Clinical Study of Lamotrigine to Treat Newly Diagnosed Typical Absence Seizure in Children and Adolescents

Overview[ - collapse ][ - ]

Purpose This is a multi-center, uncontrolled, open-label study to evaluate the efficacy and safety of lamotrigine monotherapy on newly diagnosed typical absence seizure in children and adolescents in Japan and South Korea. The study period is composed the baseline, fixed escalation phase, escalation phase, maintenance phase, taper phase, and post study examination. During the fixed escalation phase, the investigational product is administered at 0.3 mg/kg/day for 2 weeks (Week 1 to 2), followed by 0.6 mg/kg/day for 2 weeks (Week 3 to 4). Subjects thereafter visit the clinic once every 1 to 2 weeks during the escalation phase to increase the dose by 0.6 mg/kg/day up to a maximum of 10.2 mg/kg/day or 400 mg/day (whichever was less) until patients are confirmed to be seizure-free by HV tests for clinical signs. After seizure free is confirmed by HV-clinical signs, the dose is increased by one level and HV-EEG (electroencephalography) test (first test) is assessed at the next visit. If seizure free is observed by HV-EEG, the same dose is administered. Thereafter, HV-EEG (second test) is assessed at the next visit and if seizure free is confirmed again, the subjects enter the 12-week maintenance phase. During the maintenance phase, patients visit the clinic once every 4 weeks. The dose can be adjusted as necessary within the range of 1.2 to 10.2 mg/kg/day or 400 mg/day (whichever was less) taking into account the status of seizures and the safety. The investigational product is administered once daily (in the evening). However, if the number of tablets is large, twice-daily administration (in the morning and evening) is also allowed. After the completion of maintenance phase, subjects who have responded to lamotrigine without tolerability issues are eligible to enter the extension phase of the study if clinically indicated.
ConditionEpilepsy
InterventionDrug: Lamictal
PhasePhase 3
SponsorGlaxoSmithKline
Responsible PartyGlaxoSmithKline
ClinicalTrials.gov IdentifierNCT01431976
First ReceivedSeptember 1, 2011
Last UpdatedMarch 6, 2014
Last verifiedMarch 2014

Tracking Information[ + expand ][ + ]

First Received DateSeptember 1, 2011
Last Updated DateMarch 6, 2014
Start DateSeptember 2011
Estimated Primary Completion DateSeptember 2015
Current Primary Outcome Measures• Proportion of subjects seizure-free confirmed by HV-EEG at the end of the maintenance phase [Time Frame: This outcome is measured at the end of the maintenance phase (at the average of Week 32).] [Designated as safety issue: No]
Current Secondary Outcome Measures
  • • Proportion of subjects seizure-free confirmed by HV-EEG at the two consecutive visits in the escalation phase [Time Frame: This outcome is measured in the escalation phase (from Week 5 up to approximately Week 38).] [Designated as safety issue: No]
  • • Proportion of subjects seizure-free confirmed by HV-clinical signs at each visit during the escalation phase [Time Frame: This outcome is measured in the escalation phase (from Week 5 up to approximately Week 38).] [Designated as safety issue: No]
  • • Proportion of subjects seizure-free confirmed by HV-clinical signs during the maintenance phase [Time Frame: This outcome is measured in the maintenance phase (approximately from Week 38 to Week 50).] [Designated as safety issue: No]
  • • Number of days with seizure episodes on seizure diary per week [Time Frame: This outcome is measured in the escalation and the maintenance phase after start dosing up to approximately Week 50.] [Designated as safety issue: No]

Descriptive Information[ + expand ][ + ]

Brief TitleClinical Study of Lamotrigine to Treat Newly Diagnosed Typical Absence Seizure in Children and Adolescents
Official TitleA Multi-center, Uncontrolled, Open-label, Evaluation of Lamotrigine Monotherapy on Newly Diagnosed Typical Absence Seizures in Children and Adolescents
Brief Summary
This is a multi-center, uncontrolled, open-label study to evaluate the efficacy and safety
of lamotrigine monotherapy on newly diagnosed typical absence seizure in children and
adolescents in Japan and South Korea.

The study period is composed the baseline, fixed escalation phase, escalation phase,
maintenance phase, taper phase, and post study examination. During the fixed escalation
phase, the investigational product is administered at 0.3 mg/kg/day for 2 weeks (Week 1 to
2), followed by 0.6 mg/kg/day for 2 weeks (Week 3 to 4). Subjects thereafter visit the
clinic once every 1 to 2 weeks during the escalation phase to increase the dose by 0.6
mg/kg/day up to a maximum of 10.2 mg/kg/day or 400 mg/day (whichever was less) until
patients are confirmed to be seizure-free by HV tests for clinical signs. After seizure free
is confirmed by HV-clinical signs, the dose is increased by one level and HV-EEG
(electroencephalography) test (first test) is assessed at the next visit. If seizure free is
observed by HV-EEG, the same dose is administered. Thereafter, HV-EEG (second test) is
assessed at the next visit and if seizure free is confirmed again, the subjects enter the
12-week maintenance phase. During the maintenance phase, patients visit the clinic once
every 4 weeks. The dose can be adjusted as necessary within the range of 1.2 to 10.2
mg/kg/day or 400 mg/day (whichever was less) taking into account the status of seizures and
the safety. The investigational product is administered once daily (in the evening).
However, if the number of tablets is large, twice-daily administration (in the morning and
evening) is also allowed. After the completion of maintenance phase, subjects who have
responded to lamotrigine without tolerability issues are eligible to enter the extension
phase of the study if clinically indicated.
Detailed DescriptionNot Provided
Study TypeInterventional
Study PhasePhase 3
Study DesignAllocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionEpilepsy
InterventionDrug: Lamictal
No comparison
Study Arm (s)Experimental: Lamotrigine
No comparison

