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EpilepsyPhase 3NCT00477295

A Double-blind Study to Compare the Efficacy and Safety of Zonisamide and Carbamazepine as Monotherapy, in Newly Diagnosed Partial Epilepsy

A Phase 3 study testing Zonisamide and Carbamazepine in people with Epilepsy, run by Eisai Inc. at 79 sites in 18 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a two-arm, randomized, double-blind, non-inferiority study using a flexible dosing regime to allow optimal zonisamide or carbamazepine therapy for individual subjects. Assessment of eligibility will take place at the Screening Visit. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Epilepsy
What is being tested?
Zonisamide and Carbamazepine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
583 participants
Where
79 sitesin 18 countries
Study dates
May 2007to Jan 2011
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subjects will be eligible for the study if they meet all of the following inclusion criteria:
  • Male or female subjects, 18 to 75 years of age inclusive.
  • Subjects with untreated, newly diagnosed epilepsy having at least two well documented, unprovoked, clinically evaluated and classified partial seizures (with or without secondary generalization) or generalized tonic-clonic seizures (without clear focal origin) within 12 months of the Screening Visit, of which at least one seizure occurred within three months of the Screening Visit (> one seizure within a 24 hour period will be counted as one seizure).
  • Subjects will either have had no previous use of an AED, or treatment with one AED for a maximum duration of two weeks before the Randomization Visit (T1).
  • Subjects have a documented electroencephalogram (EEG) within 12 months of the Screening Visit, compatible with localization-related epilepsy (to exclude primary generalized epilepsy).
  • Subjects have a documented computed axial tomography (CAT) scan or magnetic resonance imaging (MRI) scan confirming the absence of a progressive neurological lesion within 12 months of the Screening Visit.
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  • Female subjects without childbearing potential (two years post-menopausal, bilateral oophorectomy or tubal ligation, complete hysterectomy) are eligible. Female subjects with childbearing potential must not be pregnant as confirmed by a negative pregnancy test at screening and randomization, must not be lactating and must be using a medically acceptable form of contraception, for the duration of the study and for one month following discontinuation of the study drug. Medically acceptable contraception is defined here as oral contraception pill with at least 50 micrograms ethinylestradiol per intake, contraceptive injections and implants, or intrauterine device in place for at least three months.
  • Subjects who are able and willing to follow investigational study procedures, maintain a seizure diary, and report AEs.
  • Subjects who are able and willing to give written informed consent.

Who cannot join

  • Subjects who meet any of the following exclusion criteria will not be eligible for the study:
  • Subjects have a history of clinical investigations, including EEG data, that are suggestive of idiopathic generalised epilepsy as defined by the International League Against Epilepsy (ILAE).
  • Subjects with a history of absence, myoclonic, clonic, tonic, or atonic seizures.
  • Subjects have a history of status epilepticus, and/or non-epileptic seizures (e.g., metabolic, pseudo-seizures).
  • Subjects have experienced seizures relating to drugs, alcohol, acute medical illness, mental retardation, or subjects with situation-related seizures.
  • Subjects have progressive encephalopathy or findings consistent with progressive CNS disease or lesion (e.g. infection, demyelination, or tumour).
Show all 19Show fewer
  • Subjects have a history of a significant or currently uncontrolled disease that will interfere with the conduct of this study or the assessment of safety and efficacy of the study drug.
  • Subjects have been previously treated with carbamazepine or zonisamide.
  • Subjects have received an investigational drug or device in the three months prior to the Screening Visit.
  • Subjects have a known hypersensitivity to sulfonamides, dibenzazepine derivatives, or tricyclic antidepressants.
  • Subjects have a history of bone marrow depression, low platelet count or other blood dyscrasia.
  • Subjects have a history of acute intermittent porphyria.
  • Subjects have a history of renal disorder (serum creatinine level of > 135 ìmol / l (1.5 mg/dL at the Screening Visit), hepatic disorder or clinically significant abnormal liver function tests; aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >2 times the upper normal limit.
  • Subjects have a body weight of less than 40 kg.
  • Subjects have a history of progressive malignancy within the previous 5 years (excluding a history of non-metastasized and adequately treated cutaneous squamous cell carcinoma).
  • Subjects have a history of psychiatric illness or mood disorder requiring electro-convulsive or drug therapy within the previous 6 months which is considered uncontrolled; a history of suicide attempt; alcohol or drug abuse; chronic treatment with benzodiazepines or barbiturates.
  • Subjects are currently taking carbonic anhydrase inhibitors.
  • Subjects have a history of pancreatitis, nephrolithiasis or hypercalcuria, clinically significant laboratory or electro-cardiographic abnormalities, or uncontrolled hypertension.
  • Subjects are currently taking mono-amine oxidase inhibitors (MAOIs) or any other excluded medications.

