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EpilepsyPhase 2NCT03179891

Study of Diazepam Buccal Film Administered in the Interictal and in the Ictal-Periictal States to Adults With Epilepsy

A Phase 2 study testing Diazepam Buccal Film 12.5 mg in people with Epilepsy, run by Aquestive Therapeutics at 11 sites in United States.

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 Phase 2 open-label, two-way study was conducted in adult subjects with epilepsy who were on stable regimens of anti-epileptic drugs (AEDs) and who were admitted to an Epilepsy Monitoring Unit (EMU), General Clinical Research Center (GCRC), or similar facility for evaluation of their seizures. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Epilepsy
What is being tested?
Diazepam Buccal Film 12.5 mg
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
11 sitesUnited States
Study dates
25 May 2017to 21 Dec 2018
Phase
Phase 2
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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Potential subjects meeting all of the following criteria may be included in the study:
  • Subjects scheduled for admission to the institution's EMU, GCRC (General Clinical Research Center) or similar facility for evaluation within 28 days.
  • Male and female subjects between 18 to 65 years of age, inclusive.
  • Subjects having a body weight of ≥ 40 kg to 111 kg.
  • Subjects have a clinical diagnosis of epilepsy and are scheduled to be admitted to an Epilepsy Monitoring Unit (EMU) for extracranial video-Electroencephalogram (EEG) recording of a seizure event for evaluation of their epilepsy.
  • Subjects have an average frequency of > 1 seizure every 3 days or > 10 seizures / month as documented by seizure diaries dispensed at the Screening Visit and verified prior to initiation of Period A or Period B.
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  • Female subjects have a negative serum pregnancy test at Screening. Female subjects of childbearing potential (i.e., not surgically sterile or 2 years postmenopausal) must have a negative pregnancy test at screening and a partner who is sterile, agree to abstinence, be practicing double barrier contraception or using an FDA approved contraceptive (e.g., licensed hormonal or barrier methods) for greater than 2 months prior to screening visit and commit to an acceptable form of birth control for the duration of the study and for 30 days after participation in the study.
  • Subjects are currently receiving at least one antiepileptic medication.
  • Subjects or subject's legally authorized representative (LAR) must be willing and able to complete informed consent/assent and HIPAA authorization.
  • Subjects must agree and must be willing to comply with all required study procedures while in the EMU or GCRC.
  • Ability to comprehend and be informed of the nature of the study, as assessed by the PI or Sub-Investigator.
  • Ability to consume standard meals.
  • Availability to volunteer for the entire study duration and willing to adhere to all protocol requirements.

Who cannot join

  • Potential subjects meeting any of the following criteria will be excluded:
  • Subjects having a progressive neurological disorder such as brain tumor, demyelinating disease, or degenerative central nervous system (CNS) disease that is likely to progress in the next 12 months.
  • Subjects having respiratory failure (or is at risk for respiratory failure) or other severe cardiorespiratory disease with New York Heart Association Class III or IV functional status, or requires supplemental oxygen.
  • Female subjects who are lactating or positive serum pregnancy test (ß-hCG) at screening for female subjects ≥12 years of age.
  • Subjects with severe psychiatric disease that in the Investigator's judgment would prevent the patient's successful completion of the study.
  • Subjects who have an episode of status epilepticus, as determined by the Principal Investigator/Sub-Investigator, at any time during Period B (EMU, GCRC or similar facility Visit
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  • Subjects with known history or presence of any clinically significant hepatic (e.g. hepatic impairment), renal/genitourinary (renal impairment, kidney stones), psychiatric, dermatological or hematological disease or condition unless determined as not clinically significant by the Principal Investigator/Sub-Investigator and confirmed by Sponsor via written communication prior to subject enrollment.
  • Subjects with any clinically significant illness other than epilepsy within 30 days prior to first dosing, as determined by the Principal Investigator/Sub-Investigator.
  • Subjects with any significant physical or organ abnormality as determined by the Principal Investigator/Sub-Investigator.
  • Subjects with any significant lesion of the oral cavity or having oral prophylactic procedures within 30 days prior to first dosing.
  • Subjects with a QTc interval QTcF>450 msec for males and QTcF>470 msec for females on screening ECG, unless determined as not clinically significant by the Investigator.
  • Subjects with a positive test result for any of the following: drugs of abuse (amphetamines, cocaine, opiates, or phencyclidine), a positive breath alcohol test.
  • Subjects with a known history or presence of: a. Alcohol abuse or dependence within one year prior to first drug administration; b. Drug abuse or dependence; c. Hypersensitivity or idiosyncratic reaction to diazepam, its excipients, sodium phosphates; and/or related substances, e.g. benzodiazepines; d. Glaucoma (open or acute narrow angle); e. Severe allergic reactions (e.g. anaphylactic reactions, angioedema
  • Subjects who have participated in another clinical trial or who received an investigational drug within 30 days prior to first drug administration or 5 half-lives of the investigational drug-whichever is the longer period.
  • Blood or plasma donation within 30 days prior to Screening
  • Subjects not willing or unable to tolerate blood draws.
  • Subjects who have received any other dosage form of diazepam or benzodiazepines within 2 weeks prior to entering Period A or Period B.
  • Consumption of alcohol within 48 hours before dosing and food or beverages containing grapefruit, star fruit, Seville oranges, and/or pomelo or their derived products (e.g., fruit juice) within 10 days prior to first drug administration.
  • Use of any enzyme-modifying drugs, including strong inhibitors of cytochrome P450 (CYP) enzymes (e.g. cimetidine, fluoxetine, quinidine, erythromycin, ciprofloxacin, fluconazole, ketoconazole, diltiazem, or HIV antivirals) and strong inducers of CYP enzymes (e.g. glucocorticoids, St. John´s Wort, or rifampicin) in the previous 30 days before first drug administration [barbiturates, carbamazepine, and phenytoin are allowed since these are common AEDs (Anti-epileptic drugs)].
  • Use of any monoamine oxidase (MAO) inhibitors (e.g. phenelzine, tranylcypromine), phenothiazines (chlorpromazine) within 30 days prior to first drug administration.
  • Employee or immediate relative of an employee of the investigator, MonoSol Rx LLC, any of its affiliates or partners, or inVentiv Health.

