Pharmacokinetic Study With an Oral Suspension of Perampanel as Adjunctive Therapy in Pediatric Subjects With Epilepsy
Epilepsy
About this trial
This is an interventional treatment trial for Epilepsy focused on measuring epilepsy, refractory partial seizures
Eligibility Criteria
Inclusion Criteria:
- Male or female, from 1 month to less than 4 years of age (and of at least 36 weeks gestational age) at the time of consent
- Have a minimum weight of 4 kilograms (kg) (8.8 pounds [lb])
- Have a diagnosis of epilepsy with any type of seizure according to the International League Against Epilepsy's (ILAE) Classification of Epileptic Seizures (1981). Diagnosis should have been established at least 2 weeks (≤6 months of age) or 4 weeks (>6 months of age) before Visit 1, by clinical history and an electroencephalogram (EEG) that is consistent with epilepsy; normal interictal EEGs will be allowed provided that the participant meets the other diagnosis criterion (i.e., clinical history)
- Have had brain imaging (computed tomography [CT] or magnetic resonance imaging [MRI]) before Visit 1 that ruled out a progressive cause of epilepsy
- Have had 1 or more seizure(s) before Visit 1
- Currently being treated with a stable dose (i.e., unchanged for at least 5 half-lives) of 1 to a maximum of 4 antiepileptic drugs (AEDs) (at least 6, but not more than 8, in the age group of 1 to less than 24 months, and up to 13 subjects in the age group of 2 to less than 4 years, will be taking 1 EIAEDs [that is, carbamazepine (CBZ), oxcarbazepine (OXC), phenytoin (PHT), or eslicarbazepine (ESL)] out of the maximum of 4 AEDs. The remaining participants cannot be taking any EIAEDs).
- Have been on their current concomitant AED(s) with a stable dose for at least 2 weeks or 5 half-lives, whichever is longer, before Visit 1
- Must have discontinued all restricted medications (example, medications known to be inducers of cytochrome P450 3A) at least 2 weeks or 5 half-lives (whichever is longer) before Visit 1
- If entering the Extension Phase, must have completed the last visit of the Maintenance Period of the Core Study
Exclusion Criteria:
- Have a history of status epilepticus that required hospitalization during the 3 months before Visit 1
- Have seizures due to treatable medical conditions, such as those arising due to metabolic disturbances, toxic exposure, or an active infection
- Have epilepsy secondary to progressive central nervous system (CNS) disease or any other progressive neurodegenerative disease, including tumors
- Have had epilepsy surgery within 1 year of Visit 1
- Are scheduled and/or confirmed to have epilepsy surgery within 6 months after Visit 1
- Used intermittent rescue benzodiazepines (i.e., 1 to 2 doses over a 24-hour period considered one-time rescue) 2 or more times in the 2 weeks before Visit 1
- Current use of felbamate, or any evidence of ongoing hepatic or bone marrow dysfunction associated with prior felbamate treatment. (Prior use of felbamate must be discontinued at least 8 weeks before Visit 1.)
- Current use of vigabatrin or any evidence of clinically significant vision abnormality associated with prior vigabatrin treatment. (Prior use of vigabatrin must be discontinued at least 2 weeks before Visit 1.)
- Are on ketogenic diet regimen that has not been stable for at least 4 weeks before Visit 1
- Concomitant use of other drugs known to influence the CNS, (other than AEDs for epilepsy), where the dose has not been stabilized for at least 5 half-lives or 2 weeks, whichever is longer, before Visit 1
- Have any concomitant illnesses/co-morbidities that could severely affect the participant's safety or study conduct
- Have evidence of clinically significant disease (e.g., cardiac, respiratory, gastrointestinal, renal disease) that in the opinion of the investigator(s) could affect the participant's safety or study conduct
- Have clinically significant laboratory abnormalities or any clinically acute or chronic disease
- Have evidence of significant active hepatic disease. Stable elevation of liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) due to concomitant medication(s), will be allowed if they are less than 3 times the upper limit of normal (ULN)
- Have clinical evidence of significant active hematological disease; white blood cell (WBC) count ≤2500/ microliter (μL) (2.50 x 10^9/Liter [L]) or an absolute neutrophil count ≤1000/μL (1.00 x 10^9/L)
- Have conditions that may interfere with their participation in the study and/or with the PK of study drug
- Have participated in a study involving administration of an investigational drug or device within 4 weeks before Visit 1, or within approximately 5 half-lives of the previous investigational compound, whichever is longer
- Have recently (within 30 days before Visit 1) been exposed to perampanel in a clinical study or by prescription, and/or previous discontinuation from perampanel treatment due to adverse events related to perampanel
- Have a clinically significant ECG abnormality, including prolonged corrected QT interval (QTc) defined as >450 milliseconds (msec)
- Have had multiple drug allergies or a severe drug reaction to an AED(s), including dermatological (e.g., Stevens-Johnson syndrome), hematological, or organ toxicity reactions
Sites / Locations
- Children's Hospital Los Angeles
- David Geffen School of Medicine at UCLA
- NW FL Clinical Research Group, LL-ClinEdge- PPDS
- Axcess Medical Research
- Pediatric Neurology PA
- Pediatric Epilepsy And Neurology Specialists
- Children's Healthcare of Atlanta
- Augusta University
- Carle Foundation Hospital
- University of Kentucky
- Children's Mercy Hospital
- Children's Hospital at Saint Peter's University Hospital
- Duke University Medical Center, Children's Health Center
- Atrium Health Wake Forest Baptist Medical Center PPDS
- Children's Hospital of Philadelphia
- Child Neurology Consultants of Austin
- Road Runner Research, Ltd
- Children's Clinical University Hospital
Arms of the Study
Arm 1
Experimental
Perampanel up to 12 or 16 mg/day
Pediatric participants, ranging from 1 month to less than 4 years of age, will receive perampanel oral suspension once a day in titration period starting at Week 0 at a dose of 0.50 mg per day (mg/day) titrated up to 4 mg/day (for participants taking non-EIAED) or up to 8 mg/day (for participants taking EIAED). Depending on participants clinical response, tolerability and investigator's decision, dose can be up titrated to 6 mg/day (for participants taking non-EIAED) and up titrated to 8 mg/day (for participants taking EIAED). Dose titration must not exceed 12 mg/day (non-EIAED) and 16 mg/day (EIAED). Participants will continue taking the perampanel oral suspension at dose level achieved at end of titration period through maintenance period of core study and maintenance period of extension phase (Up to Week 52).