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EpilepsyPhase 3NCT02091375

Antiepileptic Efficacy Study of GWP42003-P in Children and Young Adults With Dravet Syndrome (GWPCARE1)

A Phase 3 study testing GWP42003-P 20 mg/kg/day Dose in people with Epilepsy and Dravet Syndrome, run by Jazz Pharmaceuticals at 22 sites in 4 countries.

Completed

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

Official record
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Trial summary

To investigate the potential antiepileptic effects of cannabidiol (GWP42003-P) in children and young adults with Dravet syndrome. Read more about this study

Who is it for?
Ages 2 to 18 years
Conditions the study is for
Epilepsy, Dravet Syndrome
What is being tested?
GWP42003-P 20 mg/kg/day Dose
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
22 sitesin 4 countries
Study dates
30 Mar 2015to 26 Nov 2015
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

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

  • Ages 2 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Participants were male or female aged between 2 and 18 years (inclusive).
  • Participants had a documented history of Dravet Syndrome that was not completely controlled by current antiepileptic drugs.
  • Participants took one or more antiepileptic drugs at a dose that had been stable for at least four weeks.
  • All medications or interventions for epilepsy (including ketogenic diet and vagus nerve stimulation) were stable for four weeks prior to screening and participants were willing to maintain a stable regimen throughout the study.

Who cannot join

  • Participants had clinically significant unstable medical conditions other than epilepsy.
  • Participants had clinically relevant symptoms or a clinically significant illness in the four weeks prior to screening or randomization, other than epilepsy.
  • Participants were currently using or had in the past used recreational or medicinal cannabis or synthetic cannabinoid based medications (including Sativex®) within the three months prior to study entry and were unwilling to abstain for the duration for the study.
  • Participants had any known or suspected hypersensitivity to cannabinoids or any of the excipients of the investigational medicinal products.
  • Participants had been part of a previous clinical trial involving another investigational product in the previous six months.
  • There were plans for the participants to travel outside their country of residence during the study.
  • Participants previously randomized into this study. In particular, participants who participated in Part A of the study could not enter Part B.

Trial locations and contacts

22 sites in 4 countries.

22 sites in 4 countries

United States13 sites
  • Study site

    Atlanta, Georgia, 30328

  • Study site

    Boston, Massachusetts, 02114

  • Study site

    Chicago, Illinois, 60611

  • Study site

    Columbus, Ohio, 43205

  • Study site

    Houston, Texas, 77030

  • Study site

    Iowa City, Iowa, 52242

  • Study site

    Miami, Florida, 33155

  • Study site

    New York, New York, 10016

  • Study site

    Orlando, Florida, 32819

  • Study site

    Philadelphia, Pennsylvania, 19104

  • Study site

    Rochester, Minnesota, 55905

  • Study site

    Salt Lake City, Utah, 84113

  • Study site

    Winston-Salem, North Carolina, 27408

Other trials in United States

France4 sites
  • Study site

    Marseille, 13385

  • Study site

    Paris, 75015

  • Study site

    Strasbourg, 67098

  • Study site

    Toulouse, 70034

Other trials in France

United Kingdom3 sites
  • Study site

    Glasgow, G51 4TF

  • Study site

    Liverpool, L12 2AP

  • Study site

    London, WC1N 3JH

Other trials in United Kingdom

Poland2 sites
  • Study site

    Gdansk, 80-952

  • Study site

    Krakow, 30-349

Other trials in Poland

About this study

Official title: A Double Blind, Placebo Controlled Two-part Study to Investigate the Dose-ranging Safety and Pharmacokinetics, Followed by the Efficacy and Safety of Cannabidiol (GWP42003-P) in Children and Young Adults With Dravet Syndrome

To investigate the potential antiepileptic effects of cannabidiol (GWP42003-P) in children and young adults with Dravet syndrome.

Read the detailed description

GWEP1332 Part B recruited an entirely new group of participants than GWEP1332 Part A. Participants who failed the entry criteria for Part A were eligible to take part in Part B.

Part B was a 1:1 randomized, double-blind, placebo-controlled, 14-week comparison of GWP42003-P versus placebo. The aim of Part B was to assess the antiepileptic efficacy of GWP42003-P as an adjunctive antiepileptic treatment compared with placebo, with respect to the percentage change from baseline during the treatment period of the study in convulsive seizure frequency in children and young adults.

Following the establishment of initial eligibility and baseline measurements, participants entered Part B and began a 28-day baseline observation period.

Eligible participants were then randomized to receive either GWP42003-P or placebo on a 1:1 basis and titrated up to the target dose that was identified in Part A (up to 20 milligrams [mg] per kilogram [kg] per day), which was confirmed following completion of Part A by an independent Data Safety Monitoring Committee who reviewed unblinded safety and pharmacokinetic data from Part A.

Participants received investigational medicinal product for 14 weeks, consisting of a titration period followed by a 12-week maintenance period.