Trial locations and contacts

79 sites in 18 countries.

79 sites in 18 countries

Poland9 sites
  • Study site

    Gdansk

  • Study site

    Katowice

  • Study site

    Krakow

  • Study site

    Lodz

  • Study site

    Lublin

  • Study site

    Poznan

  • Study site

    Sosnowiec

  • Study site

    Szcecin

  • Study site

    Warsaw

Other trials in Poland

Australia8 sites
  • Study site

    Camperdown

  • Study site

    Clayton

  • Study site

    Fitzroy

  • Study site

    Flinders

  • Study site

    Heidelberg West

  • Study site

    Parkville

  • Study site

    Queensland

  • Study site

    Wellington

Other trials in Australia

Spain7 sites
  • Study site

    Alicante

  • Study site

    Bacelona

  • Study site

    Barcelona

  • Study site

    Madrid

  • Study site

    Málaga

  • Study site

    Oviedo

  • Study site

    Seville

Other trials in Spain

Germany6 sites
  • Study site

    Berlin

  • Study site

    Bochum

  • Study site

    Düsseldorf

  • Study site

    Munich

  • Study site

    Schwerin

  • Study site

    Westerstede

Other trials in Germany

Hungary6 sites
  • Study site

    Budapest

  • Study site

    Debrecen

  • Study site

    Gyula

  • Study site

    Hódmezővásárhely

  • Study site

    Nyregyhaza

  • Study site

    Zalaegerszeg-Pozva

Other trials in Hungary

India6 sites
  • Study site

    Bangalore

  • Study site

    Hyderabad

  • Study site

    Koturpuram

  • Study site

    Madurai

  • Study site

    New Delhi

  • Study site

    Pune

Other trials in India

Slovakia6 sites
  • Study site

    Bratislava

  • Study site

    Bratslava

  • Study site

    Brezno

  • Study site

    Nové Zámky

  • Study site

    Vranov nad Topľou

  • Study site

    Žilina

Other trials in Slovakia

Russia5 sites
  • Study site

    Kaliningrad

  • Study site

    Kazan'

  • Study site

    Moscow

  • Study site

    Saint Petersburg

  • Study site

    Yaroslavl

Other trials in Russia

France4 sites
  • Study site

    Béthune

  • Study site

    Dijon

  • Study site

    Paris

  • Study site

    Saint-Etienne

Other trials in France

Italy4 sites
  • Study site

    Milan

  • Study site

    Monza

  • Study site

    Orbassano

  • Study site

    Rome

Other trials in Italy

Serbia4 sites
  • Study site

    Belgrade

  • Study site

    Niš

  • Study site

    Novi Sad

  • Study site

    Subotica

Other trials in Serbia

South Korea3 sites
  • Study site

    Anyang

  • Study site

    Seoul

  • Study site

    Wŏnju

Other trials in South Korea

United Kingdom3 sites
  • Study site

    Bristol

  • Study site

    Liverpool

  • Study site

    Treliske

Other trials in United Kingdom

Greece2 sites
  • Study site

    Athens

  • Study site

    Thessaloniki

Other trials in Greece

Sweden2 sites
  • Study site

    Gothenburg

  • Study site

    Lund

Other trials in Sweden

Taiwan2 sites
  • Study site

    Changhua

  • Study site

    Yongkang District

Other trials in Taiwan

Denmark1 site
  • Study site

    Aalborg

Other trials in Denmark

South Africa1 site
  • Study site

    Sandton

Other trials in South Africa

About this study

Official title: A Randomized, Multi-centre, Double-blind Study, to Compare the Efficacy and Safety of Zonisamide and Carbamazepine as Monotherapy, in Newly Diagnosed Partial Epilepsy

This is a two-arm, randomized, double-blind, non-inferiority study using a flexible dosing regime to allow optimal zonisamide or carbamazepine therapy for individual subjects. Assessment of eligibility will take place at the Screening Visit. The subjects will be randomized to either the carbamazepine or zonisamide arm at the Randomization Visit (T1). T1 must occur as soon as possible (and at least within 14 days) of the Screening Visit in order to optimize subject care.

