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EpilepsyPhase 2NCT02607891

A Study of Possible Drug-drug Interactions Between Stiripentol or Valproate and Cannabidiol in Patients With Epilepsy

A Phase 2 study testing GWP42003-P in people with Epilepsy, run by Jazz Pharmaceuticals at 5 sites in 3 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

This trial consists of 2 parts: a double-blinded phase and an open-label extension phase. The blinded phase only will be described in this record. Participants will be randomized in a 4:1 ratio to receive GWP42003-P or matching placebo. Read more about this study

Who is it for?
Ages 16 to 55 years
Conditions the study is for
Epilepsy
What is being tested?
GWP42003-P
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
35 participants
Where
5 sitesin 3 countries
Study dates
9 Nov 2016to 2 Oct 2018
Phase
Phase 2
Are there results?
None posted in the registry

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 16 to 55 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Participant must be taking STP (for the STP arm) or VPA (for the VPA arm) and no more than 2 other antiepileptic drugs (AEDs) during the blinded period of the trial.
  • In the VPA arm only, the participant must not be receiving STP (VPA allowed in STP arm).
  • AED doses, including STP or VPA, must be stable for 4 weeks prior to screening and regimen must remain stable throughout the duration of the blinded period of the trial.
  • Participant must have a documented magnetic resonance imaging/computerized tomography of the brain that ruled out a progressive neurologic condition.
  • Participant must have experienced at least 1 countable uncontrolled seizure of any type (i.e., tonic-clonic, tonic, clonic, atonic, partial onset or focal: focal seizures with retained consciousness and a motor component, focal seizures with impaired consciousness, focal seizures evolving to bilateral secondary generalization) within 2 months prior to randomization.
  • Intervention with vagus nerve stimulation and/or ketogenic diet must be stable for 4 weeks prior to baseline and the participant must be willing to maintain a stable regimen during the blinded period of the trial.
  • Participant must abstain from alcohol during the blinded period of the trial.

Who cannot join

  • Participant has clinically significant unstable medical conditions other than epilepsy.
  • Participant has a history of symptoms related to a drop in blood pressure due to postural changes (e.g., dizziness, light-headedness, blurred vision, palpitations, weakness, syncope).
  • Participant has a QT interval, corrected for heart rate with Bazett's formula (QTcB), greater than:
  • 450 msec for males.
  • 470 msec for females.
  • 480 msec if right bundle branch block is present.
Show all 20Show fewer
  • Participant has any history of suicidal behavior or any suicidal ideation of type 4 or 5 on the C-SSRS in the last month or at screening.
  • Participant has had clinically relevant symptoms or a clinically significant illness in the 4 weeks prior to screening or enrollment, other than epilepsy.
  • Participant is currently using felbamate and has been taking it for less than 12 months prior to screening.
  • Participant has consumed alcohol during the 7 days prior to enrollment and is unwilling to abstain during the blinded phase of the trail.
  • Participant is currently using or has in the past used recreational or medicinal cannabis, or synthetic cannabinoid-based medications (including Sativex®) within the 3 months prior to trial entry.
  • Participant has any known or suspected history of any drug abuse or addiction.
  • Participant is unwilling to abstain from recreational or medicinal cannabis, or synthetic cannabinoid based medications (including Sativex) for the duration for the study.
  • Participant has consumed grapefruit or grapefruit juice 7 days prior to enrollment and is unwilling to abstain from drinking grapefruit juice within 7 days of pharmacokinetic visits.
  • Participant has any known or suspected hypersensitivity to cannabinoids or any of the excipients of the Investigational Medicinal Product (IMP), e.g., sesame oil.
  • Participant has received an IMP within the 12 weeks prior to the screening visit.
  • Participant has significantly impaired hepatic function at the screening or randomization visit, defined as any of the following:
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 5 × upper limit of normal (ULN).
  • ALT or AST > 3 × ULN and total bilirubin (TBL) > 2 × ULN or international normalized ratio (INR) > 1.5.
  • ALT or AST > 3 × ULN with the presence of fatigue, nausea, vomiting, right upper quadrant pain or tenderness, fever, rash, and/or eosinophilia (> 5%).

Trial locations and contacts

5 sites in 3 countries.

