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This is a 12 month safety study to evaluate the safety of repeated doses of NRL-1
This is a Phase 3, repeat dose, open-label, safety study in Epilepsy subjects who have frequent breakthrough seizures or Acute Repetitive Seizures (ARS). NRL-1 will be administered as needed to treat bouts of those seizures over a 12-month period of time. Doses will be defined as 5 mg, 10 mg, 15 mg, or 20 mg based on the subject's body weight. A diary will be used to record the seizure and NRL-1 administration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NRL-1 | Experimental | Intranasal dose of NRL-1 will be administered at either 5 mg, 10 mg, 15 mg, or 20 mg based on the subject's body weight. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NRL-1 | Drug |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Who Received NRL-1 (Valtoco) | Assess the number of participants who received at least one dose of NRL-1 (Valtoco) during the study and comprised the safety population. | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical Trials, Inc. | Little Rock | Arkansas | 72205 | United States | ||
| Mayo Clinic |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41809194 | Derived | Tarquinio D, Wheless JW, Segal EB, Rabinowicz AL, Carrazana E. Safety and effectiveness of diazepam nasal spray in patients with Rett syndrome and seizure clusters: post hoc analyses from a long-term safety study and survey of severity and burden. Front Neurol. 2026 Feb 23;17:1702423. doi: 10.3389/fneur.2026.1702423. eCollection 2026. | |
| 38175488 |
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| ID | Title | Description |
|---|---|---|
| FG000 | NRL-1 | Intranasal dose of NRL-1 will be administered at either 5 mg, 10 mg, 15 mg, or 20 mg based on the subject's body weight. NRL-1 |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | NRL-1 | Intranasal dose of NRL-1 will be administered at either 5 mg, 10 mg, 15 mg, or 20 mg based on the subject's body weight. NRL-1 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants Who Received NRL-1 (Valtoco) | Assess the number of participants who received at least one dose of NRL-1 (Valtoco) during the study and comprised the safety population. | Subjects who received at least one dose of NRL-1. | Posted | Count of Participants | Participants | 12 months |
|
12 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | NRL-1 5mg | Intranasal dose of NRL-1 will be administered at 5, 10, 15, and 20 mg based on age and weight. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Seizure | Nervous system disorders | MedDRA | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharyngitis | Infections and infestations | MedDRA | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Cyndi Guerra | Neurelis, Inc. | 9736156258 | cguerra@neurelis.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Sep 28, 2017 | Oct 26, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jul 8, 2020 | Oct 26, 2021 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D012640 | Seizures |
| D004827 | Epilepsy |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Rochester |
| Minnesota |
| 55905 |
| United States |
| Washington University School of Medicine | St Louis | Missouri | 63110 | United States |
| New York University Comprehensive Epilepsy Center | New York | New York | 10016 | United States |
| Thomas Jefferson University Hospital Laboratory | Philadelphia | Pennsylvania | 19107 | United States |
| Misra SN, Jarrar R, Stern JM, Becker DA, Carrazana E, Rabinowicz AL. Rapid Rescue Treatment with Diazepam Nasal Spray Leads to Faster Seizure Cluster Termination in Epilepsy: An Exploratory Post Hoc Cohort Analysis. Neurol Ther. 2024 Feb;13(1):221-231. doi: 10.1007/s40120-023-00568-4. Epub 2024 Jan 4. |
| 37455404 | Derived | Tarquinio D, Wheless JW, Segal EB, Misra SN, Rabinowicz AL, Carrazana E. Safety of Diazepam Nasal Spray in Pediatric Patients With Developmental Epileptic Encephalopathies: Results From a Long-term Phase 3 Safety Study. J Child Neurol. 2023 May;38(6-7):389-393. doi: 10.1177/08830738231185424. Epub 2023 Jul 16. |
| 35816831 | Derived | Cramer JA, Faught E, Davis C, Misra SN, Carrazana E, Rabinowicz AL. Quality-of-life results in adults with epilepsy using diazepam nasal spray for seizure clusters from a long-term, open-label safety study. Epilepsy Behav. 2022 Sep;134:108811. doi: 10.1016/j.yebeh.2022.108811. Epub 2022 Jul 8. |
| 34418086 | Derived | Wheless JW, Miller I, Hogan RE, Dlugos D, Biton V, Cascino GD, Sperling MR, Liow K, Vazquez B, Segal EB, Tarquinio D, Mauney W, Desai J, Rabinowicz AL, Carrazana E; DIAZ.001.05 Study Group. Final results from a Phase 3, long-term, open-label, repeat-dose safety study of diazepam nasal spray for seizure clusters in patients with epilepsy. Epilepsia. 2021 Oct;62(10):2485-2495. doi: 10.1111/epi.17041. Epub 2021 Aug 21. |
| 34033266 | Derived | Miller I, Wheless JW, Hogan RE, Dlugos D, Biton V, Cascino GD, Sperling MR, Liow K, Vazquez B, Segal EB, Tarquinio D, Mauney W, Desai J, Rabinowicz AL, Carrazana E; DIAZ.001.05 Study Group. Consistent safety and tolerability of Valtoco(R) (diazepam nasal spray) in relationship to usage frequency in patients with seizure clusters: Interim results from a phase 3, long-term, open-label, repeat-dose safety study. Epilepsia Open. 2021 Sep;6(3):504-512. doi: 10.1002/epi4.12494. Epub 2021 May 13. |