Recruitment Information[ + expand ][ + ]

Recruitment StatusActive, not recruiting
Estimated Enrollment20
Estimated Completion DateSeptember 2015
Estimated Primary Completion DateFebruary 2014
Eligibility Criteria
Inclusion Criteria:

1. Target disease: Subjects with newly diagnosed and untreated typical absence seizure
which is classifiable by the International Classification of Seizures.

2. Diagnosis of typical absence seizures is established by at least one of two 4-minute
hyperventilation tests as supported by clinical signs and EEG findings.

The following criteria will be used to define a typical absence seizure on the EEG: a
discharge of generalized spike-and-wave or multiple spike-and-wave activity lasting
≥3 seconds during the awake state. The frequency of the spike-and-wave should be
between 2.5-4.5 Hz.

3. Age (at the time of obtaining consent):

- 2 to 15 years of age in Japan

- 2 to 12 years of age in South Korea

4. Subjects must weigh at least 7 kg

5. Outpatients

6. Parent/guardian must have given written informed consent. Subjects who are
intellectually able to understand the concepts and procedures of the protocol must
give assent by also signing the consent.

7. Gender: Male or female

8. QTc<450 millisecond (msec) or <480msec for subjects with Bundle Branch Block - values
based on either single ECG values or triplicate ECG averaged QTc values obtained over
a brief recording period.

Exclusion Criteria:

1. Subjects with partial seizure or generalized seizures other than typical absence.

2. Subjects with a history of rash associated with other treatment.

3. Subjects with any clinically significant chronic cardiac, renal, or hepatic medical
condition. Any patient with these conditions will be excluded from the study even if
these conditions are being controlled with chronic therapy.

4. Subjects with an acute or chronic illness likely to impair drug absorption,
distribution, metabolism or excretion or with any unstable physical symptoms likely
to require hospitalization during participation in the study.

5. Subjects with a psychiatric disorder requiring medication, or who had psychiatric
conditions in the past that was both judged to be severe and required
hospitalization.

6. Subjects with an acute or progressive neurological disorder or an organic disease.

7. Subjects with currently taking any psychoactive drugs to treat hyperactivity disorder
or attention deficit disorder.

8. Subjects with an unstable liver disease (as defined by the presence of ascites,
encephalopathy, coagulopathy, hypoalbuminaemia, oesophageal or gastric varices or
persistent jaundice), cirrhosis, known biliary abnormalities (with the exception of
Gilbert's syndrome or asymptomatic gallstones).

9. Female subjects who are pregnant or lactating, who may be pregnant, or who plan for
pregnancy during the study.

10. Children in foster care: A child who has been placed under the control or protection
of an agency, organisation, institution or entity by the courts, the government or a
government body, acting in accordance with powers conferred on them by law or
regulation. This can include a child cared for by foster parents or living in a care
home or institution, provided that the arrangement falls within the definition above.
The definition of a child in care does not include a child who is adopted or who has
an appointed legal guardian.

11. Subjects taking inducers of lamotrigine glucuronidation (i.e., rifampicin,
lopinavir/ritonavir), atazanavir/ritonavir, risperidone, oral contraceptives or
hormone drug which includes estrogen.

12. Subjects having participated in other clinical study in the past 3 months before the
start of investigational product.

13. Subjects who have active suicidal plan/intent or have had active suicidal thoughts in
the past 3 months before the start of investigational product or who have history of
suicide attempt in the last 1 year before the start of investigational product or
more than 1 lifetime suicide attempt.

14. Subjects whom the investigator (or subinvestigator) considers ineligible for the
study.
GenderBoth
Ages2 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesJapan, Korea, Republic of

Administrative Information[ + expand ][ + ]

NCT Number NCT01431976
Other Study ID Numbers115377
Has Data Monitoring CommitteeNo
Information Provided ByGlaxoSmithKline
Study SponsorGlaxoSmithKline
CollaboratorsNot Provided
Investigators Study Director: GSK Clinical Trials GlaxoSmithKline
Verification DateMarch 2014

Locations[ + expand ][ + ]

GSK Investigational Site
Aichi, Japan, 453-8511
GSK Investigational Site
Ehime, Japan, 791-0295
GSK Investigational Site
Ehime, Japan, 790-8524
GSK Investigational Site
Fukuoka, Japan, 814-0180
GSK Investigational Site
Fukuoka, Japan, 807-8555
GSK Investigational Site
Hiroshima, Japan, 730-8518
GSK Investigational Site
Hokkaido, Japan, 006-0041
GSK Investigational Site
Hokkaido, Japan, 060-8648
GSK Investigational Site
Kanagawa, Japan, 232-8555
GSK Investigational Site
Niigata, Japan, 950-2085
GSK Investigational Site
Okayama, Japan, 700-8558
GSK Investigational Site
Shizuoka, Japan, 430-8558
GSK Investigational Site
Tokyo, Japan, 113-8603
GSK Investigational Site
Seoul, Korea, Republic of, 120-752