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| Name | Class |
|---|---|
| Syneos Health | OTHER |
| Covance | INDUSTRY |
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This Phase 3, multicenter, open-label study of chronic, intermittent use of study drug (DBF) is designed to evaluate the safety and tolerability of the buccal formulation of diazepam in children, adolescents and adults with intermittent, stereotypic episodes of frequent seizure activity (eg, seizure clusters) that are distinct from the subject's usual seizure pattern.
The Primary objective of the study is to assess the safety and tolerability of DBF (study drug) administered a minimum of 3 times to subjects with epilepsy for the treatment of seizures over a minimum 6-month period.
Secondary objectives:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subjects with Epilepsy | Experimental | Male or female subjects between the ages of 2 and 65 years who had an established diagnosis of epilepsy exhibited by motor seizures with clear alteration of awareness, and while on a regimen of anti-epileptic medication(s), still experienced bouts of seizures (frequent breakthrough seizures, eg, seizure clusters) and who, in the opinion of the Investigator, could need benzodiazepine intervention for seizure control at least 1 time a month on average. Subjects must have been on at least 1 concomitant anti-epileptic drug at screening. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Diazepam Buccal Soluble Film 5, 7.5,10, 12.5,15 or 17.5 mg with individual dose determined according to age and weight category | Drug | The subjects in this study administered DBF themselves or with the help of a caregiver, (trained by the study site staff in study drug administration and documentation) in the same setting as they typically used the diazepam rectal gel or other rescue medication, without the presence of study staff. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects in the Safety Analysis Set With at Least 1 Treatment-emergent Adverse Event (TEAE) | A TEAE was defined as any adverse event with onset date on the day of or after administration of study drug including relationship and severity. | Adverse events (AEs) were recorded from Day 1 through the last study contact (Month 7 telephone contact). |
| Number of Subjects in Safety Analysis Set With Adverse Events of Special Interest (AESI) | A.Oral irritation related AEs including but not limited to: buccal mucosal swelling, mouth ulceration, injuries to oral cavity (such as tongue or mucosal laceration, broken tooth, bleeding), erythema, stomatitis, gingivitis, xerostomia, staining, dysphagia, dysgeusia, burning, stinging, tingling. B. Abuse related AEs including euphoria, euphoric mood, feeling of relaxation, anger, dissociative effects, hallucinations, psychosis, changes in mood, impaired cognition, attention, psychomotor effects, inappropriate affect, overdose, and misuse. C. Other: Respiratory disorders, nervous system disorders | AESIs were recorded from Day 1 through the last study contact (Month 7 telephone contact). |
| Measure | Description | Time Frame |
|---|---|---|
| Usability Assessment: Number of Use Occasions Where Difficulty in Opening the Outer Packaging Was Recorded. | For each use occasion the following question was asked: Did you have difficulty in opening the outer plastic packaging on this use occasion? Yes | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gary Slatko | Aquestive Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hawaii Neuroscience Center | Honolulu | Hawaii | 96187 | United States | ||
| Consultants in Epilepsy and Neurology, PLLC |
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149 were enrolled but only 130 received at least 1 dose of study drug and were included in the analyses
150 subjects with epilepsy passed screening but 1 was never enrolled
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| ID | Title | Description |
|---|---|---|
| FG000 | Safety Set | Male or female subjects between the ages of 2 and 65 years who had an established diagnosis of epilepsy exhibited by motor seizures with clear alteration of awareness, and while on a regimen of anti-epileptic medication(s), still experienced bouts of seizures (frequent breakthrough seizures, eg, seizure clusters) and who, in the opinion of the Investigator, could need benzodiazepine intervention for seizure control at least 1 time a month on average. Subjects must have been on at least 1 concomitant anti-epileptic drug at screening. Diazepam Buccal Soluble Film 5, 7.5,10, 12.5,15 or 17.5 mg with individual dose determined according to age and weight category: The subjects administered DBF themselves or with the help of a caregiver, (trained by the study site staff in study drug administration and documentation) in the same setting as they typically used the diazepam rectal gel or other rescue medication, without the presence of study staff. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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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 | Mar 2, 2020 | Jun 22, 2021 |
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The study population was male or female pediatric, adolescent, and adult subjects with a clinical diagnosis of epilepsy and with bouts of increased seizure activity, frequent breakthrough seizures, seizure clusters, or cluster seizures and who were on chronic, intermittent use of rescue medication (eg, Diastat AcuDial or other benzodiazepine).
