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Topiramate for the Prophylactic Treatment of Cyclic Vomiting Syndrome in Children

Primary Purpose

Vomiting

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Topiramate
Sponsored by
Monarch Medical Research
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional prevention trial for Vomiting focused on measuring Preventative, Open-Label, Safety/Efficacy

Eligibility Criteria

4 Years - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Meet the2004 ICHD Criteria for Cyclical Vomiting. 1 vomiting attack lasting > 24 hours duration for 3 consecutive months 4-12 years of age. If female, subjects must: be premenarchal or otherwise incapable of pregnancy, or have practiced one of the following methods of contraception for at least one month prior to study entry: hormonal contraceptives, spermicide and barrier, intrauterine device, partner sterility, or be practicing abstinence and agree to continue abstinence or to use an acceptable method of contraception (as listed above) should sexual activity commence. Able to take oral medication in tablet form or sprinkle form Subjects or their guardians must be willing and able to: a) read and comprehend written instructions, b) complete the assessment forms, c) return for regular visits, and d) adhere to medication regimens. Subjects (or their legally acceptable representative) must have signed an informed consent document Exclusion Criteria Have taken topiramate within 14 days prior to the start of the prospective baseline period. Have taken certain medications for cyclical vomiting prophylaxis Have progressive neurological disorder or a structural disorder of the brain from birth, trauma or past infection. Subjects who have taken any medications for migraine prophylaxis, within 2 weeks of the start of the prospective baseline period. Subjects starting non-pharmacologic prophylactic approaches (e.g., acupuncture, biofeedback, chiropractic methods) within 1 month prior to Visit 1. Require continuing treatment with anticonvulsant therapy for a non-migraine condition. Significant major psychiatric disorder (e.g., major depression) or subjects receiving anti-psychotic medication. History of attempted suicide or suicidal tendencies. History of substance abuse. Pregnant or lactating females. Have clinically unstable neurological, cardiovascular, gastrointestinal, musculoskeletal, pulmonary or other disease. Have any disease or condition that could compromise the function of those body systems that could result in altered absorption, excess accumulation, or impaired metabolism or excretion of the test medications (e.g., abnormal renal and/or hepatic function). Have active liver disease. Have received an investigational drug or used an investigational device within 30 days of study entry. Employees of the investigator, study center, or sponsor (i.e., principal investigator, sub-investigator(s), study coordinators, other study staff, employees, or contractors of each), with direct involvement in the proposed study or other studies under the direction of that investigator, study center or sponsor, as well as family members of the employees or the investigator.

Sites / Locations

  • Monarch Medical Research - Child and Adolescent Neurology

Outcomes

Primary Outcome Measures

Reduction of cycle frequency as measured by number of days between cycles.

Secondary Outcome Measures

Decreased duration of attacks (measured in hours)
Decreased intensity of attacks (0-4 point scale; none, mild, moderate, severe, excruciating)
Decreased associated symptoms (0-4 point scales; none, mild, moderate, severe, excruciating)
Nausea
Vomiting
Headache
Abdominal pain
Decreased disability
PedMidas
Missed school (days per attack)
Missed work (parent(s)) (days per attack)
Decreased use of acute therapies (e.g. anti-emetics)
Decreased emergency department visits.

Full Information

First Posted
February 1, 2006
Last Updated
January 5, 2011
Sponsor
Monarch Medical Research
Collaborators
Ortho-McNeil Neurologics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00286988
Brief Title
Topiramate for the Prophylactic Treatment of Cyclic Vomiting Syndrome in Children
Official Title
Topiramate for the Prophylactic Treatment of Cyclic Vomiting Syndrome in Children
Study Type
Interventional

2. Study Status

Record Verification Date
April 2007
Overall Recruitment Status
Terminated
Why Stopped
Insufficient potential subjects
Study Start Date
March 2006 (undefined)
Primary Completion Date
May 2007 (Actual)
Study Completion Date
June 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Monarch Medical Research
Collaborators
Ortho-McNeil Neurologics, Inc.

