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EpilepsyBLESSNCT05859854

Cenobamate in Adults With Focal-Onset Seizures

An observational study of Epilepsy and Focal-Onset Seizure, run by Aziende Chimiche Riunite Angelini Francesco S.p.A at 10 sites in Italy.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The BLESS Study contributes to filling this information gap by collecting data from the Italian clinical practice and the Compassionate Use Program, to better characterize the clinical profile of cenobamate describing its effectiveness, safety and tolerability in adult patients diagnosed with uncontrolled focal… Read more about this study

Who is it for?
Ages 18 to 99 years
How many people
936 participants
Where
10 sitesItaly
Study dates
24 Jan 2023to Dec 2025
Phase
Observational
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 18 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients diagnosed with focal epilepsy uncontrolled despite the use of at least two antiepileptic medicinal products, treated with adjunctive cenobamate in Italy. A single cohort of patients will be involved in the study, enrolling both subjects who initiated cenobamate treatment in accordance with the current clinical practice, and subjects previously included in the cenobamate Compassionate Use Programme in Italy, provided that they fulfil all of the eligibility criteria listed below

Who may be able to join

  • Age ≥18 years at the time of cenobamate treatment initiation
  • Male or female patients
  • Patients diagnosed with focal epilepsy uncontrolled despite a history of treatment with at least two antiepileptic medicinal products at the time of cenobamate treatment initiation in agreement with the Summary of Product Characteristics (SmPC)
  • Patients who at enrolment had received at least 12 weeks (titration period up to the initial recommended target dose of 200 mg daily completed) but no more than 52 weeks of cenobamate as adjunctive treatment of focal-onset seizures with or without secondary generalization
  • Patients with available retrospective data in medical charts and seizure diaries, including information about baseline seizure frequency prior to cenobamate treatment initiation
  • Patients who gave written informed consent to take part into the study and personal data processing consent following local regulation.
  • Patients who received adjunctive cenobamate for at least 12 weeks and discontinued permanently treatment before enrolment will also be included in the study-

Who cannot join

  • Patients diagnosed with familial short-QT syndrome
  • Patients affected by hypersensitivity to the active substance cenobamate or to any of the excipients (e.g., lactose monohydrate)
  • Patients with history of severe drug-induced hypersensitivity reaction, including (but not limited to) drug reaction with eosinophilia and systemic symptoms (DRESS), and Stevens Johnson syndrome
  • Patients enrolled in a clinical trial in which treatments for epilepsy are managed through a study protocol
  • Patient unable to read and write in Italian language and to autonomously fill in questionnaires and scales
  • Patients with a known pregnancy or who are breast-feeding from cenobamate treatment initiation till enrolment visit.

Trial locations and contacts

10 sites in 1 country.

10 sites in 1 country

Italy10 sites
  • Policlinico di Bari

    Bari, Bari, 70124

  • Università degli Studi di Catanzaro "Magna Graecia"

    Catanzaro, Catanzaro, 88100

  • Associazione La Nostra Famiglia - IRCCS Eugenio Medea

    Conegliano, Treviso, 31015

  • Fondazione Istituto Neurologico Casimiro Mondino

    Pavia, Pavia, 27100

  • IRCCS Neuromed

    Pozzilli, Isernia, 86077

  • Campus Bio-Medico

    Roma, Roma, 00128

  • Policlinico Umberto I

    Roma, Roma, 00161

  • Humanitas Gradenigo

    Torino, Torino, 10153

  • Azienda Sanitaria Universitaria (A.O.U.) Integrata

    Udine, Udine, 33100

  • Ospedale San Bortolo

    Vicenza, Vicenza, 36100

Other trials in Italy

About this study

Official title: Cenobamate in Adults With Focal-Onset Seizures: a Real-World Multicenter Observational Italian

The BLESS Study contributes to filling this information gap by collecting data from the Italian clinical practice and the Compassionate Use Program, to better characterize the clinical profile of cenobamate describing its effectiveness, safety and tolerability in adult patients diagnosed with uncontrolled focal epilepsy despite the use of at least two antiepileptic medicinal products.

Read the detailed description

The main objective of the study is to describe the effectiveness of adjunctive cenobamate treatment in adult patients with uncontrolled focal epilepsy in Italy, overall and according to age class, setting of cenobamate treatment, cenobamate final target daily dose prescribed, and number of concomitant Anti Seizure Medications (ASMs). This will be assessed by intra-patient percent change and achievement of a ≥50% reduction in the seizure frequency from the pre-treatment baseline over a period of 52 weeks.

Keywords
cenobamate, Real-word, epilepsy, focal-onset seizure, observational, focal epilepsy uncontrolled
Medical subject headings
Epilepsy, Seizures, Nervous System Diseases

What participants receive

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

Study groups in NCT05859854
Study groupRoleWhat they receive
Adult patients diagnosed treated with adjunctive cenobamate in Italy.Adult patients diagnosed with focal epilepsy uncontrolled despite the use of at least two antiepileptic medicinal products, treated with adjunctive cenobamate in Italy. A single cohort of patients will be involved in the study, enrolling both subjects who initiated cenobamate treatment in accordance with the current clinical practice, and subjects previously included in the cenobamate Compassionate Use Programme in Italy, provided that they fulfil all of the eligibility criteria listed below

What is being measured

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

  1. Absolute frequency of patients achieving a 50 % or greater reduction in the seizure frequency (overall)

    Seizure frequency during the baseline and post-baseline assessments was calculated by summing the total number of seizures (all types of seizures) reported in each considered period and dividing by the duration of that period (number of days), excluding days with no available diary data, and multiplying by 28 to normalize to a monthly rate ("monthly seizure frequency").

