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BEEP Follow Up: Evaluation of Repeatability of Lamotrigine Pharmacokinetics in Epileptic Patients

Primary Purpose

Epilepsy

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
lamotrigine (brand Lamictal)
lamotrigine (generic Teva)
Sponsored by
University of Maryland, Baltimore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Epilepsy

Eligibility Criteria

18 Years - 76 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject is able to provide informed consent and was enrolled in previous BEEP study.
  • Subject is male or female between 18 and 76 years of age inclusive.
  • Subject has a diagnosis of epilepsy with simple partial seizures and/or complex partial seizures, with or without secondary generalization or primary generalized seizures
  • Subject has been maintained on a stable dose regimen of anti-epileptic drugs (AEDs), including lamotrigine at 200mg, 400mg, or 600mg total daily dosage divided BID for at least 8 weeks prior to Visit 1 and during the screening period
  • Subject is willing to be switched between brand and generic lamotrigine
  • Subject is an acceptable candidate for venipuncture
  • Subject is willing to stop all OTC medications for 24 hours prior to and during 12 hour study visits

Exclusion Criteria:

  • Subject is currently participating or has participated within the last 2 months in any trial of an investigational drug or experimental device
  • Subject has a history of status epilepticus within the 12 month period prior to Visit 1.
  • Subject has any medical condition, which in the opinion of the investigator, could jeopardize the subject's health or would compromise the subject's ability to participate in the trial
  • Subject has any psychiatric condition, which in the opinion of the investigator, could jeopardize the subject's health or would compromise the subject's ability to participate in this trial or confound the interpretation of the trial data
  • Subject has known hypersensitivity to lamotrigine
  • Subject has a medical condition that impacts drug absorption (e.g. gastric bypass surgery), including routine use (i.e.

daily or weekly) use of acid blockers, antacids, anti-diarrhea, stimulants, appetite suppressants, or anti nausea medication or other drugs that modulate GI function

  • Subject has any history of alcohol or drug abuse within the previous two years
  • Subject has acute or subacutely progressive CNS disease
  • Subject has moderate or severe liver impairment as assessed by alanine aminotransferase (ALT), aspartate aminotransferase (AST), or total bilirubin levels ≥5 times the upper limit of normal (ULN).
  • Subject has moderate or severe renal impairment as assessed by creatinine clearance lower than 50mL/min, using the Cockcroft-Gault formula
  • Female subjects of childbearing potential will not be eligible to participate who are unwilling or unable to use a medically acceptable method of contraception throughout the entire study period and for one week after the study is completed. Medically acceptable methods of contraception that may be used by the subject and/or her partner are: condom with spermicide, diaphragm with spermicide, IUD without progesterone, vaginal spermicidal suppository, surgical sterilization of their partner(s) or abstinence
  • Female subject is pregnant or nursing
  • Female subject is using hormonal contraceptive precautions including progesterone-coated IUD
  • Subjects is using hormonal replacement therapy
  • Subject is unwilling or unable to maintain their approximate daily smoking use during the study
  • Subject is using rifampin or other non-AED that strongly modulates lamotrigine levels
  • addition to lamotrigine and/or vagus nerve stimulation and/or intermittent benzodiazepine use (e.g. lorazepam, diazepam, clonazepam), subject is taking more than two concomitant AEDs
  • Subject is not willing or able to be adherent to study protocol (e.g. dosing of lamotrigine and any interacting comedication).

Sites / Locations

  • University of Maryland

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Experimental

Active Comparator

Experimental

Arm Label

lamotrigine brand tablet1

lamotrigine generic tablet1

lamotrigine brand tablet2

lamotrigine generic tablet2

Arm Description

lamotrigine tablet Lamictal

lamotrigine tablet Teva

lamotrigine tablet Lamictal

lamotrigine tablet Teva

Outcomes

Primary Outcome Measures

AUC
pharmacokinetic exposure (ng*hr/ml). Pharmacokinetic (PK) blood levels will be drawn at the schedule times: immediately prior to lamotrigine administration, then after drug administration at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 10.0, and 12.0 hr.
Cmax
pharmacokinetic rate (ng/ml). Pharmacokinetic (PK) blood levels will be drawn at the schedule times: immediately prior to lamotrigine administration, then after drug administration at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 10.0, and 12.0 hr.

Secondary Outcome Measures

Full Information

First Posted
March 17, 2015
Last Updated
August 15, 2019
Sponsor
University of Maryland, Baltimore
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1. Study Identification

Unique Protocol Identification Number
NCT02404168
Brief Title
BEEP Follow Up: Evaluation of Repeatability of Lamotrigine Pharmacokinetics in Epileptic Patients
Official Title
Evaluation of Repeatability of Lamotrigine Pharmacokinetics in Epileptic Patients
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
July 7, 2015 (Actual)
Primary Completion Date
January 18, 2016 (Actual)
Study Completion Date
April 6, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Maryland, Baltimore

