Status EpilepticusPhase 3KESETTNCT06907173
Ketamine add-on Therapy for Established Status Epilepticus Treatment Trial (KESETT)
A Phase 3 study testing Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET), Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET) and Levetiracetam (LEV) (60 mg/Kg) in people with Status Epilepticus, run by University of Virginia at 63 sites in United States.
Trial summary
The goal of this clinical trial is to determine if treatment of patients with two doses of ketamine plus levetiracetam versus levetiracetam alone leads to more effective control of status epilepticus. Read more about this study
- Who is it for?
- Ages 1 year and older
- Conditions the study is for
- Status Epilepticus
- What is being tested?
- Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET), Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET) and Levetiracetam (LEV) (60 mg/Kg)
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 770 participants
- Where
- 63 sitesUnited States
- Study dates
- 6 Mar 2026to Dec 2029
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
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 1 year and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- The patient was witnessed to have a convulsive seizure for greater than 5-minute duration
- The patient received an adequate dose of benzodiazepines. The doses may be divided.
- The last dose of a benzodiazepine was administered 5-30 minutes before study drug administration.
- Continued or recurring seizures in the Emergency Department.
- Age 1 years or older
- Known or estimated weight ≥10 Kg
Who cannot join
- Known pregnancy
- Prisoner
- Opt-out identification or otherwise known to be previously enrolled in KESETT
- Treatment with a second line anticonvulsant (FOS, PHT, VPA, LEV, phenobarbital, or other agents defined in the MoP) for this episode of SE
- Treatment with sedatives with anticonvulsant properties other than benzodiazepines for this episode of SE(propofol, etomidate, ketamine or other agents defined in the MoP)
- Endotracheal intubation prior to enrollment
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- Acute traumatic brain injury clearly precedes seizures
- Scalp injury or burn preventing EEG placement
- Known allergy or other known contraindication to KET or LEV
- Hypoglycemia < 50 mg/dL
- Hyperglycemia > 400 mg/dL
- Cardiac arrest / post-anoxic seizures
Trial locations and contacts
63 sites in 1 country. Contact the study team or a site near you to ask about taking part.
63 sites in 1 country
United States63 sites, 62 recruiting
- Not yet recruiting
University of New Mexico Hospital
Albuquerque, New Mexico, 87106
Masoom Desai, MD, 505-272-0356, MDesai@salud.unm.edu
Masoom Desai, MD
- Recruiting
University of Michigan University Hospital
Ann Arbor, Michigan, 48109
Mariama Runcie, MD, 734-232-2145, runciema@med.umich.edu
Mariama Runcie, MD
- Active, not recruiting
Grady Memorial Hospital
Atlanta, Georgia, 30303
- Recruiting
Arthur M. Blank Hospital
Atlanta, Georgia, 30329
Claudia Morris, MD, 404-785-7070, claudia.r.morris@emory.edu
Claudia Morris, MD
- Recruiting
University of Maryland Medical Center
Baltimore, Maryland, 21201
Jennifer Hopp, MD, 410-328-7635, jhopp@som.umaryland.edu
Jennifer Hopp, MD
- Recruiting
Johns Hopkins Hospital
Baltimore, Maryland, 21287
Kathryn Rosenblatt, MD, 410-955-6488, krosenb3@jhmi.edu
Kathryn Rosenblatt, MD
- Not yet recruiting
UAB Hospital
Birmingham, Alabama, 35233
Lauren Walter, MD, MSPH, 205-996-4791, lwalter@uabmc.edu
Lauren Walter, MD, MSPH
- Not yet recruiting
Massachusetts General Hospital
Boston, Massachusetts, 02114
Michael Filbin, MD, 617-724-4758, mfilbin@mgh.harvard.edu
Michael Filbin, MD
- Not yet recruiting
Cooper University Hospital
Camden, New Jersey, 08103
Christopher Jones, MD, 856-342-2637, jones-christopher@cooperhealth.edu
Christopher Jones, MD
