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Effects of Eslicarbazepine Acetate (Esl, Bia 2-093) on Cognitive Function in Children With Partial Onset Seizures

Primary Purpose

Partial Epilepsy

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Eslicarbazepine acetate (BIA 2-093)
Placebo
Sponsored by
Bial - Portela C S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Partial Epilepsy focused on measuring Partial Epilepsy, eslicarbazepine acetate, Children

Eligibility Criteria

6 Years - 16 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

At visit 1 (screening), patient must be/have:

  • written informed consent by parent or legal guardian and, where applicable, the patient;
  • age 6 to 16 years, inclusive;
  • a documented diagnosis of epilepsy for at least 12 months prior to screening;
  • at least 2 partial onset seizures during the 4 weeks prior to screening despite treatment with 1 to 2 AEDs in a stable dose regimen;
  • an Intelligence Quotient (IQ) of at least 70;
  • current treatment with 1 to 2 AEDs (except oxcarbazepine, benzodiazepines other than clobazam and vagus nerve stimulation (VNS));
  • excepting epilepsy, patient is judged to be in general good health based on medical history, physical examination and clinical laboratory tests;
  • in the opinion of the investigator, able to complete the Cognitive Drug Research (CDR) test battery;
  • in case of a girl of childbearing potential, patient presents a serum B-human chorionic gonadotropin (B hCG) test consistent with a non gravid state and agrees to remain abstinent or use reliable contraception (if used, hormonal contraception must be combined with a barrier method) starting at screening and continuing until at least the post-study visit (PSV).

At visit 2 (randomisation), patient must be/have:

  • at least 2 partial-onset seizures during the 4 week baseline period prior to randomisation (documented in a diary);
  • in case of a girl of childbearing potential, patient presents a urine B-hCG test consistent with a non-gravid state;
  • stable dose regimen of concomitant AEDs during the 4 week baseline period;
  • diaries satisfactorily completed by the patient or his/her caregiver during the baseline period;
  • satisfactory compliance with the study requirements during the baseline period.

Exclusion Criteria:

At visit 1 (screening), patients must not be/have:

  • only simple partial seizures with no motor symptomatology;
  • primarily generalised seizures;
  • known rapidly progressive neurological disorders (progressive brain disease, epilepsy secondary to progressive cerebral lesion);
  • occurrence of seizures too close to count accurately;
  • history of status epilepticus or cluster seizures (i.e., 3 or more seizures within 30 minutes) within the 3 months prior to screening; seizures of non-epileptic origin;
  • Lennox-Gastaut syndrome;
  • West syndrome;
  • major psychiatric disorders;
  • seizures of psychogenic origin within the last 2 years;
  • history of schizophrenia or suicide attempt;
  • history of attention deficit disorder or other diseases adversely affecting cognitive abilities;
  • currently treated with oxcarbazepine, benzodiazepines other than clobazam (on a routine or chronic basis) and/or VNS;
  • known hypersensitivity to carboxamide derivatives (oxcarbazepine or carbamazepine);
  • uncontrolled cardiac, renal, hepatic, endocrine, gastrointestinal, metabolic, haematological or oncology disorder;
  • second or third degree atrioventricular blockade;
  • relevant clinical laboratory abnormalities;
  • estimated creatinine clearance (CLCR) <60 mL/min;
  • pregnancy or nursing;
  • treatment with eslicarbazepine acetate in any previous study;
  • participation in other drug clinical trial within the last 2 months;
  • not ensured capability to perform the trial;
  • any other condition or circumstance that, in the opinion of the investigator, may compromise the patient's ability to comply with the study protocol.

At visit 2 (randomisation), patients must not be / have:

• any condition or circumstance that, in the opinion of the investigator, may compromise the patient's ability to comply with the study protocol.

Sites / Locations

  • Ospedale Salesi
  • Ospedale Pediatrico Giovanni XXII
  • Ospedale Maggiore "C.A. Pizzardi"
  • Istituto Scientifico G. Gaslini
  • Ospedale Carlo Poma
  • Policlinico Martino
  • Ospedale Fatebenefratelli
  • Policlinico Seconda Università di Napoli
  • Istituto Mondino
  • Ospedale Bambin Gesu
  • Azienda Ospedaliera O.I.R.M.- Sant'Anna
  • Amphia Ziekenhuis
  • Kempenhaeghe, location Heeze
  • Uniwersyteckie Centrum Kliniczne
  • Gabinet Lekarski Neurologii Dzieciecej i Leczenia Padaczki
  • Wielkopolskie Centrum Neurologii Dzieci i Mlodziezy
  • AKADEMIA MEDYCZNA im. Karola Marcinkowskiego w Poznaniu Katedra I Klinika Neurologii Wieku Rozwojowego
  • Instytut "Pomnik-Centrum Zdrowia Dziecka"
  • State Medical Institution "Children Republic Clinical Hospital of Minzdrav of Republic Tatarstan"
  • Moscow State Healthcare Institution Scientific and Practical centre of medical help to children
  • State Institution "Moscow Regional Scientific and Research Clinical Institute named after M.F. Vladimirsky"
  • OOO City Neurological Center "Sibneuromed"
  • Institution Russian Academy of Science Institute of human brain RAN
  • Saint-Petersburg State Pediatric Medical Academy of Ministry of Health and Social development of Russian Federation
  • Saint-Petersburg Sate Healthcare Institution "Children City Hospital #1"
  • State Healthcare Institution "Samarskaya Regional Clinical Hosptital named after M.I.Kalinin"
  • Saint-Petersburg State Pediatric Medical Academy of Ministry of Health and Social
  • Saint Petersburg Scientific and Research Psycho-Neurology Institute
  • Yaroslavskay State Medical Academy of Roszdrav
  • Donetsk Region Child Clinical Centre of Neuroreabilitation
  • Regional psycho-neurological hospital #3
  • chair of neuropathology and pediatric neurology of Kharkov Medical Academy
  • Danylo Galytskyy Lviv National Medical University
  • Communal institution "Child City Hospital #3"
  • Vinnytsya National Medical University,Vinnytsya Regional Psychoneurological Hospital
  • Zaporizhya regional clinical children hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Eslicarbazepine acetate (BIA 2-093)

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Change From Baseline in Power of Attention Score to the End of the Double Blind (DB) Period
Power of Attention was defined as the sum of the reaction time measures from the attentional tasks (simple [dominant hand only] reaction time, choice reaction time and digit vigilance speed) in order to assess information processing speed and attention/psychomotor speed.Change from baseline to the end of the double-blind period in Power of Attention will be compared between the treatment groups using an ANCOVA. Non-inferiority of ESL vs Placebo will be assessed by comparing the 95% CI's upper bound of the difference of Least Squares Mean (LSmeans) between treatment groups (ESL-placebo) with 121 ms. If the upper bound is greater than 121 ms then the null hypothesis that the change from baseline in the Power of Attention score in ESL group is at least 121 ms inferior than the placebo group will be rejected. Single Values were calculated the average of post treatment visits (visits 5 and 7or EDV) minus average of baseline visits (visits 1 and 2)

Secondary Outcome Measures

Change From Baseline in Standardized Seizure Frequency - Part I
Change From Baseline in Seizure Frequency During the One-year Open-Label (OL)
Overall Change from Baseline in Seizure Frequency per week for the One-Year Open-Label Period

Full Information

First Posted
February 3, 2012
Last Updated
October 23, 2014
Sponsor
Bial - Portela C S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT01527513
Brief Title
Effects of Eslicarbazepine Acetate (Esl, Bia 2-093) on Cognitive Function in Children With Partial Onset Seizures
Official Title
Effects of Eslicarbazepine Acetate (Esl, Bia 2-093) on Cognitive Function in Children With Partial Onset Seizures: an add-on, Double-blind, Randomised, Placebo-controlled, Parallel Group, Multicentre Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
October 2014
Overall Recruitment Status
Completed
Study Start Date
August 2010 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
May 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bial - Portela C S.A.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate the effects of eslicarbazepine acetate on cognition in comparison with placebo as adjunctive therapy in children aged 6 to 16 years old with refractory partial-onset seizures.
Detailed Description
This will be a 2-part multicentre study in approximately 117 patients. Part I of the study will consist of a 4-week prospective observational baseline period, a 12-week double-blind period (4-week up-titration and 8-week maintenance), and a tapering-off period. After the screening visit (V1), patients will enter the baseline period. At the end of the baseline period (V2), eligible patients will be randomised in a ratio of 2:1 to receive double-blind treatment with Eslicarbazepine acetate or Placebo in addition to concomitant therapy with 1 or 2 Anti-Epileptic Drugs (AEDs). Concomitant AED therapy will be kept stable during the whole study. Initial dose of the study treatment will be 10 mg/kg/day. After 2-weeks on 10 mg/kg/day, the dose will be up-titrated to 20 mg/kg/day (maximum 1200 mg/day). After 2 weeks on 20 mg/kg/day, dose will be up-titrated to 30 mg/kg/day (maximum 1200 mg/day) and patients will receive this dose for 8 weeks. If intolerable adverse events (AEs) occur, the patient can be down-titrated to the previous dose (only 1 down-titration step will be allowed) or discontinued. After the 8-week maintenance period, the study treatment will be tapered off in 10 mg/kg/day 2 week steps. However, if a patient experiences an increase in seizure frequency (e.g. more than 100% increase vs. baseline) during tapering-off, the patient can proceed directly to the open-label part of the study (Part II). After completion of the last 2-week 10 mg/kg/day step, patients will have the option to enter a 1 year open-label treatment (Part II) with Eslicarbazepine acetate (up to 30 mg/kg/day, maximum 1200 mg/day), or will have a 4 week observational follow-up period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Partial Epilepsy
Keywords
Partial Epilepsy, eslicarbazepine acetate, Children