Efficacy and safety were monitored at various clinic visits and via telephone. After 14 weeks of treatment, all participants were offered the option of entering an open label extension (OLE) study. Entry was within seven days of the final treatment visit. Participants who did not immediately enter the OLE study commenced a down-titration taper period lasting up to 10 days. The taper period was interrupted if the participant wished to enter the open label extension study within the seven-day timeframe.

For participants who opted not to enter the OLE study, a follow-up telephone call was made 28 days after the end of dosing and weekly safety telephone calls were made during the 28-day follow-up period.

Being tested
GWP42003-P 20 mg/kg/day Dose, Placebo control
Keywords
Cannabidiol, CBD, Epidiolex, GWP42003-P
Medical subject headings
Epilepsy, Epilepsies, Myoclonic

What participants receive

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

  • GWP42003-P 20 mg/kg/day DoseDrug

    Also called Cannabidiol, Epidiolex

    GWP42003-P was an oral solution containing 100 mg/milliliter (mL) cannabidiol (CBD) dissolved in the excipients, sesame oil and anhydrous ethanol (79 mg/mL), with added sweetener (0.5 mg/mL sucralose) and strawberry flavoring (0.2 mg/mL).

  • Placebo controlDrug

    Also called Placebo

    Placebo oral solution contained the excipients, sesame oil and anhydrous ethanol (79 mg/mL), with added sweetener (0.5 mg/mL sucralose) and strawberry flavoring (0.2 mg/mL).

Study groups in NCT02091375
Study groupRoleWhat they receive
GWP42003-P 20 mg/kg/day DoseExperimentalParticipants received 20 mg/kg/day of GWP42003-P administered orally, half in the morning and half in the evening. Participants titrated GWP42003-P to 20 mg/kg/day over 11 days and remained at this dose for the 12-week maintenance period. If the participant did not immediately enter the OLE study, the maintenance period was followed by a 10-day taper (10% per day) period.
Receives: Drug: GWP42003-P 20 mg/kg/day Dose
PlaceboPlacebo comparatorParticipants received placebo (0 mg/mL CBD), volume-matched to the 20 mg/kg/day dose level, administered orally, half in the morning and half in the evening. To maintain the blinded aspect of the study, participants titrated the placebo dose over 11 days and remained at this dose for the 12-week maintenance period. If the participant did not immediately enter the OLE study, the maintenance period was followed by a 10-day taper (10% per day of the matched dose) period.
Receives: Drug: Placebo control

What is being measured

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

  1. Percentage Change From Baseline In Convulsive Seizure Frequency During The Treatment Period

    Convulsive seizures (atonic, clonic, tonic, or tonic-clonic) were recorded by the participant or caregiver using an interactive voice response system (IVRS) diary. Percentage change from baseline was calculated as: ([frequency during the treatment period - frequency during baseline]/frequency during baseline) * 100. The frequency during each period was based on 28-day averages and calculated as: (number of seizures in the period/number of reported days in the IVRS period) * 28. Baseline included all available data prior to Day 1 (28-day average). Negative percentages show an improvement from baseline.

    Measured: Baseline to End of Treatment (EOT) (Day 99) or Early Termination (ET)

Secondary outcomes (11)
  1. Number Of Participants With A ≥50% Reduction From Baseline In Convulsive Seizure Frequency During The Treatment Period

    Convulsive seizures (atonic, clonic, tonic, or tonic-clonic) were recorded by the participant or caregiver using an IVRS diary. Percentage change from baseline was calculated as per the primary outcome measure.

    Measured: Baseline to EOT (Day 99) or ET

  2. Number of Participants With A ≥25%, ≥75% Or 100% Reduction From Baseline In Convulsive Seizure Frequency During The Treatment Period

    Convulsive seizures (atonic, clonic, tonic, or tonic-clonic) were recorded by the participant or caregiver using an IVRS diary. Percentage change from baseline was calculated as per the primary outcome measure.

    Measured: Baseline to EOT (Day 99) or ET

  3. Percentage Change From Baseline In Non-Convulsive Seizure Frequency During The Treatment Period

    Non-convulsive seizures (myoclonic, partial, or absence) were recorded by the participant or caregiver using an IVRS diary. Percentage change from baseline was calculated as per the primary outcome measure. Only participants with non-convulsive seizures during the baseline period were included. Negative percentages show an improvement from baseline.

    Measured: Baseline to EOT (Day 99) or ET

  4. Caregiver Global Impression Of Change In Seizure Duration (CGICSD)

    Seizure duration was assessed qualitatively using the CGICSD. Caregivers were asked "Since the patient started treatment, please assess the average duration of the patient's seizures (comparing their condition now to their condition before treatment)"; responses included decrease, no change, or increase in average duration. For each seizure type, only participants with at least 1 seizure for the corresponding seizure type, reported at any time during the study, were included.

    Measured: Baseline to EOT (Day 99) or ET

  5. Number Of Participants Using Rescue Medication

    The use of rescue medication was recorded by the participant or caregiver using a paper diary.

    Measured: Baseline to EOT (Day 99) or ET

  6. Number Of Participants With Inpatient Hospitalizations Due To Epilepsy

    Inpatient hospitalizations due to epilepsy were recorded by the participant or caregiver and through the serious adverse events (SAE) reporting process.