- Recruiting
University of Virginia Medical Center
Charlottesville, Virginia, 22908
Thomas Hartka, MD, 434-924-2897, trh6u@uvahealth.org
Thomas Hartka, MD
- Not yet recruiting
Northwestern Memorial Hospital
Chicago, Illinois, 60611
Peter Pruitt, MD, 312-694-7000, peter.pruitt@nm.org
Peter Pruitt, MD
- Recruiting
Rush University Medical Center
Chicago, Illinois, 60612
Michael Gottlieb, MD, MBA, 631-922-1705, Michael_A_Gottlieb@rush.edu
Michael Gottlieb, MD, MBA
- Not yet recruiting
University of Illinois Hospital
Chicago, Illinois, 60612
Pavitra Kotini-Shah, MD, 817-703-1723, pkotini@uic.edu
Pavitra Kotini-Shah, MD
- Recruiting
Comer Children's Hospital
Chicago, Illinois, 60637
David Beiser, MD, 773-834-4135, dbeiser@medicine.bsd.uchicago.edu
David Beiser, MD
- Recruiting
University of Chicago Medical Center
Chicago, Illinois, 60637
David Beiser, MD, 773-834-4135, dbeiser@medicine.bsd.uchicago.edu
David Beiser, MD
- Recruiting
University of Cincinnati Medical Center
Cincinnati, Ohio, 45267
Jason McMullan, MD, 513-675-3072, jason.mcmullan@uc.edu
Jason McMullan, MD
- Recruiting
Nationwide Children's Hospital
Columbus, Ohio, 43205
Aarti Gaglani Aarti Gaglani, MD, 6147226910, kesett@nationwidechildrens.org
Aarti Gaglani, MD
- Recruiting
OSU Wexner Medical Center
Columbus, Ohio, 43210
Kirstin Acus, MD, 614-293-6185, kirstin.acus@osumc.edu
Kirstin Acus, MD
- Not yet recruiting
Children's Medical Center Dallas
Dallas, Texas, 75235
Pamela Okada, MD, 214-456-7000 ext. 67102, pamela.okada@utsouthwestern.edu
Pamela Okada, MD
- Not yet recruiting
Detroit Receiving Hospital
Detroit, Michigan, 48201
Wazim Mohamed, MD, 313-577-8824, wmohamed@med.wayne.edu
Wazim Mohamed, MD
- Not yet recruiting
Sinai-Grace Hospital
Detroit, Michigan, 48201
Arun Sherma, MD, 313-745-4238, arun@sherma.org
Arun Sherma, MD
- Not yet recruiting
Henry Ford Hospital
Detroit, Michigan, 48202
Joseph Miller, MD, 313-404-9110, jmiller6@hfhs.org
Joseph Miller, MD
- Not yet recruiting
Duke University Hospital
Durham, North Carolina, 27710
Alexander Limkakeng, MD, 919-681-0908, alexander.limkakeng@duke.edu
Alexander Limkakeng, MD
- Recruiting
Memorial Hermann Texas Medical Center
Houston, Texas, 77030
Kayleigh Fischer, MD, 713-500-7803, Kayleigh.A.Fischer@uth.tmc.edu
Kayleigh Fischer, MD
- Recruiting
IU Health Methodist Hospital
Indianapolis, Indiana, 46202
Daniel Udrea, MD, 317-274-0829, dudrea@iu.edu
Daniel Udrea, MD
- Recruiting
Riley Hospital for Children
Indianapolis, Indiana, 46202
Benjamin Nti, MD, 317-416-7997, bnti@iu.edu
Benjamin Nti, MD
- Recruiting
University of Iowa Medical Center
Iowa City, Iowa, 52242
Brett Faine, MD, 319-384-5228, brett-faine@uiowa.edu
Brett Faine, MD
- Not yet recruiting
UC San Diego Health La Jolla
La Jolla, California, 92037
Vanessa Tamas, MD, 858-966-8033, vtamas@rchsd.org
Vanessa Tamas, MD
- Not yet recruiting
Ronald Reagan UCLA Medical Center
Los Angeles, California, 90024
Richelle Cooper, MD, 424-440-0486, rcooper@mednet.ucla.edu
Richelle Cooper, MD
- Not yet recruiting
Children's Hospital Los Angeles
Los Angeles, California, 90027
Ara Festekjian, MD, 323-804-8142, afestekjian@chla.usc.edu
Ara Festekjian, MD
- Recruiting
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
Keli Coleman, MD, 414-266-2767, kcoleman@mcw.edu
Keli Coleman, MD
- Recruiting
Froedtert Hospital
Milwaukee, Wisconsin, 53226
Jamie Jasti, MD, 414-805-6493, jjasti@mcw.edu
Jamie Jasti, MD
- Recruiting
University of Minnesota Masonic Children's Hospital
Minneapolis, Minnesota, 55414
James Miner, MD, 612-624-7426, miner015@umn.edu
James Miner, MD
- Not yet recruiting
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Brian Driver, MD, 612-873-7448, brian.driver@hcmed.org
Brian Driver, MD
- Recruiting
University of Minnesota Medical Center
Minneapolis, Minnesota, 55455
James Miner, MD, 612-624-7426, miner015@umn.edu
James Miner, MD
- Recruiting
