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Pharmacokinetics Study of Oral 2-Deoxy-D-Glucose (2DG) in Subjects With a Confirmed Diagnosis of Epilepsy

Primary Purpose

Epilepsy; Seizure

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oral 2-Deoxy-D-Glucose (2DG)
Sponsored by
University of Virginia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Epilepsy; Seizure

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Confirmed diagnosis of epilepsy. For the purpose of inclusion, the seizure types include complex partial, simple partial motor, primary generalized tonic-clonic, secondary generalized tonic-clonic, tonic, clonic and atonic seizures, as well as simple partial and absence seizures. Stable treatment regimen with no change in antiepileptic drugs or antiepileptic drug doses for 28 days prior to enrollment. Women of childbearing potential must be using a standard method of birth control and agree not to become pregnant during the trial. Men must agree to not father a child during the trial. BMI must be between 18 and 35. Exclusion Criteria: Occurrence of non-epileptic psychogenic spells within 2 years prior to enrollment. Current or past history of diabetes or any abnormality of glucose metabolism. Use of glucocorticoids, hypoglycemic agents (e.g. metformin) or any drug that alters glucose levels. Use of any drug that is expected to alter glucose absorption, metabolism or serum measurements. Clinically significant psychiatric or medical disease. Previous therapeutic use of 2DG. Pregnant or nursing women. Use of an investigational medication within 2 months prior to enrollment. Supine systolic blood pressure < 90 or > 160 mm Hg or diastolic > 90 mm Hg, or pulse < 60 or > 110 BPM. Clinically significant abnormal 12-lead ECG. Baseline prolongation of the QTc interval > 450 msec. Clinically significant abnormal result by speckle tracking echocardiography (STE). Elevated ALT or AST more than 1.5 times upper reference limit. Baseline fasting glucose < 60 or > 110. History of status epilepticus within 6 months prior to enrollment. Progressive structural brain lesion or illness likely to progress during the study.

Sites / Locations

  • University of Virginia School of MedicineRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sequential ascending dose cohort

Arm Description

Cohort 1 will receive single 40 mg dose once. Cohort 2 will receive single 60 mg dose once. Cohort 3 will receive (2) 60 mg dose on one occasion.

Outcomes

Primary Outcome Measures

Pharmacokinetics
AUC will be calculated from 2DG blood levels collected at time 0, 15, 30, 45, and 60 minutes and at 2, 4, 6, 12, and 24 hours after single dose of 2DG.
Incidence of Treatment-Emergent Adverse Events
Spontaneously reported adverse events will be summarized by type and severity by the most recent version of MedRA terminology. Adverse events will be graded as mild, moderate, or severe and by whether the relationship to study drug is related, possibly related, or unrelated.

Secondary Outcome Measures

Full Information

First Posted
October 22, 2022
Last Updated
October 28, 2022
Sponsor
University of Virginia
Collaborators
Epilepsy Foundation, University of Wisconsin, Madison
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1. Study Identification

Unique Protocol Identification Number
NCT05605301
Brief Title
Pharmacokinetics Study of Oral 2-Deoxy-D-Glucose (2DG) in Subjects With a Confirmed Diagnosis of Epilepsy
Official Title
Pharmacokinetics Study of Oral 2-Deoxy-D-Glucose (2DG) in Subjects With a Confirmed Diagnosis of Epilepsy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 2, 2022 (Actual)
Primary Completion Date
October 1, 2023 (Anticipated)
Study Completion Date
October 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Virginia
Collaborators
Epilepsy Foundation, University of Wisconsin, Madison

