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A Study to Assess Cannabidiol Oral Solution With Vigabatrin as Initial Therapy in Participants With Infantile Spasms

Primary Purpose

Infantile Spasm

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Cannabidiol Oral Solution
Placebo
Vigabatrin
Sponsored by
Radius Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infantile Spasm focused on measuring Infantile spasm, Vigabatrin, Cannabidiol oral solution

Eligibility Criteria

1 Month - 24 Months (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Parent(s)/caregiver(s) fully comprehends and signs the informed consent form, understands all study procedures, and can communicate satisfactorily with the Investigator and study coordinator, in accordance with applicable laws, regulations, and local requirements.
  2. Clinical diagnosis of Infantile Spasms and hypsarrythmia, confirmed by a 9-hour video-EEG obtained during screening Period and read by the central reader.
  3. General good health (defined as the absence of any clinically relevant abnormalities as determined by the Investigator) based on physical and neurological examinations, medical history, and clinical laboratory values completed during the Screening Visit (Visit 1).
  4. In the opinion of the investigator, the parent(s)/caregiver(s) is (are) willing and able to comply with the study procedures and visit schedules.

Exclusion Criteria:

  1. Is considered by the investigator, for any reason (including, but not limited to, the risks described as precautions, warnings, and contraindications in the current version of the Investigator's Brochure for Cannabidiol Oral Solution) to be an unsuitable candidate to receive the study drug.
  2. Known or suspected allergy to cannabidiol.
  3. History of an allergic reaction or a known or suspected sensitivity to any substance that is contained in the investigational product formulation.
  4. Use of any cannabidiol/cannabis product within 30 days of study entry.
  5. Patient is diagnosed or suspected of having tuberous sclerosis.
  6. Patient has received treatment with either vigabatrin, ACTH, or high-dose steroids previously.
  7. Previous or concomitant therapy with felbamate, clobazam, valproic acid, or the ketogenic diet.
  8. Patient currently on any disallowed CYP3A4-related medication listed in Appendix 1 (phenytoin, fluvoxamine, carbamazepine, and St. John's Wort).
  9. Previously received any investigational drug or device or investigational therapy within 30 days before Screening.
  10. Clinically significant abnormal laboratory values, including: liver function tests (LFTs) such as albumin, direct bilirubin, total bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) ≥3 times the upper limit of normal (ULN). The investigator may deem the patient eligible if he or she judges the laboratory values to be not clinically significant.

Sites / Locations

  • Nicklaus Children's Hospital
  • Beaumont Children's Hospital
  • Akron Children's Hospital
  • Oregon Health & Science University
  • Institute for Research and Innovation | MultiCare Health System

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

CBD with Vigabatrin

Placebo with Vigabatrin

Arm Description

Participants received up to 40 milligrams per kilogram per day (mg/kg/day) divided twice daily (BID) of CBD with food. Participants also received up to 150 mg/kg/day BID of vigabatrin with food.

Participants received a matching placebo to CBD with food, and also received up to 150 mg/kg/day BID of vigabatrin with food.

Outcomes

Primary Outcome Measures

Percentage of Participants Considered Complete Responders
Complete response is defined as complete resolution of spasms and hypsarrhythmia confirmed by 24-hour video-electroencephalogram (EEG).

Secondary Outcome Measures

Percentage of Participants With Resolution of Infantile Spasms
Resolution of IS was assessed by 24-hour video-EEG.
Percentage of Participants With Resolution of Hypsarrhythmia
Resolution of hypsarrhythmia was assessed by 24-hour video-EEG.
Investigator Impression of Efficacy and Tolerability of Study Drug Clinical Global Impression- Global Improvement (CGI-I)
Investigators will use the CGI-I scale, which is a 7-point scale that requires the clinician to assess how much the participant's illness has improved or worsened relative to a baseline state at the beginning of the intervention and is rated as: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse. Higher scores indicated worse condition.
Percentage of Participants With Increase in Number of Spasm-Free Days Between Day 1 and Day 15
Increase in spasm-free days will be determined by seizure diary entries.
Percentage of Participants With Complete Response During the Initial Treatment Period Who Relapse During the Extended Treatment Period
Relapse during the extended treatment period will be confirmed by video-EEG following parent report of relapse.
Time to Relapse During the Extended Treatment Period

Full Information

First Posted
January 26, 2018
Last Updated
May 11, 2023
Sponsor
Radius Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03421496
Brief Title
A Study to Assess Cannabidiol Oral Solution With Vigabatrin as Initial Therapy in Participants With Infantile Spasms
Official Title
A Phase 3 Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Assess the Efficacy, Safety, and Tolerability of Cannabidiol Oral Solution as Adjunctive Therapy With Vigabatrin as Initial Therapy in Patients With Infantile Spasms
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Terminated
Why Stopped
The study was terminated due to slow enrollment and failure to identify adequate patients that met entry criteria.
Study Start Date
September 5, 2018 (Actual)
Primary Completion Date
May 29, 2019 (Actual)
Study Completion Date
May 29, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Radius Pharmaceuticals, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The primary purpose of this study was to evaluate the efficacy, safety, and tolerability of Cannabidiol Oral Solution (CBD) as adjunctive therapy with vigabatrin as initial therapy, compared to vigabatrin alone in the treatment of infants newly diagnosed with Infantile Spasms (IS).
Detailed Description
This was a randomized, double-blind, placebo-controlled, parallel-group study in which participants were randomized in a 1:1 ratio to 1 of 2 treatment groups. During the Initial Treatment Period, participants received either vigabatrin plus CBD or vigabatrin plus matching placebo and were dosed approximately every 12 hours, with a meal. This study was comprised of five periods: Screening, Initial Treatment, Extended Treatment, Taper, and Follow up Periods, with a maximum duration of approximately 140 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infantile Spasm
Keywords
Infantile spasm, Vigabatrin, Cannabidiol oral solution