Yale New Haven Hospital
New Haven, Connecticut, 06519
Charles Wira, MD, 203-785-5781, charles.wira@yale.edu
Charles Wira, MD
- Not yet recruiting
University Medical Center New Orleans
New Orleans, Louisiana, 70112
Stephen Lim, MD, 504-702-2440, slim@lsuhsc.edu
Stephen Lim, MD
- Not yet recruiting
Christiana Hospital
Newark, Delaware, 19718
Jason Nomura, MD, 302-733-4113, jnomura@christianacare.org
Jason Nomura, MD
- Recruiting
Orlando Regional Medical Center
Orlando, Florida, 32806
Dipali Nemade, MD, 321-841-1324, Dipali.Nemade@orlandohealth.com
Dipali Nemade, MD
- Recruiting
Stanford University Medical Center
Palo Alto, California, 94304
Alexandra June Gordon, MD, 650-248-7701, ajgordon@stanford.edu
Alexandra June Gordon, MD
- Not yet recruiting
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, 19104
John Greenwood, MD, 267-252-8741, john.greenwood@pennmedicine.upenn.edu
John Greenwood, MD
- Not yet recruiting
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania, 19104
John Greenwood, MD, 267-252-8741, john.greenwood@pennmedicine.upenn.edu
John Greenwood, MD
- Recruiting
Temple University Hospital Jeanes Campus
Philadelphia, Pennsylvania, 19111
Derek Isenberg, MD, 215-707-0222, derek.isenberg@tuhs.temple.edu
Derek Isenberg, MD
- Recruiting
Temple University Hospital Main Campus
Philadelphia, Pennsylvania, 19140
Derek Isenberg, MD, 215-707-0222, derek.isenberg@tuhs.temple.edu
Derek Isenberg, MD
- Recruiting
Jefferson Einstein Philadelphia Hospital
Philadelphia, Pennsylvania, 19141
Joseph Herres, DO, 215-457-5865, Joseph.herres@jefferson.edu
Joseph Herres, DO
- Recruiting
UPMC Presbyterian Hospital
Pittsburgh, Pennsylvania, 15213
Adam Frisch, MD, 412-647-9047, frischan@upmc.edu
Adam Frisch, MD
- Recruiting
UPMC Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, 15224
Robert Hickey, MD, 412-692-6567, robert.hickey@chp.edu
Robert Hickey, MD
- Recruiting
Oregon Health & Science University Hospital
Portland, Oregon, 97239
Bory Kea, MD, 503-494-8083, kea@ohsu.edu
Bory Kea, MD
- Not yet recruiting
VCU Medical Center
Richmond, Virginia, 23298
Lisa Merck, MD, MPH, MHA, 862-383-1688, Lisa.Merck@vcuhealth.org
Lisa Merck, MD, MPH, MHA
- Recruiting
UC Davis Medical Center
Sacramento, California, 95817
Daniel Nishijima, MD, 916-734-5010, dnishijima@ucdavis.edu
Daniel Nishijima, MD
- Not yet recruiting
Primary Children's Hospital
Salt Lake City, Utah, 84108
Maija Holsti, MD, MPH, 801-656-8833, Maija.Holsti@hsc.utah.edu
Maija Holsti, MD, MPH
- Not yet recruiting
University of Utah Healthcare
Salt Lake City, Utah, 84112
Scott Youngquist, MD, 801-349-0241, scott.youngquist@utah.edu
Scott Youngquist, MD
- Not yet recruiting
UC San Diego Health Hillcrest Hospital
San Diego, California, 92103
Vanessa Tamas, MD, 858-966-8033, vtamas@rchsd.org
Vanessa Tamas, MD
- Not yet recruiting
Rady Children's Hospital
San Diego, California, 92123
Vanessa Tamas, MD, 858-966-8033, vtamas@rchsd.org
Vanessa Tamas, MD
- Recruiting
San Francisco General Hospital
San Francisco, California, 94143
Debbie Madhok, MD, 415-601-6399, Debbie.madhok@ucsf.edu
Debbie Madhok, MD
- Recruiting
UCSF Medical Center
San Francisco, California, 94143
Debbie Madhok, MD, 415-601-6399, Debbie.madhok@ucsf.edu
Debbie Madhok, MD
- Recruiting
Harborview Medical Center
Seattle, Washington, 98104
Vasisht Srinivasan, MD, 585-730-3843, vasishts@uw.edu
Vasisht Srinivasan, MD
- Not yet recruiting
SUNY Upstate Medical University
Syracuse, New York, 13210
Lindsay Nausin, DO, 315-464-4363, nausinl@upstate.edu
Lindsay Nausin, DO
- Not yet recruiting
Harbor-UCLA Medical Center
Torrance, California, 90502
Juliana Tolles, MD, 434-243-6768, jtolles@emedharbor.edu
Juliana Tolles, MD
- Recruiting
Banner University Medical Center - Tucson Campus
Tucson, Arizona, 85724
Aaron Leetch, MD, 520-621-8752, aleetch@arizona.edu
Aaron Leetch, MD
- Recruiting
Children's National Medical Center