Conditions
Epilepsy
Being tested
Zonisamide, Carbamazepine
Keywords
Epilepsy
Medical subject headings
Epilepsy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ZonisamideDrug

    Also called Zonegran

    Week 1 and 2 either 100mg zonisamide or 200 mg carbamazepine Week 3 and 4 either 200mg zonisamide or 4800 mg carbamazepine Week 5 and 6 either 300mg zonisamide or 600 mg carbamazepine; this dose then to be maintained unless a subject has a seizure more than two weeks post a dose increase.

  • CarbamazepineDrug

    Week 1 and 2 either 100mg zonisamide or 200 mg carbamazepine Week 3 and 4 either 200mg zonisamide or 4800 mg carbamazepine Week 5 and 6 either 300mg zonisamide or 600 mg carbamazepine; this dose then to be maintained unless a subject has a seizure more than two weeks post a dose increase.

Study groups in NCT00477295
Study groupRoleWhat they receive
ZonisamideActive comparatorNot described
Receives: Drug: Zonisamide
CarbamazepineActive comparatorNot described
Receives: Drug: Carbamazepine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants Who Experienced Seizure Freedom for 26-weeks During the Maintenance Phase

    A subject achieved a 26-week seizure-free period if they were free of all seizures, regardless of seizure type, for 26 weeks while receiving the same dose. The occurrence of seizures was documented in the seizure diary, which was maintained by the subject and reviewed at each following visit.

    Measured: Week 31 through Week 109

Secondary outcomes (10)
  1. Percentage of Participants Who Experienced Seizure Freedom for 12-months During the FDP and Maintenance Period

    A subject achieved a 12-month seizure-free period if they were free of all seizures, regardless of seizure type, for 12 months while receiving the same dose. The occurrence of seizures was documented in the seizure diary, which was maintained by the subject and reviewed at each following visit.

    Measured: Week 5 through Week 109

  2. Analysis of Time to Drop Out Due to an Adverse Event (AE)

    An AE is defined as any untoward medical occurrence in a subject and does not necessarily have a causal relationship with the medicinal product. Adverse events were identified by: any unfavorable or unintended sign, symptom or disease temporarily associated with the use of a medicinal product; any new disease or exacerbation of an existing disease; any deterioration in nonprotocol-required measurements of laboratory values or other clinical test; and recurrence of an intermittent medical condition not present at Baseline.

    Measured: Week 1 through Week 109

  3. Analysis of Time to Drop Out Due to Lack of Efficacy

    Lack of efficacy was evaluated by the subject and on the basis of whether zonisamide and carbamazepine gave the subject at least a 26-week seizure free rate. The subject could withdraw at any time due to lack of efficacy.

    Measured: Week 1 through Week 109

  4. Time to 6-months Seizure Freedom

    A subject achieved a 6-months seizure-free period if they were free of all seizures, regardless of seizure type, for 6-months while receiving the same dose. The occurrence of seizures was documented in the seizure diary, which was maintained by the subject and reviewed at each following visit.

    Measured: Week 5 through Week 83

  5. Time to 12-months Seizure Freedom

    A subject achieved a 12-month seizure-free period if they were free of all seizures, regardless of seizure type, for 12-months while receiving the same dose. The occurrence of seizures was documented in the seizure diary, which was maintained by the subject and reviewed at each following visit.

    Measured: Week 5 through Week 83

  6. Change From Baseline in Total ABNAS Score at Maintenance Period Visit 1

    The Aldenkamp-Baker Neuropsychological Assessment Scale(ABNAS) is a subject based questionnaire to measure subjective perceived drug-related cognitive impairments. The ABNAS measured seven critical domains of cognition(tiredness/fatigue,hyperexcitability, slowing(mental and motor),memory impairment,attention disorders,impairment of motor coordination, and language disorders). The total score ranged from 0 to 72, with a higher score reflecting a high level of problems.