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
No

5. Study Description

Brief Summary
The prior BEEP study involved patients being switched between brand and generic in a very structured manner. Other secondary comparisons were also made (i.e. any differences in adverse effects and seizure control). Some subjects were more disparate than other, in terms of generic being similar to brand. In this follow up study, BEEP subjects that showed disparate results will be tested again to assess reproducibility of disparate results.
Detailed Description
This is an double-blind, multiple-dose, full replicate design, pharmacokinetic study of lamotrigine in "enriched" patients with epilepsy who previously participated in HP-00048923. LAMICTAL 100mg tablets and the most commonly used generic lamotrigine 100mg tablet (from Teva) will be compared pharmacokinetically.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Non-Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
lamotrigine brand tablet1
Arm Type
Active Comparator
Arm Description
lamotrigine tablet Lamictal
Arm Title
lamotrigine generic tablet1
Arm Type
Experimental
Arm Description
lamotrigine tablet Teva
Arm Title
lamotrigine brand tablet2
Arm Type
Active Comparator
Arm Description
lamotrigine tablet Lamictal
Arm Title
lamotrigine generic tablet2
Arm Type
Experimental
Arm Description
lamotrigine tablet Teva
Intervention Type
Drug
Intervention Name(s)
lamotrigine (brand Lamictal)
Other Intervention Name(s)
Lamictal
Intervention Description
an anti-epileptic drug (brand)
Intervention Type
Drug
Intervention Name(s)
lamotrigine (generic Teva)
Other Intervention Name(s)
generic lamotrigine
Intervention Description
an anti-epileptic drug (brand)
Primary Outcome Measure Information:
Title
AUC
Description
pharmacokinetic exposure (ng*hr/ml). Pharmacokinetic (PK) blood levels will be drawn at the schedule times: immediately prior to lamotrigine administration, then after drug administration at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 10.0, and 12.0 hr.
Time Frame
0-12hr
Title
Cmax
Description
pharmacokinetic rate (ng/ml). Pharmacokinetic (PK) blood levels will be drawn at the schedule times: immediately prior to lamotrigine administration, then after drug administration at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 10.0, and 12.0 hr.
Time Frame
0-12hr

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
76 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is able to provide informed consent and was enrolled in previous BEEP study. Subject is male or female between 18 and 76 years of age inclusive. Subject has a diagnosis of epilepsy with simple partial seizures and/or complex partial seizures, with or without secondary generalization or primary generalized seizures Subject has been maintained on a stable dose regimen of anti-epileptic drugs (AEDs), including lamotrigine at 200mg, 400mg, or 600mg total daily dosage divided BID for at least 8 weeks prior to Visit 1 and during the screening period Subject is willing to be switched between brand and generic lamotrigine Subject is an acceptable candidate for venipuncture Subject is willing to stop all OTC medications for 24 hours prior to and during 12 hour study visits Exclusion Criteria: Subject is currently participating or has participated within the last 2 months in any trial of an investigational drug or experimental device Subject has a history of status epilepticus within the 12 month period prior to Visit 1. Subject has any medical condition, which in the opinion of the investigator, could jeopardize the subject's health or would compromise the subject's ability to participate in the trial Subject has any psychiatric condition, which in the opinion of the investigator, could jeopardize the subject's health or would compromise the subject's ability to participate in this trial or confound the interpretation of the trial data Subject has known hypersensitivity to lamotrigine Subject has a medical condition that impacts drug absorption (e.g. gastric bypass surgery), including routine use (i.e. daily or weekly) use of acid blockers, antacids, anti-diarrhea, stimulants, appetite suppressants, or anti nausea medication or other drugs that modulate GI function Subject has any history of alcohol or drug abuse within the previous two years Subject has acute or subacutely progressive CNS disease Subject has moderate or severe liver impairment as assessed by alanine aminotransferase (ALT), aspartate aminotransferase (AST), or total bilirubin levels ≥5 times the upper limit of normal (ULN). Subject has moderate or severe renal impairment as assessed by creatinine clearance lower than 50mL/min, using the Cockcroft-Gault formula Female subjects of childbearing potential will not be eligible to participate who are unwilling or unable to use a medically acceptable method of contraception throughout the entire study period and for one week after the study is completed. Medically acceptable methods of contraception that may be used by the subject and/or her partner are: condom with spermicide, diaphragm with spermicide, IUD without progesterone, vaginal spermicidal suppository, surgical sterilization of their partner(s) or abstinence Female subject is pregnant or nursing Female subject is using hormonal contraceptive precautions including progesterone-coated IUD Subjects is using hormonal replacement therapy Subject is unwilling or unable to maintain their approximate daily smoking use during the study Subject is using rifampin or other non-AED that strongly modulates lamotrigine levels addition to lamotrigine and/or vagus nerve stimulation and/or intermittent benzodiazepine use (e.g. lorazepam, diazepam, clonazepam), subject is taking more than two concomitant AEDs Subject is not willing or able to be adherent to study protocol (e.g. dosing of lamotrigine and any interacting comedication).
Facility Information:
Facility Name
University of Maryland
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17346246
Citation
Andermann F, Duh MS, Gosselin A, Paradis PE. Compulsory generic switching of antiepileptic drugs: high switchback rates to branded compounds compared with other drug classes. Epilepsia. 2007 Mar;48(3):464-9. doi: 10.1111/j.1528-1167.2007.01007.x.
Results Reference
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BEEP Follow Up: Evaluation of Repeatability of Lamotrigine Pharmacokinetics in Epileptic Patients

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