Washington D.C., District of Columbia, 20010
James Chamberlain, MD, 202-476-8877, jchamber@childrensnational.org
James Chamberlain, MD
- Recruiting
Reading Hospital
West Reading, Pennsylvania, 19611
Adam Sigal, MD, 484-628-7016, adam.sigal@towerhealth.org
Adam Sigal, MD
- Recruiting
Nemours Children's Hospital
Wilmington, Delaware, 19803
Amy Thompson, MD, 302-490-4146, amy.thompson@nemours.org
Amy Thompson, MD
About this study
The goal of this clinical trial is to determine if treatment of patients with two doses of ketamine plus levetiracetam versus levetiracetam alone leads to more effective control of status epilepticus.
Read the detailed description
KESETT is a multicenter, randomized, blinded study to determine whether adding 1 mg/kg or 3 mg/kg dose of KET to 60 mg/kg LEV can terminate status epilepticus (SE) in a larger fraction of subjects with benzodiazepine-refractory SE than those treated with LEV (60 mg/kg) alone.
The primary outcome is termination of SE from 15 minutes after starting the study drug infusion, sustained until 60 minutes from enrollment without using additional anti-seizure medication. Termination of SE is determined by (1) improving consciousness and absence of clinically apparent seizures at 60 minutes or (2) absence of any electrographic SE after 15 minutes in those with EEG monitoring and no improvement in consciousness.
Secondary objectives include determining the relative safety of the treatment arms on defined safety outcomes and all adverse events, analysis of secondary/exploratory efficacy outcomes, and evaluation of both effectiveness and safety in the pediatric subpopulation.
The trial will initially allocate subjects equally (1:1:1) for the first 350 participants (burn-in period) before transitioning to response-adaptive randomization. Interim analyses will be conducted for efficacy and futility beginning when 350 subjects have been randomized, and will occur every 100 subjects thereafter. A maximum of 770 participants will be enrolled.
- Conditions
- Status Epilepticus
- Being tested
- Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET), Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET), Levetiracetam (LEV) (60 mg/Kg)
- Medical subject headings
- Status Epilepticus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET)Drug
The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study.
All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded.
Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET)Drug
The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study.
All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded.
Levetiracetam (LEV) (60 mg/Kg)Drug
The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study.
All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded.
| Study group | Role | What they receive |
|---|---|---|
| Levetiracetam | Active comparator | Levetiracetam (LEV) (60 mg/Kg) Receives: Drug: Levetiracetam (LEV) (60 mg/Kg) |
| Levetiracetam + low dose Ketamine | Experimental | LEV 60 mg/mL + 1 mg/mL KET Receives: Drug: Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET) |
| Levetiracetam + high dose Ketamine | Experimental | LEV 60 mg/mL + 3 mg/mL KET increasing up to a weight of 75 kg Receives: Drug: Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Termination of SE
Termination of SE from 15 minutes after starting the study drug infusion, sustained for 60 minutes without using additional anti-seizure medication.
Termination of SE is determined by (1) improving consciousness and absence of clinically apparent seizures at 60 minutes or (2) absence of any electrographic status epilepticus (ESE) after 15 minutes in those with EEG monitoring and no improvement in consciousness.
Measured: From 15 minutes after starting the study drug infusion, sustained for 60 minutes without using additional anti-seizure medication.