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|
| Usability Assessment: Ability to Open Foil Pouch on Each Use Occasion | For each use occasion the following question was asked: Did you have difficulty in opening the foil pouch on this use occasion? Yes or No | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
| Usability Assessment: Ability to Remove Study Drug From Foil Pouch on Each Use Occasion | For each use occasion the following question was asked: Did you have difficulty in removing study drug from foil pouch on this occasion? Yes or No | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
| Number of Occasions With Successful Insertion/Retention in Cheek | Of the total number of use occasions over the course of the study, the number of use occasions that were successfully inserted/retained in the cheek | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
| Usability Assessment: Difficulty Inserting DBF Against the Buccal Mucosa (Number of Attempts to Insert Film for Each Use Occasion) | Number of occasions where it took 1 attempt to insert film, Number of occasions where it took 2 attempts to insert film, Number of occasions where it took 3 attempts to insert film, Number of occasions where it took >3 attempts to insert film | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
| Usability Assessment: Number of Occasions Where DBF Was Not Placed or Retained on the Inner Cheek Until Dissolution | Number of occasions where the study drug was not successfully placed and or retained in cheek until the film fully dissolved. | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
| Usability Assessment: Reasons for Multiple Placement/Insertion Attempts During a Use Occasion | Reasons for multiple attempts at insertion Multiple choice answer was: Excessive drooling, Clenching jaw / Won't open mouth, Spit out before sticking, Other/None of the above | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months |
| Boise |
| Idaho |
| 83702 |
| United States |
| Clinical Research Center of New Jersey (CRCNJ) | Voorhees Township | New Jersey | 08043 | United States |
| OnSite Clinical Solutions LLC | Charlotte | North Carolina | 28203 | United States |
| Hospital of the University of Pennsylvania | Philadelphia | Pennsylvania | 19104 | United States |
| Austin Epilepsy Care Center | Austin | Texas | 78758 | United States |
| COMPLETED |
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| NOT COMPLETED |
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Safety Analysis Set: Enrolled subjects with epilepsy who received at least 1 dose of study drug
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| ID | Title | Description |
|---|---|---|
| BG000 | Safety Analysis Set: Enrolled Subjects With Epilepsy Who Received at Least 1 Dose of Study Drug | Male or female subjects between the ages of 2 and 65 years who had an established diagnosis of epilepsy exhibited by motor seizures with clear alteration of awareness, and while on a regimen of anti-epileptic medication(s), still experienced bouts of seizures (frequent breakthrough seizures, eg, seizure clusters) and who, in the opinion of the Investigator, could need benzodiazepine intervention for seizure control at least 1 time a month on average. Subjects must have been on at least 1 concomitant anti-epileptic drug at screening. Diazepam Buccal Soluble Film 5, 7.5,10, 12.5,15 or 17.5 mg with individual dose determined according to age and weight category: The subjects in this study administered DBF themselves or with the help of a caregiver, (trained by the study site staff in study drug administration and documentation) in the same setting as they typically used the diazepam rectal gel or other rescue medication, without the presence of study staff. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Body Mass Index (kg/m^2 | Mean | Standard Deviation | kg/m^2 |
|
| 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 Subjects in the Safety Analysis Set With at Least 1 Treatment-emergent Adverse Event (TEAE) | A TEAE was defined as any adverse event with onset date on the day of or after administration of study drug including relationship and severity. | Subjects who received at least 1 dose of study drug | Posted | Count of Participants | Participants | Adverse events (AEs) were recorded from Day 1 through the last study contact (Month 7 telephone contact). |
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| ||||||||||||||||||||||||||||||||||||
| Primary | Number of Subjects in Safety Analysis Set With Adverse Events of Special Interest (AESI) | A.Oral irritation related AEs including but not limited to: buccal mucosal swelling, mouth ulceration, injuries to oral cavity (such as tongue or mucosal laceration, broken tooth, bleeding), erythema, stomatitis, gingivitis, xerostomia, staining, dysphagia, dysgeusia, burning, stinging, tingling. B. Abuse related AEs including euphoria, euphoric mood, feeling of relaxation, anger, dissociative effects, hallucinations, psychosis, changes in mood, impaired cognition, attention, psychomotor effects, inappropriate affect, overdose, and misuse. C. Other: Respiratory disorders, nervous system disorders | Subjects who received at least 1 dose of study drug | Posted | Number | participants | AESIs were recorded from Day 1 through the last study contact (Month 7 telephone contact). |
| ||||||||||||||||||||||||||||||||||||||
| Secondary | Usability Assessment: Number of Use Occasions Where Difficulty in Opening the Outer Packaging Was Recorded. | For each use occasion the following question was asked: Did you have difficulty in opening the outer plastic packaging on this use occasion? Yes | Subjects who received at least 1 dose of study drug (Safety Analysis Set) | Posted | Number | total number of use occasions | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions | total number of use occasions |
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| Secondary | Usability Assessment: Ability to Open Foil Pouch on Each Use Occasion | For each use occasion the following question was asked: Did you have difficulty in opening the foil pouch on this use occasion? Yes or No | Number of subjects reporting use occasions | Posted | Count of Units | total number of use occasions | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions | total number of use occasions |
|
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| Secondary | Usability Assessment: Ability to Remove Study Drug From Foil Pouch on Each Use Occasion | For each use occasion the following question was asked: Did you have difficulty in removing study drug from foil pouch on this occasion? Yes or No | Subjects who received at least 1 dose of study drug (Safety Analysis Set) | Posted | Count of Units | total number of use occasions rpoeted | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions rpoeted | total number of use occasions rpoeted |
|
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| Secondary | Number of Occasions With Successful Insertion/Retention in Cheek | Of the total number of use occasions over the course of the study, the number of use occasions that were successfully inserted/retained in the cheek | Subjects who received at least 1 dose of study drug (Safety Analysis Set) | Posted | Number | Number of events | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions | total number of use occasions |