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
123 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Eslicarbazepine acetate (BIA 2-093)
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Eslicarbazepine acetate (BIA 2-093)
Other Intervention Name(s)
Eslicarbazepine acetate
Intervention Description
Eslicarbazepine acetate (ESL) tablets 200 mg and the matching placebo will be supplied. Treatments will be administered by oral route, once-daily, in the evening. The dose will be rounded to the nearest 100 mg unit. Half tablets may be used for dose adjustment if necessary.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Treatments will be administered by oral route, once-daily, in the evening.
Primary Outcome Measure Information:
Title
Change From Baseline in Power of Attention Score to the End of the Double Blind (DB) Period
Description
Power of Attention was defined as the sum of the reaction time measures from the attentional tasks (simple [dominant hand only] reaction time, choice reaction time and digit vigilance speed) in order to assess information processing speed and attention/psychomotor speed.Change from baseline to the end of the double-blind period in Power of Attention will be compared between the treatment groups using an ANCOVA. Non-inferiority of ESL vs Placebo will be assessed by comparing the 95% CI's upper bound of the difference of Least Squares Mean (LSmeans) between treatment groups (ESL-placebo) with 121 ms. If the upper bound is greater than 121 ms then the null hypothesis that the change from baseline in the Power of Attention score in ESL group is at least 121 ms inferior than the placebo group will be rejected. Single Values were calculated the average of post treatment visits (visits 5 and 7or EDV) minus average of baseline visits (visits 1 and 2)
Time Frame
Visit 1 (-4 weeks for training), Visit 2 (Day 1), Visit 5 (6 weeks), Visit 7 (12 weeks) or at early discontinuation visit (EDV)
Secondary Outcome Measure Information:
Title
Change From Baseline in Standardized Seizure Frequency - Part I
Time Frame
Baseline; Titration Period (4 Weeks: V2-V3-V4)
Title
Change From Baseline in Seizure Frequency During the One-year Open-Label (OL)
Description
Overall Change from Baseline in Seizure Frequency per week for the One-Year Open-Label Period
Time Frame
Weeks 1 to ≥ 41 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At visit 1 (screening), patient must be/have: written informed consent by parent or legal guardian and, where applicable, the patient; age 6 to 16 years, inclusive; a documented diagnosis of epilepsy for at least 12 months prior to screening; at least 2 partial onset seizures during the 4 weeks prior to screening despite treatment with 1 to 2 AEDs in a stable dose regimen; an Intelligence Quotient (IQ) of at least 70; current treatment with 1 to 2 AEDs (except oxcarbazepine, benzodiazepines other than clobazam and vagus nerve stimulation (VNS)); excepting epilepsy, patient is judged to be in general good health based on medical history, physical examination and clinical laboratory tests; in the opinion of the investigator, able to complete the Cognitive Drug Research (CDR) test battery; in case of a girl of childbearing potential, patient presents a serum B-human chorionic gonadotropin (B hCG) test consistent with a non gravid state and agrees to remain abstinent or use reliable contraception (if used, hormonal contraception must be combined with a barrier method) starting at screening and continuing until at least the post-study visit (PSV). At visit 2 (randomisation), patient must be/have: at least 2 partial-onset seizures during the 4 week baseline period prior to randomisation (documented in a diary); in case of a girl of childbearing potential, patient presents a urine B-hCG test consistent with a non-gravid state; stable dose regimen of concomitant AEDs during the 4 week baseline period; diaries satisfactorily completed by the patient or his/her caregiver during the baseline period; satisfactory compliance with the study requirements during the baseline period. Exclusion Criteria: At visit 1 (screening), patients must not be/have: only simple partial seizures with no motor symptomatology; primarily generalised seizures; known rapidly progressive neurological disorders (progressive brain disease, epilepsy secondary to progressive cerebral lesion); occurrence of seizures too close to count accurately; history of status epilepticus or cluster seizures (i.e., 3 or more seizures within 30 minutes) within the 3 months prior to screening; seizures of non-epileptic origin; Lennox-Gastaut syndrome; West syndrome; major psychiatric disorders; seizures of psychogenic origin within the last 2 years; history of schizophrenia or suicide attempt; history of attention deficit disorder or other diseases adversely affecting cognitive abilities; currently treated with oxcarbazepine, benzodiazepines other than clobazam (on a routine or chronic basis) and/or VNS; known hypersensitivity to carboxamide derivatives (oxcarbazepine or carbamazepine); uncontrolled cardiac, renal, hepatic, endocrine, gastrointestinal, metabolic, haematological or oncology disorder; second or third degree atrioventricular blockade; relevant clinical laboratory abnormalities; estimated creatinine clearance (CLCR) <60 mL/min; pregnancy or nursing; treatment with eslicarbazepine acetate in any previous study; participation in other drug clinical trial within the last 2 months; not ensured capability to perform the trial; any other condition or circumstance that, in the opinion of the investigator, may compromise the patient's ability to comply with the study protocol. At visit 2 (randomisation), patients must not be / have: • any condition or circumstance that, in the opinion of the investigator, may compromise the patient's ability to comply with the study protocol.