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to assess the effectiveness, tolerability and safety of oral topiramate for the preventative management of Cyclic Vomiting Syndrome. It is believed that topiramate will decrease the frequency, duration and severity of attacks experienced by children and adolescents with Cyclic Vomiting Syndrome.
Detailed Description
There is very little controlled data on the preventative treatment for Cyclic Vomiting Syndrome. The existing evidence consists of small, retrospective clinical series that evaluate symptomatic responses to five medications including cyproheptadine, propranolol, amitriptyline, phenobarbital and pizotifen (n >10). These published data consist of uncontrolled or retrospective reports. In addition, varying inclusion criteria and outcomes (i.e. obtained by family recall) were used in these studies limiting the basis upon which to compare relative effectiveness. During the prospective baseline period, the subject will maintain cyclical vomiting records in which all headache occurrences will be recorded and characterized. (Cyclical vomiting records will be maintained throughout the study). The purpose of this study is to assess the effectiveness, tolerability and safety of oral topiramate for the preventative management of Cyclic Vomiting Syndrome using a prospective design, established diagnostic criteria (ICHD 2004), and defined, objective primary and secondary endpoints.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vomiting
Keywords
Preventative, Open-Label, Safety/Efficacy

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Topiramate
Primary Outcome Measure Information:
Title
Reduction of cycle frequency as measured by number of days between cycles.
Secondary Outcome Measure Information:
Title
Decreased duration of attacks (measured in hours)
Title
Decreased intensity of attacks (0-4 point scale; none, mild, moderate, severe, excruciating)
Title
Decreased associated symptoms (0-4 point scales; none, mild, moderate, severe, excruciating)
Title
Nausea
Title
Vomiting
Title
Headache
Title
Abdominal pain
Title
Decreased disability
Title
PedMidas
Title
Missed school (days per attack)
Title
Missed work (parent(s)) (days per attack)
Title
Decreased use of acute therapies (e.g. anti-emetics)
Title
Decreased emergency department visits.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Meet the2004 ICHD Criteria for Cyclical Vomiting. 1 vomiting attack lasting > 24 hours duration for 3 consecutive months 4-12 years of age. If female, subjects must: be premenarchal or otherwise incapable of pregnancy, or have practiced one of the following methods of contraception for at least one month prior to study entry: hormonal contraceptives, spermicide and barrier, intrauterine device, partner sterility, or be practicing abstinence and agree to continue abstinence or to use an acceptable method of contraception (as listed above) should sexual activity commence. Able to take oral medication in tablet form or sprinkle form Subjects or their guardians must be willing and able to: a) read and comprehend written instructions, b) complete the assessment forms, c) return for regular visits, and d) adhere to medication regimens. Subjects (or their legally acceptable representative) must have signed an informed consent document Exclusion Criteria Have taken topiramate within 14 days prior to the start of the prospective baseline period. Have taken certain medications for cyclical vomiting prophylaxis Have progressive neurological disorder or a structural disorder of the brain from birth, trauma or past infection. Subjects who have taken any medications for migraine prophylaxis, within 2 weeks of the start of the prospective baseline period. Subjects starting non-pharmacologic prophylactic approaches (e.g., acupuncture, biofeedback, chiropractic methods) within 1 month prior to Visit 1. Require continuing treatment with anticonvulsant therapy for a non-migraine condition. Significant major psychiatric disorder (e.g., major depression) or subjects receiving anti-psychotic medication. History of attempted suicide or suicidal tendencies. History of substance abuse. Pregnant or lactating females. Have clinically unstable neurological, cardiovascular, gastrointestinal, musculoskeletal, pulmonary or other disease. Have any disease or condition that could compromise the function of those body systems that could result in altered absorption, excess accumulation, or impaired metabolism or excretion of the test medications (e.g., abnormal renal and/or hepatic function). Have active liver disease. Have received an investigational drug or used an investigational device within 30 days of study entry. Employees of the investigator, study center, or sponsor (i.e., principal investigator, sub-investigator(s), study coordinators, other study staff, employees, or contractors of each), with direct involvement in the proposed study or other studies under the direction of that investigator, study center or sponsor, as well as family members of the employees or the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald W Lewis, MD
Organizational Affiliation
Monarch Medical Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Monarch Medical Research - Child and Adolescent Neurology
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23510
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
14024194
Citation
CULLEN KJ, MA CDONALD WB. The periodic syndrome: its nature and prevalence. Med J Aust. 1963 Aug 3;50(2):167-73. No abstract available.
Results Reference
background
PubMed Identifier
7618907
Citation
Abu-Arafeh I, Russell G. Prevalence and clinical features of abdominal migraine compared with those of migraine headache. Arch Dis Child. 1995 May;72(5):413-7. doi: 10.1136/adc.72.5.413.
Results Reference
background
Links:
URL
http://www.cvsaonline.org
Description
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Topiramate for the Prophylactic Treatment of Cyclic Vomiting Syndrome in Children

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