception methods (appropriate double barrier method or oral, patch, implant, or injectable contraception) from as soon as feasible during screening period until at least 30 days after the last dose (i.e., intermittent abstinence based on "rhythm," temperature monitoring, or other means of timing is not acceptable). WOCBP include any woman who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, and/or bilateral oophorectomy) or is not postmenopausal. Postmenopausal is defined as amenorrhea for ≥12 consecutive months without another cause, and a documented serum follicle stimulating hormone (FSH) level ≥35 mIU/mL. Participants who are able and willing to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. Exclusion Criteria: Participants will be excluded from the study if any of the following conditions apply: Participant who has history of surgical intervention for treatment of epilepsy. Additional seizure (clinical and electrographic) types, including, but not limited to, epileptic spasms, generalized tonic seizures, atonic seizures, or focal seizures. Subjects with GTCS or myoclonic seizures are eligible for the study. Participants with inadequately treated psychotic or mood disorder (e.g., schizophrenia, major depression, bipolar disorder). Presence of severe intellectual disability, severe autism spectrum disorder, or severe developmental disorder such that the subject cannot sign the ICF or cannot cooperate with the study procedures. Presence of positive urine drug screen for drugs of abuse, except if this is explained by use of an allowed prescription medicine. Significant hepatic (AST/ALT or bilirubin ≥2 × ULN) or renal disease (creatinine clearance ≤39 mL/min). A current C-SSRS score of 4 or 5 at screening or history of suicide attempt within the past year. Participant has any medical condition that, in the opinion of the Investigator, could jeopardize or would compromise the study participant's ability to participate in this study. Treatment with an investigational agent within 30 days prior to the first dose of EPIDIOLEX or planning to receive an investigational agent during the study. Concurrent legal use of CBD obtained from a state dispensary.
Facility Information:
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Epidiolex in Typical Absence Seizures

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