| 34022621 | Derived | Penovich P, Wheless JW, Hogan RE, Guerra C, Cook DF, Carrazana E, Rabinowicz AL. Examining the patient and caregiver experience with diazepam nasal spray for seizure clusters: Results from an exit survey of a phase 3, open-label, repeat-dose safety study. Epilepsy Behav. 2021 Aug;121(Pt A):108013. doi: 10.1016/j.yebeh.2021.108013. Epub 2021 May 19. |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| NRL-1 15 mg |
Intranasal dose of NRL-1 will be administered at 15 mg based on age and weight. |
| OG003 | NRL-1 20mg | Intranasal dose of NRL-1 will be administered at 20 mg based on age and weight. |
|
|
| 0 |
| 9 |
| 2 |
| 9 |
| 6 |
| 9 |
| EG001 | NRL-1 10mg | Intranasal dose of NRL-1 will be administered at 5, 10, 15, and 20 mg based on age and weight. | 0 | 54 | 20 | 54 | 34 | 54 |
| EG002 | NRL-1 15mg | Intranasal dose of NRL-1 will be administered at 5, 10, 15, and 20 mg based on age and weight. | 0 | 46 | 15 | 46 | 24 | 46 |
| EG003 | NRL-1 20mg | Intranasal dose of NRL-1 will be administered at 5, 10, 15, and 20 mg based on age and weight. | 1 | 54 | 13 | 54 | 21 | 54 |
| Status Epilepticus | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Epilepsy | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Seizure Cluster | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Amnesia | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Disturbance in Attention | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Generalised tonic-clonic seizure | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Lennox-Gastaut Syndrome | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Lethargy | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Muscle Spasticity | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Partial Seizures | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Petit Mal Epilepsy | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Postictal State | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Pancreatitis | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Large Intestinal Ulcer | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Proctalgia | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Hip Fracture | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
|
| Joint Dislocation | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
|
| Thermal Burn | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
|
| Wound Dehiscence | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
|
| Wrist Fracture | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
|
| Pyrexia | General disorders | MedDRA | Systematic Assessment |
|
| Chest Pain | General disorders | MedDRA | Systematic Assessment |
|
| Sudden Unexplained Death in Epilepsy | General disorders | MedDRA | Systematic Assessment |
|
| Pneumonia Aspiration | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Acute Respiratory Failure | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Restrictive Pulmonary Disease | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Chronic Myeloid Leukaemia | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA | Systematic Assessment |
|
| Colorectal Adenocarcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA | Systematic Assessment |
|
| Leiomyoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA | Systematic Assessment |
|
| Anxiety | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Depression | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Hallucination, Visual | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Major Depression | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Suicidal Ideation | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Dehydration | Metabolism and nutrition disorders | MedDRA | Systematic Assessment |
|
| Feeding Disorder | Metabolism and nutrition disorders | MedDRA | Systematic Assessment |
|
| Hyponatraemia | Metabolism and nutrition disorders | MedDRA | Systematic Assessment |
|
| Scoliosis | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
|
| Menorrhagia | Reproductive system and breast disorders | MedDRA | Systematic Assessment |
|
| Uterine Haemorrhage | Reproductive system and breast disorders | MedDRA | Systematic Assessment |
|
| Mitral Valve Prolapse | Cardiac disorders | MedDRA | Systematic Assessment |
|
| Brain Lobectomy | Surgical and medical procedures | MedDRA | Systematic Assessment |
|
| Pneumonia | Infections and infestations | MedDRA | Systematic Assessment |
|
| Abscess | Infections and infestations | MedDRA | Systematic Assessment |
|
| Appendicitis Perforated | Infections and infestations | MedDRA | Systematic Assessment |
|
| Colonic Abscess | Infections and infestations | MedDRA | Systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA | Systematic Assessment |
|
| Pharyngitis Streptococcal | Infections and infestations | MedDRA | Systematic Assessment |
|
| Upper Respiratory Tract Infection | Infections and infestations | MedDRA | Systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA | Systematic Assessment |
|
| Urinary Tract Infection | Infections and infestations | MedDRA | Systematic Assessment |
|
| Seizure | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Nasal Discomfort | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA | Systematic Assessment |
|
| Pyrexia | General disorders | MedDRA | Systematic Assessment |
|
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| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |