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A Study to Investigate Behavioral and Other Co-Occurring Outcomes With Epidiolex as Add-On Therapy in Participants Aged 1 to 65 Years of Age With Tuberous Sclerosis Complex (EpiCom)

Primary Purpose

Tuberous Sclerosis Complex Associated Neuropsychiatric Disease

Status
Recruiting
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Cannabidiol Oral Solution [Epidiolex]
Sponsored by
Jazz Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tuberous Sclerosis Complex Associated Neuropsychiatric Disease focused on measuring Seizures, Tuberous Sclerosis Complex (TSC), Tuberous Sclerosis Complex Associated Neuropsychiatric Disorders (TAND), Epidiolex, Epidyolex, GWP42003-P, JZP926, TSC Associated Neuropsychiatric Disorders, Cannabidiol, Behavior

Eligibility Criteria

1 Year - 65 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Is within the required age range at the time of signing (or at the time of the participant's parent(s)/Legally Authorized Representative (LAR) signing) the informed consent or providing assent (as applicable): Participants based in the US: 1 to 65 years of age, inclusive. Participants based outside the US: 2 to 65 years of age, inclusive. Has a confirmed clinical diagnosis of TSC with a history of seizures in accordance with the 2012 International Tuberous Sclerosis Complex Consensus Conference criteria. Has behaviors (eg, aggression, impulsivity, temper tantrum, self-injury, hyperactivity, extreme shyness, mood swings, poor eye contact, repetitive behaviors, restlessness, difficulty getting along with peers, rigid/inflexible to procedure and/or change) that are considered moderate or severe per the CareGI-S at Screening. Is taking 1 or more anti-seizure medicine (ASM) at a dose that has been stable for at least 4 weeks prior to Screening. • All medications or interventions for epilepsy (including ketogenic diet and any neurostimulation devices for epilepsy) must have been stable for 4 weeks prior to screening and any major changes to treatment regimens should be discussed with the medical monitor. Is naïve to CBD-OS treatment or has been off CBD-OS treatment for at least 3 months prior to Screening. Is willing to maintain any factors expected to affect seizures stable (eg, alcohol consumption, smoking, concomitant medication usage). Is male or female Male participants: • Male participants are eligible to participate if they agree to the following during the intervention period and for at least 2 weeks, corresponding to the time needed to eliminate the study intervention after the last dose of study intervention: Refrain from donating fresh unwashed semen. PLUS Use a male condom in addition to a second method of acceptable contraception used by their female partners when having sexual intercourse with a women of childbearing potential (WOCBP) who is not currently pregnant. Female participants: A female participant is eligible to participate if she is not pregnant or breastfeeding and one of the following conditions applies: Is a woman of nonchildbearing potential. OR Is a WOCBP and using a contraceptive method that is highly effective, preferably with low user dependency during the study intervention period and for at least 3 months after the last dose of study intervention. The investigator should evaluate the potential for contraceptive method failure (eg, noncompliance, recently initiated) in relationship to the first dose of study intervention. A WOCBP must have a negative highly sensitive pregnancy test within 28 days before the first dose of study intervention. Exclusion Criteria: Has a clinically significant unstable medical condition other than epilepsy. Has an illness during the 4 weeks prior to screening other than epilepsy which, in the investigator's opinion, could affect study outcomes. Has TSC-specific tumor growth which, in the investigator's opinion, could affect the effectiveness endpoints. Has previously undergone significant surgery for epilepsy that, in the investigator's opinion, may impact the assessment of outcomes. Has initiated felbamate within the last 12 months prior to Screening. Is currently using or has in the past used recreational or medicinal cannabis or synthetic cannabinoid-based medications within the 3 months prior to Screening and is not willing to undergo a 1-month washout period before being rescreened. Has received an investigational medicinal product within the 3 months prior to the Screening Visit. Has previously been assigned study intervention for this study or is currently enrolled in any other interventional study. Has laboratory values at the Baseline Visit that are abnormal and of clinical significance in the investigator's opinion. Participant has significantly impaired hepatic function at the Baseline Visit. Has any history of suicidal behavior or any suicidal ideation of type 4 or 5 as evaluated with C-SSRS or Children's C-SSRS at the Screening Visit (for participants ≥ 4 years of age). Has any known or suspected hypersensitivity to cannabinoids or any of the excipients of CBD-OS. Has a known or suspected history of alcohol or substance abuse.