|
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| Secondary | Usability Assessment: Difficulty Inserting DBF Against the Buccal Mucosa (Number of Attempts to Insert Film for Each Use Occasion) | Number of occasions where it took 1 attempt to insert film, Number of occasions where it took 2 attempts to insert film, Number of occasions where it took 3 attempts to insert film, Number of occasions where it took >3 attempts to insert film | Subjects who received at least 1 dose of study drug (Safety Analysis Set) | Posted | Number | Number of events | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions | total number of use occasions |
|
| |||||||||||||||||||||||||||||||||||
| Secondary | Usability Assessment: Number of Occasions Where DBF Was Not Placed or Retained on the Inner Cheek Until Dissolution | Number of occasions where the study drug was not successfully placed and or retained in cheek until the film fully dissolved. | Subjects who received at least 1 dose of study drug (Safety Analysis Set) | Posted | Count of Units | total number of use occasions | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions | total number of use occasions |
|
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| Secondary | Usability Assessment: Reasons for Multiple Placement/Insertion Attempts During a Use Occasion | Reasons for multiple attempts at insertion Multiple choice answer was: Excessive drooling, Clenching jaw / Won't open mouth, Spit out before sticking, Other/None of the above | Subjects who received at least 1 dose of study drug (Safety Analysis Set) | Posted | Number | total number of use occasions | Recorded in an electronic diary after each use of study drug, throughout the course of the study; approximately 6 months | total number of use occasions | total number of use occasions |
|
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Adverse events that started after the first intake of DBF through the Final Visit were considered treatment-emergent adverse events (TEAEs).
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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 | Safety Analysis Set | Male or female subjects between the ages of 2 and 65 years who had an established diagnosis of epilepsy exhibited by motor seizures with clear alteration of awareness, and while on a regimen of anti-epileptic medication(s), still experienced bouts of seizures (frequent breakthrough seizures, eg, seizure clusters) and who, in the opinion of the Investigator, could need benzodiazepine intervention for seizure control at least 1 time a month on average. Subjects must have been on at least 1 concomitant anti-epileptic drug at screening. Diazepam Buccal Soluble Film 5, 7.5,10, 12.5,15 or 17.5 mg with individual dose determined according to age and weight category: The subjects in this study administered DBF themselves or with the help of a caregiver, (trained by the study site staff in study drug administration and documentation) in the same setting as they typically used the diazepam rectal gel or other rescue medication, without the presence of study staff. | 3 | 130 | 17 | 130 | 84 | 130 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Seizure | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Epilepsy | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Partial seizure | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Aspiration | Respiratory, thoracic and mediastinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Acute respiratory failure | Respiratory, thoracic and mediastinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Pneumonitis | Respiratory, thoracic and mediastinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Respiratory failure | Respiratory, thoracic and mediastinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Enterocolitis | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Small bowel obstruction | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Joint dislocation | Injury, poisoning and procedural complications | MedDRA (19.1) | Systematic Assessment |
| |
| Toxicity to various agents | Injury, poisoning and procedural complications | MedDRA (19.1) | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | MedDRA (19.1) | Systematic Assessment |
| |
| Hypokalaemia | Metabolism and nutrition disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Brain neoplasm malignant | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (19.1) | Systematic Assessment |
| |
| Death | General disorders | MedDRA (19.1) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Seizure | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
| |
| Somnolence | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
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| Lethargy | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (19.1) | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA (19.1) | Systematic Assessment |
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| Sinusitis | Infections and infestations | MedDRA (19.1) | Systematic Assessment |
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| Ear infection | Infections and infestations | MedDRA (19.1) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (19.1) | Systematic Assessment |
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| Fall | Injury, poisoning and procedural complications | MedDRA (19.1) | Systematic Assessment |
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| Skin abrasion | Injury, poisoning and procedural complications | MedDRA (19.1) | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (19.1) | Systematic Assessment |
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| Pneumonia aspiration | Respiratory, thoracic and mediastinal disorders | MedDRA (19.1) | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA (19.1) | Systematic Assessment |
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| Weight decreased | Investigations | MedDRA (19.1) | Systematic Assessment |
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| Weight increased | Investigations | MedDRA (19.1) | Systematic Assessment |
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Only those subjects who received at least one dose of DBF (130 out of 149) for a breakthrough seizure were included in the Safety Analysis Set.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Project Manager | Aquestive Therapeutics | 9089411896 | cbuan@aquestive.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Aug 11, 2020 | Jul 14, 2021 | SAP_001.pdf |
| ID | Term |
|---|---|
| D004827 | Epilepsy |
| D012640 | Seizures |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
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| Unknown or Not Reported |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
|
| Title | Measurements |
|---|---|
|
| At least 1 severe and related TEAE |
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| At least 1 serious TEAE |
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| At least 1 serious and related TEAE |
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| total number of use occasions |
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