5 sites in 3 countries

Spain3 sites
  • Hospital Universitari Vall d'Hebron

    Barcelona

  • Hospital Ruber Internacional

    Madrid

  • Hospital Universitario Virgen del Rocio

    Seville

Other trials in Spain

Netherlands1 site
  • SEIN - Epilepsy Institute in the Netherlands Foundation

    Zwolle

Other trials in Netherlands

Sweden1 site
  • Sahlgrenska University Hospital

    Gothenburg

Other trials in Sweden

About this study

Official title: A Phase 2, Double-blind, Randomized, Placebo-controlled Pharmacokinetic Trial in 2 Parallel Groups to Investigate Possible Drug-drug Interactions Between Stiripentol or Valproate and GWP42003-P in Patients With Epilepsy

This trial consists of 2 parts: a double-blinded phase and an open-label extension phase. The blinded phase only will be described in this record. Participants will be randomized in a 4:1 ratio to receive GWP42003-P or matching placebo. The hypothesis is that levels of stiripentol (STP) or valproate (VPA) may be altered (increased or decreased) as a result of using GWP42003-P.

Conditions
Epilepsy
Being tested
GWP42003-P, Placebo
Keywords
Cannabidiol, GWP42003-P, Epidiolex, Stiripentol, Valproate
Medical subject headings
Epilepsy

What participants receive

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

  • GWP42003-PDrug

    Also called Cannabidiol, CBD, Epidiolex

    Clear, colorless to yellow solution containing cannabidiol dissolved in the excipients sesame oil and anhydrous ethanol with added sweetener (sucralose) and strawberry flavoring.

  • PlaceboDrug

    Clear, colorless to yellow solution containing the excipients sesame oil and anhydrous ethanol with added sweetener (sucralose) and strawberry flavoring.

Study groups in NCT02607891
Study groupRoleWhat they receive
STP + GWP42003-PExperimentalAdministered orally, twice daily (morning and evening; immediately after the participant's STP dose), commencing with up-titration of 100 mg/mL GWP42003-P to a maintenance dose of 20 mg/kg/day over 11 days. Participants remain on the maintenance dose for a further 14 days. Dosing is tapered (10% each day) for participants who do not enter the open-label-extension (OLE) phase or who withdraw early. STP Arm: Last patient completion October 2018
Receives: Drug: GWP42003-P
STP + PlaceboPlacebo comparatorAdministered orally, twice daily (morning and evening; immediately after the participant's STP dose), commencing with up-titration of placebo to an equivalent maintenance dose of 20 mg/kg/day over 11 days. Participants remain on the maintenance dose for a further 14 days. Dosing is tapered (10% each day) for participants who do not enter the OLE phase or who withdraw early. STP Arm: Last patient completion February 2018
Receives: Drug: Placebo
VPA + GWP42003-PExperimentalAdministered orally, twice daily (morning and evening; immediately after the participant's VPA dose), commencing with up-titration of 100 mg/mL GWP42003-P to a maintenance dose of 20 mg/kg/day over 11 days. Participants remain on the maintenance dose for a further 14 days. Dosing is tapered (10% each day) for participants who do not enter the OLE phase or who withdraw early. VPA Arm: Last patient completion February 2018
Receives: Drug: GWP42003-P
VPA + PlaceboPlacebo comparatorAdministered orally, twice daily (morning and evening; immediately after the participant's VPA dose), commencing with up-titration of placebo to an equivalent maintenance dose of 20 mg/kg/day over 11 days. Participants remain on the maintenance dose for a further 14 days. Dosing is tapered (10% each day) for participants who do not enter the OLE phase or who withdraw early. VPA Arm: Last patient completion January 2018
Receives: Drug: Placebo

What is being measured

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

  1. Maximum plasma concentration (Cmax) of STP, VPA, cannabidiol (CBD).

    The Cmax of STP, VPA and CBD is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

  2. Time to the maximum plasma concentration (Tmax) of STP, VPA and CBD.

    The Tmax of STP, VPA and CBD is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

  3. Area under the curve (AUC) from zero to final time of positive detection (0-t) of STP, VPA and CBD.

    The AUC(0-t) of STP, VPA and CBD is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

  4. Area under the plasma concentration time curve over a dosing interval, where tau is the dosing interval [AUCtau].

    The AUC(tau) of STP, VPA, and CBD is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

Secondary outcomes (14)
  1. Number of participants who experienced an adverse event.