Sites / Locations

  • University of California, Los Angeles (UCLA)
  • Children's Hospital Colorado
  • Nicklaus Children's Health, Miami
  • Massachusetts General Hospital
  • Minnesota Epilepsy GroupRecruiting
  • Duke University Hospital
  • Atrium Health Wake Forest Baptist Medical CenterRecruiting
  • Cincinnati Children's Hospital Medical Center
  • Le Bonheur Children's Hospital
  • University of Texas Health Science Center at Houston - Clinical Research UnitRecruiting
  • University of Texas Health Science Center - San Antonio
  • University of Virginia, Charlottesville
  • The Children's Memorial Health Institute
  • University Hospitals Bristol NHS Foundation Trust
  • Sheffield Children's NHS Foundation Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cannabidiol Oral Solution

Arm Description

Participants who will receive the Cannabidiol Oral Solution (CBD-OS) titrated up to a dose of 12.5 mg/kg administered twice daily for a total dose of up to 25 mg/kg/day for 26 consecutive weeks. Participants will have the option to continue receiving the CBD-OS for an additional 26 weeks, for a total of 52 weeks.

Outcomes

Primary Outcome Measures

Change in the most problematic behavior Numerical Rating Score (NRS) score within the TAND-SQ
Change in Tuberous Sclerosis Complex Associated Neuropsychiatric Disorders Self-report, Quantified Checklist (TAND-SQ) score
Change in Aberrant Behavior Checklist (ABC) score
Change in Child Behavior Checklist (CBCL) score
Change in Adult Behavior Checklist (ABCL) score
Change in Adult Self-Report (ASR) score
Change in Patient-Reported Outcomes Measurement Information System (PROMIS) domains score
Change in sleep characteristics using the Children's Sleep Habits Questionnaire (CSHQ)
Change in sleep characteristics using the Pittsburgh Sleep Quality Index (PSQI)
Change in executive function using Behavior Rating Inventory of Executive Function (BRIEF)
Change in caregiver-reported assessment of Quality of Life (QOL) using Pediatric Quality of Life Survey Family Impact Module (PedsQL FIM)
Change in caregiver-reported assessment of family functioning using Pediatric Quality of Life Survey Family Impact Module (PedsQL FIM)
Change in assessment of QOL using Pediatric Quality of Life Inventory (PedsQL)
Change in caregiver impression of overall severity of symptoms (behavior and seizure control) using the Caregiver Global Impression of Severity (CareGI-S)
Change in participant impression of overall severity of symptoms (behavior and seizure control) using the Patient Global Impression of Severity (PGI-S)
Change in clinician impression of overall severity of symptoms (behavior and seizure control) using the Clinician Global Impression of Severity (CGI-S)
Retention Rate
Retention rate is the number of participants continuing with CBD-OS treatment over total accrued participants
Number of participants considered treatment responders
Treatment responders will be reported as those with a 25%, 50%, 75% and 100% reduction in seizure frequency from baseline
Change in number of seizure-free days
Number of participants experiencing a worsening, no change, or improvement in seizure frequency
Number of participants who experience a change in seizure frequency from baseline defined as: worsening (>25%) no change (-25 to + 25%) improvement (-25% to -50%, ≥-50% to -75%, ≥-75%)
Change in ideation score per the Columbia-Suicide Severity Rating Scale (C-SSRS)
Change in number of suicide attempts per the C-SSRS
Change in ideation score per the Children's C-SSRS
Change in number of suicide attempts per the Children's C-SSRS
Number of participant inpatient hospitalizations due to epilepsy
Number of withdrawals due to Treatment Emergent Adverse Events (TEAEs)

Secondary Outcome Measures

Full Information

First Posted
May 9, 2023
Last Updated
October 18, 2023
Sponsor
Jazz Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05864846
Brief Title
A Study to Investigate Behavioral and Other Co-Occurring Outcomes With Epidiolex as Add-On Therapy in Participants Aged 1 to 65 Years of Age With Tuberous Sclerosis Complex
Acronym
EpiCom
Official Title
A Phase 4, Interventional, Multicenter, Open-Label, Single-Arm Study to Assess Behavioral and Other Co-occurring Outcomes Following Treatment With EPID(I/Y)OLEX as Add-on Therapy in Participants (Aged 1 to 65 Years Old) With Seizures Associated With Tuberous Sclerosis Complex
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 29, 2023 (Actual)
Primary Completion Date
January 1, 2026 (Anticipated)
Study Completion Date
January 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jazz Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to investigate behavioral and other co-occurring outcomes with EPID(I/Y)OLEX as an add-on therapy in participants aged 1 to 65 years with tuberous sclerosis complex (TSC) who experience seizures.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberous Sclerosis Complex Associated Neuropsychiatric Disease
Keywords
Seizures, Tuberous Sclerosis Complex (TSC), Tuberous Sclerosis Complex Associated Neuropsychiatric Disorders (TAND), Epidiolex, Epidyolex, GWP42003-P, JZP926, TSC Associated Neuropsychiatric Disorders, Cannabidiol, Behavior