Secondary outcomes (8)
Desirability of response (DOOR) outcome
One secondary outcome will be a desirability of response (DOOR) outcome which is a composite efficacy measure evaluated on a graded scale from 1 to 5 at 60 minutes, as follows:
- No clinically evident or electrographic seizures after 15 minutes, no rescue drugs, and improving mental status by 60 minutes
- No clinically evident or electrographic seizures after 15 minutes, not intubated, but not improving mental status at 60 minutes
- No clinically evident or electrographic seizures after 15 minutes, but intubated or use of additional seizures medications (including medications used for intubation)
- Any clinically evident seizure or electrographic seizure requiring rescue medicine within the timeframe between 15 and 60 minutes
- Life-threatening hypotension or cardiac arrhythmia or death within 60 minutes
The Central Adjudication Core will determine the DOOR grade (1-5) based on clinical outcome data provided by the site and EEG data provided by the Central EEG Core.
Measured: 60 minutes after starting the study drug infusion
Endotracheal intubation
Endotracheal intubation within 60 minutes of randomization (start of study drug infusion) and duration
Measured: Within 60 minutes after start of the study drug infusion
ICU duration
ICU duration during the study period for those that are admitted to the ICU as abstracted from the hospital admission record
Measured: Up to 30 days after enrollment
Hospital length-of-stay (LOS)
Hospital length-of-stay (LOS) from the ED as abstracted from the hospital admission record
Measured: Up to 30 days after enrollment
Late recurrent seizure
Number of participants with late recurrent seizure between 60 minutes and 4 hours after the start of the study drug infusion
Measured: Between 60 minutes and 4 hours after the start of the study drug infusion
Time to termination of seizures
The interval from the start of infusion of study drug to the cessation of electrographic seizure in those who meet the primary outcome
Measured: From the start of infusion of study drug to the cessation of electrographic seizure assessed up to 60 minutes from study drug initiation
Late seizures after requiring an anesthetic
Number of participants with late seizures after requiring an anesthetic between 60 minutes and 24 hours after start of study drug infusion
Measured: Between 60 minutes and 24 hours after start of study drug infusion
All cause mortality
All cause mortality to end of study
Measured: From the start of study drug infusion to hospital discharge or day 30
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Apr 2025
- Study start6 Mar 2026
- Primary completionJun 2029 (estimated)
- Study completionDec 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Status EpilepticusStudies of the same condition, open and under way.
- More trials run by University of VirginiaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 770 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Virginia
- Sponsor type
- University, hospital or other
- Collaborators
- University of Michigan, Medical University of South Carolina, Massachusetts General Hospital, Children's National Research Institute
- Responsible party
- Principal investigator, Jaideep Kapur, MD, University of Virginia
- Investigators
- Jaideep Kapur, MD, PhD, Principal investigator, University of Virginia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06907173
- Sponsor's protocol ID
- HSR231657
- Acronym
- KESETT
- Status last verified
- Apr 2026
- First submitted
- 24 Mar 2025
- Last updated
- 17 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The data will be stored in Data Archive for the Brain Initiative (DABI) after trial completion. Once submitted to the data repository, we will work with DABI support to ensure that the de-identified KESETT data is available to the public in the DABI search engine where data requests can be submitted.
Study at a glance
From the registry record, last updated by the sponsor on 17 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ketamine add-on Therapy for Established Status Epilepticus Treatment Trial (KESETT)
- ClinicalTrials.gov ID
- NCT06907173
- Acronym / sponsor ID
- KESETT / HSR231657
- Conditions
- Status Epilepticus
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 770 participants (estimated)
- Lead sponsor
- University of VirginiaUniversity, hospital or other
- Collaborators
- University of Michigan, Medical University of South Carolina, Massachusetts General Hospital, Children's National Research Institute
- Study start
- 6 Mar 2026 (actual)
- Primary completion
- Jun 2029 (estimated)
- Study completion
- Dec 2029 (estimated)
- First posted
- 2 Apr 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to determine if treatment of patients with two doses of ketamine plus levetiracetam versus levetiracetam alone leads to more effective control of status epilepticus.
Detailed description
KESETT is a multicenter, randomized, blinded study to determine whether adding 1 mg/kg or 3 mg/kg dose of KET to 60 mg/kg LEV can terminate status epilepticus (SE) in a larger fraction of subjects with benzodiazepine-refractory SE than those treated with LEV (60 mg/kg) alone.
The primary outcome is termination of SE from 15 minutes after starting the study drug infusion, sustained until 60 minutes from enrollment without using additional anti-seizure medication. Termination of SE is determined by (1) improving consciousness and absence of clinically apparent seizures at 60 minutes or (2) absence of any electrographic SE after 15 minutes in those with EEG monitoring and no improvement in consciousness.