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
This project studies how 2-deoxy-glucose (2DG) pills are absorbed and distributed in people with epilepsy. 2DG is similar to glucose, the main energy source for the brain, but it cannot be used as energy. During seizures, neurons are at a very high metabolic state with huge glucose metabolism as glycolysis is accelerated to supply the high metabolic needs of a seizure. 2DG is taken up by cells but cannot be metabolized by the first enzyme in the glycolytic pathway, thus is stops, or "clogs up", glycolysis. Since brain metabolism is almost entirely dependent on glucose as an energy source, glycolysis is arrested and may stop seizures. It is hoped that 2DG will stop seizures by interfering with the brain's energy use. This is an open-label phase 2 study of the pharmacokinetics (PK), safety, and tolerability of 2DG administered orally to adult epilepsy patients. A 3-level 2DG dose escalation is planned in sequential cohorts of 3 subjects in each cohort with review of each cohort before proceeding to the next cohort. On the day of oral 2DG exposure, subjects will receive a single dose of 40 mg in the first cohort, a single dose of 60 mg in the second cohort, and two 60 mg doses (60 mg bid) in the third cohort. After 3 subjects have completed dosing at Dose Level 1 (40 mg/day), the safety and PK results will be reviewed. The Study Committee will determine if the next cohort should be enrolled at Dose Level 2 (60 mg/day). The same procedure will be repeated to determine if the next cohort should be enrolled at Dose Level 3 (60 mg bid = 120 mg/day). If the Study Committee determines that the most recent dose is not tolerated or that there are significant adverse events, the subsequent Dose Level will not be enrolled. A standard time-concentration curve will be constructed from the 2DG levels obtained from the PK blood draws. Parameters will be calculated for: time to maximum concentration (tmax), maximum concentration (Cmax), elimination rate, half-life (t1/2), AUC, and derived parameters. Statistical analysis will not be performed because of the small n, but this will nevertheless establish the PK profile of 2DG in people with epilepsy. The most important parameter will be the AUC which determines drug exposure.
Detailed Description
The study will be conducted as a 1-day Monitored Dosing and Pharmacokinetics Period in an inpatient setting. Subjects will report to the hospital in a fasted state (since midnight) on the morning of the pharmacokinetics study. Subjects will continue to fast until one hour after the 2DG dose has been given. 2DG will be given as either a single oral dose (40 mg for Dose Level 1; 60 mg for dose level 2) or 60 mg bid (Dose Level 3). Blood for pharmacokinetic analysis will be drawn at time 0 (prior to drug administration), and then at 15, 30, 45, and 60 minutes and at 2, 4, 6, 12, and 24 hours after single dose 2DG administration. Blood for pharmacokinetic analysis will be drawn at time 0 (prior to drug administration) and then at 15, 30, 45, and 60 minutes and at 2, 4, 6, 12, and 24 hours after the last dose for Dose Level 3. Patients will be closely monitored for safety during and following dosing with 2DG.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy; Seizure

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Subjects will be given 2DG orally during a single day of dosing at one of three sequential dose levels (a single dose of 40 mg for Dose Level 1, a single dose of 60 mg for Dose Level 2, or 60 mg bid for Dose Level 3). The total dose will not exceed 120 mg/day, or 60 mg maximum. as a single dose
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Sequential ascending dose cohort
Arm Type
Experimental
Arm Description
Cohort 1 will receive single 40 mg dose once. Cohort 2 will receive single 60 mg dose once. Cohort 3 will receive (2) 60 mg dose on one occasion.
Intervention Type
Drug
Intervention Name(s)
Oral 2-Deoxy-D-Glucose (2DG)
Intervention Description
2DG will be formulated as an solid dosage form and administered orally.
Primary Outcome Measure Information:
Title
Pharmacokinetics
Description
AUC will be calculated from 2DG blood levels collected at time 0, 15, 30, 45, and 60 minutes and at 2, 4, 6, 12, and 24 hours after single dose of 2DG.
Time Frame
Collected from time of drug administration to 24 hours post dose
Title
Incidence of Treatment-Emergent Adverse Events
Description
Spontaneously reported adverse events will be summarized by type and severity by the most recent version of MedRA terminology. Adverse events will be graded as mild, moderate, or severe and by whether the relationship to study drug is related, possibly related, or unrelated.
Time Frame
From time of drug administration until 24 hours post-dose

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: Confirmed diagnosis of epilepsy. For the purpose of inclusion, the seizure types include complex partial, simple partial motor, primary generalized tonic-clonic, secondary generalized tonic-clonic, tonic, clonic and atonic seizures, as well as simple partial and absence seizures. Stable treatment regimen with no change in antiepileptic drugs or antiepileptic drug doses for 28 days prior to enrollment. Women of childbearing potential must be using a standard method of birth control and agree not to become pregnant during the trial. Men must agree to not father a child during the trial. BMI must be between 18 and 35. Exclusion Criteria: Occurrence of non-epileptic psychogenic spells within 2 years prior to enrollment. Current or past history of diabetes or any abnormality of glucose metabolism. Use of glucocorticoids, hypoglycemic agents (e.g. metformin) or any drug that alters glucose levels. Use of any drug that is expected to alter glucose absorption, metabolism or serum measurements. Clinically significant psychiatric or medical disease. Previous therapeutic use of 2DG. Pregnant or nursing women. Use of an investigational medication within 2 months prior to enrollment. Supine systolic blood pressure < 90 or > 160 mm Hg or diastolic > 90 mm Hg, or pulse < 60 or > 110 BPM. Clinically significant abnormal 12-lead ECG. Baseline prolongation of the QTc interval > 450 msec. Clinically significant abnormal result by speckle tracking echocardiography (STE). Elevated ALT or AST more than 1.5 times upper reference limit. Baseline fasting glucose < 60 or > 110. History of status epilepticus within 6 months prior to enrollment. Progressive structural brain lesion or illness likely to progress during the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stacy R Thompson, BSN
Phone
4349824315
Email
src2h@virginia.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Rohit S Kuruvilla, MD
Phone
4342436281
Email
rsk3dz@virginia.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nathan B Fountain, MD
Organizational Affiliation
University of Virginia
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Virginia School of Medicine
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stacy R Thompson, BSN
Phone
434-982-4315
Email
src2h@virginia.edu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Pharmacokinetics Study of Oral 2-Deoxy-D-Glucose (2DG) in Subjects With a Confirmed Diagnosis of Epilepsy

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