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Cannabidiol Oral Solution
Arm Type
Experimental
Arm Description
Participants who will receive the Cannabidiol Oral Solution (CBD-OS) titrated up to a dose of 12.5 mg/kg administered twice daily for a total dose of up to 25 mg/kg/day for 26 consecutive weeks. Participants will have the option to continue receiving the CBD-OS for an additional 26 weeks, for a total of 52 weeks.
Intervention Type
Drug
Intervention Name(s)
Cannabidiol Oral Solution [Epidiolex]
Other Intervention Name(s)
Epidiolex
Intervention Description
100 mg/ml Cannabidiol Oral solution
Primary Outcome Measure Information:
Title
Change in the most problematic behavior Numerical Rating Score (NRS) score within the TAND-SQ
Time Frame
Baseline, Week 13, Week 26, Week 52
Title
Change in Tuberous Sclerosis Complex Associated Neuropsychiatric Disorders Self-report, Quantified Checklist (TAND-SQ) score
Time Frame
Baseline, Week 13, Week 26, Week 52
Title
Change in Aberrant Behavior Checklist (ABC) score
Time Frame
Baseline, Week 13, Week 26, Week 52
Title
Change in Child Behavior Checklist (CBCL) score
Time Frame
Baseline, Week 26, Week 52
Title
Change in Adult Behavior Checklist (ABCL) score
Time Frame
Baseline, Week 26, Week 52
Title
Change in Adult Self-Report (ASR) score
Time Frame
Baseline, Week 26, Week 52
Title
Change in Patient-Reported Outcomes Measurement Information System (PROMIS) domains score
Time Frame
Baseline, Week 26, Week 52
Title
Change in sleep characteristics using the Children's Sleep Habits Questionnaire (CSHQ)
Time Frame
Baseline, Week 26
Title
Change in sleep characteristics using the Pittsburgh Sleep Quality Index (PSQI)
Time Frame
Baseline, Week 26
Title
Change in executive function using Behavior Rating Inventory of Executive Function (BRIEF)
Time Frame
Baseline, Week 26
Title
Change in caregiver-reported assessment of Quality of Life (QOL) using Pediatric Quality of Life Survey Family Impact Module (PedsQL FIM)
Time Frame
Baseline, Week 26
Title
Change in caregiver-reported assessment of family functioning using Pediatric Quality of Life Survey Family Impact Module (PedsQL FIM)
Time Frame
Baseline, Week 26
Title
Change in assessment of QOL using Pediatric Quality of Life Inventory (PedsQL)
Time Frame
Baseline, Week 26
Title
Change in caregiver impression of overall severity of symptoms (behavior and seizure control) using the Caregiver Global Impression of Severity (CareGI-S)
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in participant impression of overall severity of symptoms (behavior and seizure control) using the Patient Global Impression of Severity (PGI-S)
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in clinician impression of overall severity of symptoms (behavior and seizure control) using the Clinician Global Impression of Severity (CGI-S)
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Retention Rate
Description
Retention rate is the number of participants continuing with CBD-OS treatment over total accrued participants
Time Frame
Baseline, Week 13, Week 26, Week 52
Title
Number of participants considered treatment responders
Description
Treatment responders will be reported as those with a 25%, 50%, 75% and 100% reduction in seizure frequency from baseline
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in number of seizure-free days
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Number of participants experiencing a worsening, no change, or improvement in seizure frequency
Description
Number of participants who experience a change in seizure frequency from baseline defined as: worsening (>25%) no change (-25 to + 25%) improvement (-25% to -50%, ≥-50% to -75%, ≥-75%)
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in ideation score per the Columbia-Suicide Severity Rating Scale (C-SSRS)
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in number of suicide attempts per the C-SSRS
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in ideation score per the Children's C-SSRS
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Change in number of suicide attempts per the Children's C-SSRS
Time Frame
Baseline, Week 4, Week 13, Week 26, Week 52
Title
Number of participant inpatient hospitalizations due to epilepsy
Time Frame
Up to Week 52
Title
Number of withdrawals due to Treatment Emergent Adverse Events (TEAEs)
Time Frame
Up to Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is within the required age range at the time of signing (or at the time of the participant's parent(s)/Legally Authorized Representative (LAR) signing) the informed consent or providing assent (as applicable): Participants based in the US: 1 to 65 years of age, inclusive. Participants based outside the US: 2 to 65 years of age, inclusive. Has a confirmed clinical diagnosis of TSC with a history of seizures in accordance with the 2012 International Tuberous Sclerosis Complex Consensus Conference criteria. Has behaviors (eg, aggression, impulsivity, temper tantrum, self-injury, hyperactivity, extreme shyness, mood swings, poor eye contact, repetitive behaviors, restlessness, difficulty getting along with peers, rigid/inflexible to procedure and/or change) that are considered moderate or severe per the CareGI-S at Screening. Is taking 1 or more anti-seizure