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CBD with Vigabatrin
Arm Type
Experimental
Arm Description
Participants received up to 40 milligrams per kilogram per day (mg/kg/day) divided twice daily (BID) of CBD with food. Participants also received up to 150 mg/kg/day BID of vigabatrin with food.
Arm Title
Placebo with Vigabatrin
Arm Type
Placebo Comparator
Arm Description
Participants received a matching placebo to CBD with food, and also received up to 150 mg/kg/day BID of vigabatrin with food.
Intervention Type
Drug
Intervention Name(s)
Cannabidiol Oral Solution
Intervention Description
An oral solution containing pharmaceutical grade cannabidiol (nonplant-based).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching oral solution
Intervention Type
Drug
Intervention Name(s)
Vigabatrin
Other Intervention Name(s)
Sabril
Intervention Description
Powder suspension
Primary Outcome Measure Information:
Title
Percentage of Participants Considered Complete Responders
Description
Complete response is defined as complete resolution of spasms and hypsarrhythmia confirmed by 24-hour video-electroencephalogram (EEG).
Time Frame
Up to Day 15
Secondary Outcome Measure Information:
Title
Percentage of Participants With Resolution of Infantile Spasms
Description
Resolution of IS was assessed by 24-hour video-EEG.
Time Frame
Up to Day 15
Title
Percentage of Participants With Resolution of Hypsarrhythmia
Description
Resolution of hypsarrhythmia was assessed by 24-hour video-EEG.
Time Frame
Up to Day 15
Title
Investigator Impression of Efficacy and Tolerability of Study Drug Clinical Global Impression- Global Improvement (CGI-I)
Description
Investigators will use the CGI-I scale, which is a 7-point scale that requires the clinician to assess how much the participant's illness has improved or worsened relative to a baseline state at the beginning of the intervention and is rated as: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse. Higher scores indicated worse condition.
Time Frame
Day 15
Title
Percentage of Participants With Increase in Number of Spasm-Free Days Between Day 1 and Day 15
Description
Increase in spasm-free days will be determined by seizure diary entries.
Time Frame
Up to Day 15
Title
Percentage of Participants With Complete Response During the Initial Treatment Period Who Relapse During the Extended Treatment Period
Description
Relapse during the extended treatment period will be confirmed by video-EEG following parent report of relapse.
Time Frame
Up to Day 75
Title
Time to Relapse During the Extended Treatment Period
Time Frame
Up to Day 75

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Month
Maximum Age & Unit of Time
24 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Parent(s)/caregiver(s) fully comprehends and signs the informed consent form, understands all study procedures, and can communicate satisfactorily with the Investigator and study coordinator, in accordance with applicable laws, regulations, and local requirements. Clinical diagnosis of Infantile Spasms, confirmed by video-EEG (including at least one cluster of electroclinical spasms [≥3 in any 10-minute epoch] and hypsarrythmia) obtained during the Screening Period and read by a central reader. General good health (defined as the absence of any clinically relevant abnormalities as determined by the Investigator) based on physical and neurological examinations, medical history, and clinical laboratory values completed during the Screening Visit). In the opinion of the investigator, the parent(s)/caregiver(s) is (are) willing and able to comply with the study procedures and visit schedules. Exclusion Criteria: Is considered by the investigator, for any reason (including, but not limited to, the risks described as precautions, warnings, and contraindications in the current version of the Investigator's Brochure for Cannabidiol Oral Solution) to be an unsuitable candidate to receive the study drug. Known or suspected allergy to cannabidiol. History of an allergic reaction or a known or suspected sensitivity to any substance that is contained in the investigational product formulation. Use of any cannabidiol/cannabis product within 30 days of study entry. Participant is diagnosed or suspected of having tuberous sclerosis. Participant has received treatment with either vigabatrin, ACTH, or high-dose steroids previously. Previous or concomitant therapy with felbamate, clobazam, valproic acid, or the ketogenic diet. Participant currently on any disallowed CYP3A4-related medication (phenytoin, fluvoxamine, carbamazepine, and St. John's Wort). Previously received any investigational drug or device or investigational therapy within 30 days before Screening. Clinically significant abnormal laboratory values, including: liver function tests (LFTs) such as albumin, direct bilirubin, total bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) ≥3 times the upper limit of normal (ULN). The investigator may deem the participant eligible if he or she judges the laboratory values to be not clinically significant.
Facility Information:
Facility Name
Nicklaus Children's Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Facility Name
Beaumont Children's Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
Akron Children's Hospital
City
Akron
State/Province
Ohio
ZIP/Postal Code
44308
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Institute for Research and Innovation | MultiCare Health System
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98405
Country
United States

12. IPD Sharing Statement

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A Study to Assess Cannabidiol Oral Solution With Vigabatrin as Initial Therapy in Participants With Infantile Spasms

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