Secondary objectives include determining the relative safety of the treatment arms on defined safety outcomes and all adverse events, analysis of secondary/exploratory efficacy outcomes, and evaluation of both effectiveness and safety in the pediatric subpopulation.
The trial will initially allocate subjects equally (1:1:1) for the first 350 participants (burn-in period) before transitioning to response-adaptive randomization. Interim analyses will be conducted for efficacy and futility beginning when 350 subjects have been randomized, and will occur every 100 subjects thereafter. A maximum of 770 participants will be enrolled.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Levetiracetam | Active comparator | Drug: Levetiracetam (LEV) (60 mg/Kg)Levetiracetam (LEV) (60 mg/Kg) |
| Levetiracetam + low dose Ketamine | Experimental | Drug: Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET)LEV 60 mg/mL + 1 mg/mL KET |
| Levetiracetam + high dose Ketamine | Experimental | Drug: Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET)LEV 60 mg/mL + 3 mg/mL KET increasing up to a weight of 75 kg |
Who may qualify
- Ages
- 1 year and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (6 listed)
- The patient was witnessed to have a convulsive seizure for greater than 5-minute duration
- The patient received an adequate dose of benzodiazepines. The doses may be divided.
- The last dose of a benzodiazepine was administered 5-30 minutes before study drug administration.
- Continued or recurring seizures in the Emergency Department.
- Age 1 years or older
Key exclusion criteria (12 listed)
- Known pregnancy
- Prisoner
- Opt-out identification or otherwise known to be previously enrolled in KESETT
- Treatment with a second line anticonvulsant (FOS, PHT, VPA, LEV, phenobarbital, or other agents defined in the MoP) for this episode of SE
- Treatment with sedatives with anticonvulsant properties other than benzodiazepines for this episode of SE(propofol, etomidate, ketamine or other agents defined in the MoP)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET)The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study. All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded. | Drug | Levetiracetam + low dose Ketamine |
| Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET)The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study. All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded. | Drug | Levetiracetam + high dose Ketamine |
| Levetiracetam (LEV) (60 mg/Kg)The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study. All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded. | Drug | Levetiracetam |
Primary outcome
Termination of SE
Time frame: From 15 minutes after starting the study drug infusion, sustained for 60 minutes without using additional anti-seizure medication.
Termination of SE from 15 minutes after starting the study drug infusion, sustained for 60 minutes without using additional anti-seizure medication. Termination of SE is determined by (1) improving consciousness and absence of clinically apparent seizures at 60 minutes or (2) absence of any electrographic status epilepticus (ESE) after 15 minutes in those with EEG monitoring and no improvement in consciousness.
8 secondary outcomes
Desirability of response (DOOR) outcome
Time frame: 60 minutes after starting the study drug infusion
Endotracheal intubation
Time frame: Within 60 minutes after start of the study drug infusion
ICU duration
Time frame: Up to 30 days after enrollment
Hospital length-of-stay (LOS)
Time frame: Up to 30 days after enrollment
Late recurrent seizure
Time frame: Between 60 minutes and 4 hours after the start of the study drug infusion
Time to termination of seizures
Time frame: From the start of infusion of study drug to the cessation of electrographic seizure assessed up to 60 minutes from study drug initiation
Late seizures after requiring an anesthetic
Time frame: Between 60 minutes and 24 hours after start of study drug infusion
All cause mortality
Time frame: From the start of study drug infusion to hospital discharge or day 30
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Sep 2026.
- Individual participant dataSharing planned: Yes. The data will be stored in Data Archive for the Brain Initiative (DABI) after trial completion. Once submitted to the data repository, we will work with DABI support to ensure that the de-identified KESETT data is available to the public in the DABI search engine where data requests can be submitted.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jaideep Kapur, MD, PhD principal investigator
University of Virginia
63 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Levetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET), Levetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET) and Levetiracetam (LEV) (60 mg/Kg) in people with Status Epilepticus, run by University of Virginia at 63 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 6 inclusion and 12 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: looking for participants now, as of the sponsor's last update on 17 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 63 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 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Megan Wardius (434-243-6768, mew5j@virginia.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Termination of SE (time frame: From 15 minutes after starting the study drug infusion, sustained for 60 minutes without using additional anti-seizure medication.). 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 17 Sep 2026.