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • Austin Epilepsy Care Center

    Austin, Texas, 78758

  • Mid-Atlantic Epilepsy and Sleep Center

    Bethesda, Maryland, 20817

  • Onsite Clinical Solutions LLC

    Charlotte, North Carolina, 28203

  • Rancho Research Institute

    Downey, California, 90242

  • Hawaii Pacific Neuroscience

    Honolulu, Hawaii, 96817

  • Saint Peter's University Hospital

    New Brunswick, New Jersey, 08901

  • Yale University School of Medicine-Comprehensive Epilepsy Center

    New Haven, Connecticut, 06520-8018

  • Hospital of the University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Virginia Commonwealth University Medical Center

    Richmond, Virginia, 23219

  • University of Rochester Medical Center

    Rochester, New York, 14642

  • Arizona Health Sciences Center

    Tucson, Arizona, 85724-5023

Other trials in United States

About this study

Official title: A Multicenter, Open Label, Crossover Study to Assess the Pharmacokinetics and Safety of Diazepam Buccal Soluble Film (DBSF) in Adult Subjects With Epilepsy

This Phase 2 open-label, two-way study was conducted in adult subjects with epilepsy who were on stable regimens of anti-epileptic drugs (AEDs) and who were admitted to an Epilepsy Monitoring Unit (EMU), General Clinical Research Center (GCRC), or similar facility for evaluation of their seizures. All subjects received a single DBF 12.5 mg dose during the Interictal State and a single DBF 12.5 mg dose during the Ictal/peri-ictal state with at least 14 days washout between the 2 doses.

Read the detailed description

This was a Phase 2 multicenter, open-label, two-way study conducted in adult subjects to assess the bioavailability, pharmacokinetics, and safety of DBF during the Interictal Period and during the Ictal/peri-ictal Period, with a minimum of 14 days of washout between periods. Subjects had a clinical diagnosis of epilepsy (with generalized tonic-clonic seizures or focal seizures with impaired awareness) who were on stable regimens of anti-epileptic drugs and were scheduled for admission to an EMU, GCRC, or similar facility for evaluation.

All subjects were to receive a single 12.5-mg dose of study drug, without regard to meals, during both Interictal Period and Ictal/peri-ictal Period. The treatment was identical for both periods. Treatment sequence was not randomized. The interictal period and ictal/peri-ictal could occur in either order as determined by seizure occurrence.

Interictal Period: Subjects were considered to be in an interictal state if an interval of at least 3 hours had elapsed since any clinically observable postictal signs or symptoms (from the last observed seizure) and the subject had been seizure-free over this period. Subjects on electroencephalogram (EEG) video monitoring were to be considered to be in an interictal state if an interval of at least 3 hours had elapsed since there were any postictal electrical findings on EEG.