    Measured: Baseline to Safety Follow-up (Day 137)

  7. Change From Baseline In Sleep Disruption 0 To 10 Numerical Rating Scale (0 to 10 NRS) Score

    The sleep disruption 0 to 10 NRS questionnaire was completed by the participant's caregiver. The caregiver was asked 'On a scale of '0 to 10', please indicate the number that best describes your child's sleep disruption in the last week.' The markers ranged from 0 = 'slept extremely well' to 10 = 'unable to sleep at all'. The change from baseline in the sleep disruption 0 to 10 numerical rating scale score was analyzed using an analysis of covariance (ANCOVA) model with baseline and age group (2 to 5 years, 6 to 12 years and 13 to 18 years) as covariates and treatment group as a fixed factor. A negative change from baseline represents an improvement in sleep. Last visit for endpoints assessed at clinic visits was defined as the last scheduled visit (not including the end of taper or safety follow-up visits) at which participant's last evaluation was performed.

    Measured: Baseline to Last Visit (Day 99) or ET

  8. Change From Baseline In Epworth Sleepiness Scale (ESS) Score

    The ESS questionnaire was completed by the participant's caregiver. The change from baseline in the ESS score was analyzed using an ANCOVA model with baseline and age group (2 to 5 years, 6- to 2 years and 13 to 18 years) as covariates and treatment group as a fixed factor. The total score was the sum of the 8 item-scores and ranged from 0 to 24. A higher total score represents greater levels of daytime sleepiness.

    Measured: Baseline to Last Visit (Day 99) or ET

  9. Change From Baseline In Quality Of Life In Childhood Epilepsy (QOLCE) Score

    The QOLCE questionnaire was completed by the parent or caregiver of participants aged 4 years and above. The change from baseline in the overall quality of life score was analyzed using an ANCOVA model with baseline and age group (2 to 5 years, 6 to 12 years and 13 to 18 years) as covariates and treatment group as a fixed factor. Zero represents the lowest or poorest category and 100 represents the highest level of functioning. The overall quality of life score was calculated by taking the mean of the subscale scores.

    Measured: Baseline to EOT (Day 99) or ET

  10. Change From Baseline In Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) Score

    The Vineland-II scores (standard scores and adaptive levels for each adaptive behavior domain, the adaptive behavior composite, and the maladaptive behavior index score and level) were assessed by the participant's caregiver. Scores were analyzed using an ANCOVA model with baseline and age group (2 to 5 years, 6 to 12 years, and 13 to 18 years) as covariates and treatment group as a fixed factor. Higher scores represent greater levels of functioning except for the maladaptive behavior index, for which a negative change from baseline represents an improvement in condition.

    Measured: Baseline to Last Visit (Day 99) or ET

  11. Caregiver Global Impression Of Change (CGIC)

    The CGIC was used to assess the participant's overall condition on a 7-point scale using the markers "very much improved, much improved, slightly improved, no change, slightly worse, much worse, or very much worse" (1 = very much improved; 7 = very much worse). On Day 1 (prior to starting IMP), the caregiver was asked to write a brief description of the participant's overall condition as a memory aid for the CGIC questionnaire at subsequent visits.

    Measured: Baseline to Last Visit (Day 99) or ET

Timeline

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

  1. First posted19 Mar 2014 (estimated)
  2. Study start30 Mar 2015
  3. Primary completion26 Nov 2015
  4. Study completion26 Nov 2015

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02091375
Sponsor's protocol ID
GWEP1332 Part B
Other IDs
2014-002941-23, 2014
Status last verified
Sep 2022
First submitted
17 Mar 2014
Last updated
28 Sep 2022
Data monitoring committee
No

Publications

  • Devinsky O, Cross JH, Laux L, Marsh E, Miller I, Nabbout R, Scheffer IE, Thiele EA, Wright S; Cannabidiol in Dravet Syndrome Study Group. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017 May 25;376(21):2011-2020. doi: 10.1056/NEJMoa1611618.

    PubMed 28538134
  • Madan Cohen J, Checketts D, Dunayevich E, Gunning B, Hyslop A, Madhavan D, Villanueva V, Zolnowska M, Zuberi SM. Time to onset of cannabidiol treatment effects in Dravet syndrome: Analysis from two randomized controlled trials. Epilepsia. 2021 Sep;62(9):2218-2227. doi: 10.1111/epi.16974. Epub 2021 Jul 15.

    PubMed 34265088

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing GWP42003-P 20 mg/kg/day Dose in people with Epilepsy and Dravet Syndrome, run by Jazz Pharmaceuticals at 22 sites in 4 countries.

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

Who may be eligible to take part?

The sponsor lists 4 inclusion and 7 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 28 Sep 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 sites in United States, France, United Kingdom, Poland. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

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

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Jul 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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

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

What does the primary outcome measure?

Percentage Change From Baseline In Convulsive Seizure Frequency During The Treatment Period (time frame: Baseline to End of Treatment (EOT) (Day 99) or Early Termination (ET)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02091375, which also lists 2 linked publications.

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 28 Sep 2022.

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