Facility Information:
Facility Name
Ospedale Salesi
City
Ancona
ZIP/Postal Code
60123
Country
Italy
Facility Name
Ospedale Pediatrico Giovanni XXII
City
Bari
ZIP/Postal Code
70126
Country
Italy
Facility Name
Ospedale Maggiore "C.A. Pizzardi"
City
Bologna
ZIP/Postal Code
40133
Country
Italy
Facility Name
Istituto Scientifico G. Gaslini
City
Genova
ZIP/Postal Code
16146
Country
Italy
Facility Name
Ospedale Carlo Poma
City
Mantova
ZIP/Postal Code
46100
Country
Italy
Facility Name
Policlinico Martino
City
Messina
ZIP/Postal Code
98128
Country
Italy
Facility Name
Ospedale Fatebenefratelli
City
Milano
ZIP/Postal Code
20121
Country
Italy
Facility Name
Policlinico Seconda Università di Napoli
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Facility Name
Istituto Mondino
City
Pavia
ZIP/Postal Code
27100
Country
Italy
Facility Name
Ospedale Bambin Gesu
City
Roma
ZIP/Postal Code
00165
Country
Italy
Facility Name
Azienda Ospedaliera O.I.R.M.- Sant'Anna
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Amphia Ziekenhuis
City
Breda
ZIP/Postal Code
4819 EV
Country
Netherlands
Facility Name
Kempenhaeghe, location Heeze
City
Heeze
ZIP/Postal Code
5591 VE
Country
Netherlands
Facility Name
Uniwersyteckie Centrum Kliniczne
City
Gdansk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Gabinet Lekarski Neurologii Dzieciecej i Leczenia Padaczki
City
Kielce
ZIP/Postal Code
25-316
Country
Poland
Facility Name
Wielkopolskie Centrum Neurologii Dzieci i Mlodziezy
City
Poznan
ZIP/Postal Code
60-311
Country
Poland
Facility Name
AKADEMIA MEDYCZNA im. Karola Marcinkowskiego w Poznaniu Katedra I Klinika Neurologii Wieku Rozwojowego
City
Poznan
ZIP/Postal Code
60-355
Country
Poland
Facility Name
Instytut "Pomnik-Centrum Zdrowia Dziecka"
City
Warszawa
ZIP/Postal Code
04-730
Country
Poland
Facility Name
State Medical Institution "Children Republic Clinical Hospital of Minzdrav of Republic Tatarstan"
City
Kazan
ZIP/Postal Code
420138
Country
Russian Federation
Facility Name
Moscow State Healthcare Institution Scientific and Practical centre of medical help to children
City
Moscow
ZIP/Postal Code
119620
Country
Russian Federation
Facility Name
State Institution "Moscow Regional Scientific and Research Clinical Institute named after M.F. Vladimirsky"
City
Moscow
ZIP/Postal Code
129110
Country
Russian Federation
Facility Name
OOO City Neurological Center "Sibneuromed"
City
Novosibirsk
ZIP/Postal Code
630091
Country
Russian Federation
Facility Name
Institution Russian Academy of Science Institute of human brain RAN
City
Saint Petersburg
ZIP/Postal Code
197376
Country
Russian Federation
Facility Name
Saint-Petersburg State Pediatric Medical Academy of Ministry of Health and Social development of Russian Federation
City
Saint-Petersburg
ZIP/Postal Code
194100
Country
Russian Federation
Facility Name
Saint-Petersburg Sate Healthcare Institution "Children City Hospital #1"
City
Saint-Petersburg
ZIP/Postal Code
198205
Country
Russian Federation
Facility Name
State Healthcare Institution "Samarskaya Regional Clinical Hosptital named after M.I.Kalinin"
City
Samara
ZIP/Postal Code
443095
Country
Russian Federation
Facility Name
Saint-Petersburg State Pediatric Medical Academy of Ministry of Health and Social
City
St. Petersburg
ZIP/Postal Code
194100
Country
Russian Federation
Facility Name
Saint Petersburg Scientific and Research Psycho-Neurology Institute
City
St.-Petersburg
ZIP/Postal Code
192019
Country
Russian Federation
Facility Name
Yaroslavskay State Medical Academy of Roszdrav
City
Yaroslavl
ZIP/Postal Code
150030
Country
Russian Federation
Facility Name
Donetsk Region Child Clinical Centre of Neuroreabilitation
City
Donetsk
ZIP/Postal Code
83052
Country
Ukraine
Facility Name
Regional psycho-neurological hospital #3
City
Ivano-Frankivsk
ZIP/Postal Code
76014
Country
Ukraine
Facility Name
chair of neuropathology and pediatric neurology of Kharkov Medical Academy
City
Kharkov
ZIP/Postal Code
61018
Country
Ukraine
Facility Name
Danylo Galytskyy Lviv National Medical University
City
Lviv
ZIP/Postal Code
79010
Country
Ukraine
Facility Name
Communal institution "Child City Hospital #3"
City
Odesa
ZIP/Postal Code
65125
Country
Ukraine
Facility Name
Vinnytsya National Medical University,Vinnytsya Regional Psychoneurological Hospital
City
Vinnitsa
ZIP/Postal Code
21005
Country
Ukraine
Facility Name
Zaporizhya regional clinical children hospital
City
Zaporozhye
ZIP/Postal Code
69063
Country
Ukraine

12. IPD Sharing Statement

Citations:
PubMed Identifier
31878820
Citation
Mintz M, Pina-Garza JE, Wolf SM, McGoldrick PE, Jozwiak S, Grinnell T, Cantu D, Costa R, Moreira J, Li Y, Blum D. Safety and Tolerability of Adjunctive Eslicarbazepine Acetate in Pediatric Patients (Aged 4-17 Years) With Focal Seizures. J Child Neurol. 2020 Mar;35(4):265-273. doi: 10.1177/0883073819890997. Epub 2019 Dec 26.
Results Reference
derived

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Effects of Eslicarbazepine Acetate (Esl, Bia 2-093) on Cognitive Function in Children With Partial Onset Seizures

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