Lamotrigine Bioequivalence
Primary Purpose
Epilepsy
Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Brand lamotrigine
Generic lamotrigine
Sponsored by
About this trial
This is an interventional basic science trial for Epilepsy focused on measuring bioequivalence, lamotrigine, epilepsy
Eligibility Criteria
Inclusion Criteria:
- Subject is able to provide informed consent.
- Subject is male or female between 18 and 65 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 had a history of at least one seizure and/or AED related adverse event with AED changes; or had at least one seizure and/or AED related adverse event over the 12 months prior to Visit 1.
- 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 28 days prior to Visit 1. Additionally, subject must be taking lamotrigine for 8 weeks prior to Visit 1.
- 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.
- In 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 Type
Experimental
Experimental
Arm Label
Brand lamotrigine then Generic lamotrigine
Generic lamotrigine then Brand lamotrigine
Arm Description
Crossover trial. Each arm will receive Brand lamotrigine tablet for two periods and Generic lamotrigine for two periods.
Crossover trial. Each arm will receive Generic lamotrigine tablet for two periods and Brand lamotrigine for two periods.
Outcomes
Primary Outcome Measures
AUC
pharmacokinetic exposure (ng*hr/ml)
Cmax
highest concentration over the time duration 0-12hr (ng/ml)
Secondary Outcome Measures
Full Information
NCT ID
NCT01995825
First Posted
January 26, 2013
Last Updated
November 5, 2020
Sponsor
University of Maryland, Baltimore
Collaborators
Food and Drug Administration (FDA)
1. Study Identification
Unique Protocol Identification Number
NCT01995825
Brief Title
Lamotrigine Bioequivalence
Official Title
Evaluation of Bioequivalence of Lamotrigine Tablets in Epileptic Patients
Study Type
Interventional
2. Study Status
Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
May 2012 (undefined)
Primary Completion Date
October 2013 (Actual)
Study Completion Date
October 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Maryland, Baltimore
Collaborators
Food and Drug Administration (FDA)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
In this study, brand name lamotrigine (LAMICTAL) and generic lamotrigine will be compared in patients with epilepsy. Both the brand name and generic lamotrigine are approved by the Food and Drug Administration (FDA) and are commonly used to treat epilepsy. Some physicians and patients with epilepsy have believed that brand and generic lamotrigine have had clinically significant differences in efficacy and tolerability. The brand name and generic tablets have been shown to be the same when blood levels were measured in healthy volunteers without epilepsy, but these drugs have not yet been compared in patients with epilepsy. This study will do this comparison, by switching patients between brand and generic in a very structured manner, and seeing if the drugs are the same, primarily in terms of blood levels. Other comparisons will also be made secondarily, looking for any differences in adverse effects and seizure control.
Detailed Description
As is commonly done in a bioequivalence study, the null hypothesis is that the generic (i.e. test) is bioINequivalent to the brand name (i.e. reference). Hence, the alternative hypothesis is that the generic is bioequivalent to the brand name.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy
Keywords
bioequivalence, lamotrigine, epilepsy
7. Study Design
Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
35 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Brand lamotrigine then Generic lamotrigine
Arm Type
Experimental
Arm Description
Crossover trial. Each arm will receive Brand lamotrigine tablet for two periods and Generic lamotrigine for two periods.
Arm Title
Generic lamotrigine then Brand lamotrigine
Arm Type
Experimental
Arm Description
Crossover trial. Each arm will receive Generic lamotrigine tablet for two periods and Brand lamotrigine for two periods.
Intervention Type
Drug
Intervention Name(s)
Brand lamotrigine
Intervention Description
Brand lamotrigine tablet 100mg tablets (1-3 either once or twice a day) for two weeks
Intervention Type
Drug
Intervention Name(s)
Generic lamotrigine
Intervention Description
Generic lamotrigine tablet 100mg tablets (1-3 either once or twice a day) for two weeks
Primary Outcome Measure Information:
Title
AUC
Description
pharmacokinetic exposure (ng*hr/ml)
Time Frame
0-12hr
Title
Cmax
Description
highest concentration over the time duration 0-12hr (ng/ml)
Time Frame
0-12hr
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject is able to provide informed consent.
Subject is male or female between 18 and 65 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 had a history of at least one seizure and/or AED related adverse event with AED changes; or had at least one seizure and/or AED related adverse event over the 12 months prior to Visit 1.
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 28 days prior to Visit 1. Additionally, subject must be taking lamotrigine for 8 weeks prior to Visit 1.
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.
In 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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Lamotrigine Bioequivalence
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