    Measured: Baseline and Maintenance Period Visit 1 (Week 31 to Week 83)

  7. Change From Baseline in Bond and Lader VAS Mood Sub-Scores at Maintenance Period Visit 1

    The Bond-Lader Visual Analogue Scale (VAS) is made up of 16 pairs of alternative descriptors of mood and attention at either end of a 10 cm line.

    Subjects were asked to rate their feelings at the time of assessment by indicating the point on the line which best represent their mood. Each item was scored by measuring the position relative to the left hand end of the line and levels of anxiety, sedation, and dysphoria were then calculated from the combined scores of selected items. The scores ranged from 0 to 100, with a high score reflecting a high level of anxiety, sedation or dysphoria.

    Measured: Baseline and Maintenance Period Visit 1 (Week 31 to Week 83)

  8. Change From Baseline in QOLIE-31-P Overall Score at Maintenance Period Visit 1

    The Quality of Life in Epilepsy - Problems(QOLIE-31-P) was completed by the patient and contained 30 items covering seven subscales(seizure worry, overall

    Quality of Life (QOL),emotional well-being,energy-fatigue, cognition,medication effects and social function) and one item covering health status. It also included seven items addressing overall distress related to each subscale, an item addressing the relative importance of each subscale topic, and an item addressing perception of overall change in QOL at the end of the study. A high score reflects a good QOL. The following scale range is a sample of 1 of the 7 of the subscales:

    10 (Best possible quality of life) - 0 (Worst possible quality of life);

    Rand Corporation QOLIE-31 Scoring Manual was used. The QOLIE-31 overall score is calculated by summing the product of each scale score times its weight and summing overall all scales.

    Measured: Baseline and Maintenance Period Visit 1 (Week 31 to Week 83)

  9. Change From Baseline in SF-36 Aggregate Mental and Physical Component Score at Maintenance Period Visit 1

    The Short Form 36 Health and Well-Being Questionnaire (SF-36) is a 36-item generic health related QOL instrument covering the following domains: physical functioning, role-physical,bodily pain, general health, social functioning,role-emotional, mental health, and vitality. It yields a profile of eight scores, one for each domain, and physical and mental health summary measures. Each domain is described by a score ranging from 0 to 100, for a range of total possible scoes of 0-400 for physical and 0-400 for mental. An increase represents an improvement, whereas a decrease reflects a worsening.

    Measured: Baseline and Maintenance Period Visit 1 (Week 31 to Week 83)

  10. Percentage of Participants With EQ-5D Scores at Maintenance Period Visit 1

    The European Quality of Life Group 5-Dimension Self-Report Questionnaire (EQ-5D) is a preference based generic health related quality of life (HRQoL) instrument which classifies health states across five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each domain has three levels, they are (1) no problems, (2) some problems, (3) extreme problems. The percentages shown are calculated from the number of subjects at that visit with non-missing data for that score.

    Measured: Week 31 through Week 83

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 May 2007 (estimated)
  2. Study startMay 2007
  3. Primary completionDec 2010
  4. Study completionJan 2011

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
583 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00477295
Sponsor's protocol ID
E2090-E044-310
Other IDs
2006-000156-40
Status last verified
Nov 2015
First submitted
21 May 2007
Last updated
24 Dec 2015

Publications

  • Baulac M, Brodie MJ, Patten A, Segieth J, Giorgi L. Efficacy and tolerability of zonisamide versus controlled-release carbamazepine for newly diagnosed partial epilepsy: a phase 3, randomised, double-blind, non-inferiority trial. Lancet Neurol. 2012 Jul;11(7):579-88. doi: 10.1016/S1474-4422(12)70105-9. Epub 2012 Jun 8.

    PubMed 22683226

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Zonisamide and Carbamazepine in people with Epilepsy, run by Eisai Inc. at 79 sites in 18 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Dec 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 79 sites in Poland, Australia, Spain, Germany, Hungary and 13 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Feb 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants Who Experienced Seizure Freedom for 26-weeks During the Maintenance Phase (time frame: Week 31 through Week 109). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00477295, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Dec 2015.

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Clinical Trial NCT00477295 | AzTrials