medicine (ASM) at a dose that has been stable for at least 4 weeks prior to Screening. • All medications or interventions for epilepsy (including ketogenic diet and any neurostimulation devices for epilepsy) must have been stable for 4 weeks prior to screening and any major changes to treatment regimens should be discussed with the medical monitor. Is naïve to CBD-OS treatment or has been off CBD-OS treatment for at least 3 months prior to Screening. Is willing to maintain any factors expected to affect seizures stable (eg, alcohol consumption, smoking, concomitant medication usage). Is male or female Male participants: • Male participants are eligible to participate if they agree to the following during the intervention period and for at least 2 weeks, corresponding to the time needed to eliminate the study intervention after the last dose of study intervention: Refrain from donating fresh unwashed semen. PLUS Use a male condom in addition to a second method of acceptable contraception used by their female partners when having sexual intercourse with a women of childbearing potential (WOCBP) who is not currently pregnant. Female participants: A female participant is eligible to participate if she is not pregnant or breastfeeding and one of the following conditions applies: Is a woman of nonchildbearing potential. OR Is a WOCBP and using a contraceptive method that is highly effective, preferably with low user dependency during the study intervention period and for at least 3 months after the last dose of study intervention. The investigator should evaluate the potential for contraceptive method failure (eg, noncompliance, recently initiated) in relationship to the first dose of study intervention. A WOCBP must have a negative highly sensitive pregnancy test within 28 days before the first dose of study intervention. Exclusion Criteria: Has a clinically significant unstable medical condition other than epilepsy. Has an illness during the 4 weeks prior to screening other than epilepsy which, in the investigator's opinion, could affect study outcomes. Has TSC-specific tumor growth which, in the investigator's opinion, could affect the effectiveness endpoints. Has previously undergone significant surgery for epilepsy that, in the investigator's opinion, may impact the assessment of outcomes. Has initiated felbamate within the last 12 months prior to Screening. Is currently using or has in the past used recreational or medicinal cannabis or synthetic cannabinoid-based medications within the 3 months prior to Screening and is not willing to undergo a 1-month washout period before being rescreened. Has received an investigational medicinal product within the 3 months prior to the Screening Visit. Has previously been assigned study intervention for this study or is currently enrolled in any other interventional study. Has laboratory values at the Baseline Visit that are abnormal and of clinical significance in the investigator's opinion. Participant has significantly impaired hepatic function at the Baseline Visit. Has any history of suicidal behavior or any suicidal ideation of type 4 or 5 as evaluated with C-SSRS or Children's C-SSRS at the Screening Visit (for participants ≥ 4 years of age). Has any known or suspected hypersensitivity to cannabinoids or any of the excipients of CBD-OS. Has a known or suspected history of alcohol or substance abuse.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Clinical Trial Disclosure & Transparency
Phone
215-832-3750
Email
ClinicalTrialDisclosure@JazzPharma.com
Facility Information:
Facility Name
University of California, Los Angeles (UCLA)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Nicklaus Children's Health, Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Minnesota Epilepsy Group
City
Roseville
State/Province
Minnesota
ZIP/Postal Code
55113
Country
United States
Individual Site Status
Recruiting
Facility Name
Duke University Hospital
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Atrium Health Wake Forest Baptist Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Individual Site Status
Recruiting
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Le Bonheur Children's Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38103
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
University of Texas Health Science Center at Houston - Clinical Research Unit
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Texas Health Science Center - San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
University of Virginia, Charlottesville
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
The Children's Memorial Health Institute
City
Warszawa
ZIP/Postal Code
04-736
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
University Hospitals Bristol NHS Foundation Trust
City
Bristol
ZIP/Postal Code
BS1 3NU
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Name
Sheffield Children's NHS Foundation Trust
City
Sheffield
ZIP/Postal Code
2TH
Country
United Kingdom
Individual Site Status
Not yet recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Investigate Behavioral and Other Co-Occurring Outcomes With Epidiolex as Add-On Therapy in Participants Aged 1 to 65 Years of Age With Tuberous Sclerosis Complex

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