Ictal/peri-ictal Period: For the purposes of this study, the ictal state was defined as an ongoing clinically observable seizure or seizure activity as verified via EEG. The periictal state was defined clinically as the subject's immediate postictal state following a generalized tonic-clonic (GTC) seizure or focal seizure with impaired awareness, and within 5 minutes following the last clonic jerk. For subjects on EEG video monitoring, the periictal state was to be defined as less than 5 minutes after cessation of seizure activity as verified via EEG.

Conditions
Epilepsy
Being tested
Diazepam Buccal Film 12.5 mg
Keywords
Interictal, Ictal/peri-ictal
Medical subject headings
Epilepsy

What participants receive

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

  • Diazepam Buccal Film 12.5 mgDrug

    Also called DBF 12.5mg

    All subjects received a single dose of DBF 12.5 mg during the interictal state and during the ictal/peri-ictal state with at least 14 days washout between the 2 treatment periods

Study groups in NCT03179891
Study groupRoleWhat they receive
Interictal PeriodExperimentalAll subjects received 12.5 mg DBF during the interictal state.
Receives: Drug: Diazepam Buccal Film 12.5 mg
Ictal/Peri-ictal PeriodExperimentalAll subjects received 12.5 mg DBF during the ictal/peri-ictal state.
Receives: Drug: Diazepam Buccal Film 12.5 mg

What is being measured

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

  1. Tmax Pharmacokinetic EndPoints

    Observed time to reach maximum drug concentration (Tmax)

    Measured: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours

  2. Cmax Pharmacokinetic EndPoints

    Observed Peak Drug Concentration (Cmax)

    Measured: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours

  3. Area Under the Plasma Concentration Curve Pharmacokinetic EndPoints

    Area under the Plasma Concentration -time curve from time zero until the last measured time (AUC0-t)

    Measured: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours

Secondary outcomes (5)
  1. Usability Endpoint - Successful Insertion/Placement of the Diazepam Buccal Film (DBF) on First Attempt

    Number of subjects with unsuccessful insertion/placement of the DBF on first attempt at administration Number of subjects with successful insertion/placement of the DBF on first attempt at administration

    Placement is judged to be successful when film adheres to the center of buccal mucosa of either right or left cheek.

    Unsuccessful placements were followed by a subsequent successful insertion/placement of DBF

    Measured: Subject was observed for 15 minutes after initial film placement/adhesion

  2. Usability Endpoint: Swallowing the Film Before Complete Disintegration/Dissolution

    Was the film noted to have been swallowed by the subject ? Yes No

    Subjects were instructed to swallow any remnants of film still present in oral cavity 15 minutes after initial film placement.

    Results include subjects who swallowed film at any point during the 15 minutes immediately after initial film placement.

    Measured: Subject was observed for 15 minutes immediately following DBF placement/adhesion

  3. Usability Endpoint: Retention of Diazepam Buccal Film (DBF) From Placement to Complete Disintegration

    Was the DBF spit out or blown out by the subject after placement on buccal mucosa or did the subject chew, talk, or move the DBF prior to complete disintegration/dissolution? Yes No

    Measured: Subject was observed for 15 minutes immediately following DBF placement/adhesion

  4. Usability Endpoint: Exit of Saliva During the Time the Diazepam Buccal Film (DBF) Was Adhered to Buccal Mucosa

    The observer documented if any saliva was seen to exit the mouth during the time the DBF was adhered to buccal mucosa

    Measured: Subject was observed for 15 minutes immediately following DBF placement/adhesion

  5. Usability Endpoint: Amount of Saliva That Exited the Mouth After Film Placement

    If Yes - saliva exited the mouth during the time, estimate in milliliters of the amount of saliva that exited the mouth after DBF placement on the buccal surface

    Measured: Subject was observed for 15 minutes immediately following DBF placement/adhesion

Timeline

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

  1. First posted7 Jun 2017
  2. Study start25 May 2017
  3. Primary completion25 Jul 2018
  4. Study completion21 Dec 2018

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 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Crossover
Model description
This was a multicenter, open-label study comprised of 2 treatment periods with a minimum 14 days washout between the 2 treatment periods.
Masking
None (open label)
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03179891
Sponsor's protocol ID
160326
Status last verified
Sep 2020
First submitted
26 May 2017
Last updated
18 Sep 2020
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Diazepam Buccal Film 12.5 mg in people with Epilepsy, run by Aquestive Therapeutics at 11 sites in United States.

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 13 inclusion and 21 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 18 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 18 Sep 2020). 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?

Tmax Pharmacokinetic EndPoints (time frame: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 18 Sep 2020.

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