    The number of participants who experienced an adverse event during the trial is presented.

    Measured: Up to 11 weeks.

  2. Number of participants with a clinically significant change in 12-lead electrocardiogram (ECG).

    The number of participants with a clinically significant change in ECG is presented.

    Measured: Up to 7 weeks.

  3. Number of participants with a clinically significant change in serum biochemistry.

    The number of participants with a clinically significant change in serum biochemistry is presented.

    Measured: Up to 7 weeks.

  4. Number of participants with a clinically significant change in hematology.

    The number of participants with a clinically significant change in hematology is presented.

    Measured: Up to 7 weeks.

  5. Number of participants with a clinically significant change in urinalysis.

    The number of participants with a clinically significant change in urinalysis is presented.

    Measured: Up to 7 weeks.

  6. Number of participants with a clinically significant change in vital signs.

    The number of participants with a clinically significant change in vital signs (systolic blood pressure, diastolic blood pressure, pulse rate) is presented.

    Measured: Up to 7 weeks.

  7. Number of participants with a clinically significant change in physical examination.

    The number of participants with a clinically significant change in physical examination is presented.

    Measured: Up to 7 weeks.

  8. Number of participants with a treatment-emergent suicidality flag.

    Suicidality was assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS). The number of participants with a treatment-emergent flag is presented.

    Measured: Up to 7 weeks.

  9. Seizure frequency by subtype.

    The frequency of each subtype of seizure at baseline and end of treatment is presented.

    Measured: Up to 6 weeks.

  10. Number of participants with a treatment-emergent finding indicative of drug abuse liability.

    Abuse liability was assessed through monitoring of triggering adverse events of interest and study medication accountability discrepancies. Any findings were assigned to an appropriate classification by the investigator. The number of participants with a treatment-emergent finding indicative of drug abuse liability is presented.

    Measured: Up to 7 weeks.

  11. Cmax of 4-ene-VPA, clobazam (CLB), N-desmethylclobazam (N-CLB), levetiracetam (LEV), and topiramate (TOP).

    The Cmax of 4-ene-VPA, CLB, N-CLB, LEV, and TOP is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

  12. Tmax of 4-ene-VPA, CLB, N-CLB, LEV, and TOP.

    The Tmax of 4-ene-VPA, CLB, N-CLB, LEV, and TOP is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

  13. AUC(0-t) of 4-ene-VPA, CLB, N-CLB, LEV, and TOP.

    The AUC(0-t) of 4-ene-VPA, CLB, N-CLB, LEV, and TOP is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

  14. AUC(tau) of 4-ene-VPA, CLB, N-CLB, LEV, and TOP.

    The AUC(tau) of 4-ene-VPA, CLB, N-CLB, LEV, and TOP is presented.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.

Timeline

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

  1. First posted18 Nov 2015 (estimated)
  2. Study start9 Nov 2016
  3. Primary completion11 Sep 2018
  4. Study completion2 Oct 2018

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02607891
Sponsor's protocol ID
GWEP1447 Blinded Phase
Other IDs
2015-002939-18, 2015
Status last verified
Dec 2022
First submitted
16 Nov 2015
Last updated
20 Dec 2022
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Ben-Menachem E, Gunning B, Arenas Cabrera CM, VanLandingham K, Crockett J, Critchley D, Wray L, Tayo B, Morrison G, Toledo M. A Phase II Randomized Trial to Explore the Potential for Pharmacokinetic Drug-Drug Interactions with Stiripentol or Valproate when Combined with Cannabidiol in Patients with Epilepsy. CNS Drugs. 2020 Jun;34(6):661-672. doi: 10.1007/s40263-020-00726-4.

    PubMed 32350749

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing GWP42003-P in people with Epilepsy, run by Jazz Pharmaceuticals at 5 sites in 3 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 7 inclusion and 20 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 20 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Spain, Netherlands, Sweden. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Maximum plasma concentration (Cmax) of STP, VPA, cannabidiol (CBD). (time frame: 0, 0.25, 0.5, 1, 1.5, 2, 4, 6, and 12 hours post-dose.). The study lists 4 primary outcomes in all. 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 NCT02607891, which also lists 1 linked publication.

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 20 Dec 2022.

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