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation

  2. Relative frequency of patients achieving a ≥50% (50% or greater) reduction in the seizure frequency (overall)

    Seizure frequency during the baseline and post-baseline assessments was calculated by summing the total number of seizures (all types of seizures) reported in each considered period and dividing by the duration of that period (number of days), excluding days with no available diary data, and multiplying by 28 to normalize to a monthly rate ("monthly seizure frequency").

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation

  3. Intra-patient percent change in the seizure frequency (overall)

    Intra-patient percent change from baseline will be defined as [(monthly seizure frequency at post-baseline assessments - monthly seizure frequency at baseline), divided by the monthly seizure frequency at baseline] multiplied by 100.

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation

  4. Absolute frequency of patients achieving a 50 % or greater reduction in the seizure (stratified)

    Seizure frequency during the baseline and post-baseline assessments was calculated by summing the total number of seizures (all types of seizures) reported in each considered period and dividing by the duration of that period (number of days), excluding days with no available diary data, and multiplying by 28 to normalize to a monthly rate ("monthly seizure frequency").

    Population will be stratified according to the following:

    • Age class of patient at the time of cenobamate treatment initiation (i.e., <65 years; ≥65 years).
    • Setting of cenobamate treatment initiation (i.e., CUP; current clinical practice).
    • Cenobamate final target daily dose prescribed (i.e., 200 mg; >200 mg).
    • Number of ASMs concomitant with cenobamate (i.e., ≤2 ASMs; >2 ASMs).

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation

  5. Relative frequency of patients achieving a ≥50% (50% or greater) reduction in the seizure frequency (stratified)

    Seizure frequency during the baseline and post-baseline assessments was calculated by summing the total number of seizures (all types of seizures) reported in each considered period and dividing by the duration of that period (number of days), excluding days with no available diary data, and multiplying by 28 to normalize to a monthly rate ("monthly seizure frequency").

    Population will be stratified according to the following:

    • Age class of patient at the time of cenobamate treatment initiation (i.e., <65 years; ≥65 years).
    • Setting of cenobamate treatment initiation (i.e., CUP; current clinical practice).
    • Cenobamate final target daily dose prescribed (i.e., 200 mg; >200 mg).
    • Number of ASMs concomitant with cenobamate (i.e., ≤2 ASMs; >2 ASMs).

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation

  6. Intra-patient percent change in the seizure frequency (stratified)

    Intra-patient percent change from baseline will be defined as [(monthly seizure frequency at post-baseline assessments - monthly seizure frequency at baseline), divided by the monthly seizure frequency at baseline] multiplied by 100.

    Population will be stratified according to the following:

    • Age class of patient at the time of cenobamate treatment initiation (i.e., <65 years; ≥65 years).
    • Setting of cenobamate treatment initiation (i.e., CUP; current clinical practice).
    • Cenobamate final target daily dose prescribed (i.e., 200 mg; >200 mg).
    • Number of ASMs concomitant with cenobamate (i.e., ≤2 ASMs; >2 ASMs).

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation

Secondary outcomes (17)
  1. Absolute frequency of patients achieving a ≥50%/≥75%/≥90%/=100% sustained reduction in the seizure frequency

    Sustained seizure frequency reduction will be defined as a ≥50%/≥75%/≥90%/=100% reduction in baseline seizure frequency achieved at 12 weeks of cenobamate treatment initiation, that continues (is sustained) without interruption and without cenobamate permanent discontinuation through the observation period until 24 and 52 weeks of cenobamate treatment initiation, respectively.

    Measured: 24 and 52 weeks of cenobamate treatment initiation.

  2. Absolute frequency of patients achieving a ≥75%/≥90%/=100% reduction in the seizure frequency

    Seizure frequency reduction will be defined as a ≥75%/≥90%/=100% reduction in baseline seizure frequency achieved at 12, 24 and 52 weeks of cenobamate treatment initiation, respectively.

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation.

  3. Relative frequencies of patients achieving a ≥50%/≥75%/≥90%/=100% sustained reduction in the seizure frequency

    Sustained seizure frequency reduction will be defined as a ≥50%/≥75%/≥90%/=100% reduction in baseline seizure frequency achieved at 12 weeks of cenobamate treatment initiation, that continues (is sustained) without interruption and without cenobamate permanent discontinuation through the observation period until 24 and 52 weeks of cenobamate treatment initiation, respectively

    Measured: 24 and 52 weeks of cenobamate treatment initiation.

  4. Relative frequencies of patients achieving a ≥75%/≥90%/=100% reduction in the seizure frequency

    Seizure frequency reduction will be defined as a ≥75%/≥90%/=100% reduction in baseline seizure frequency achieved at 12, 24 and 52 weeks of cenobamate treatment initiation.

    Measured: 12, 24 and 52 weeks of cenobamate treatment initiation.

  5. Absolute frequency of patients with at least one AE

    Absolute frequency of patients treated with cenobamate who experienced at least one AE during the applicable observation period

    Measured: Through study completion, an average of 1 year

  6. Relative frequency of patients with at least one AE

    Relative frequency of patients treated with cenobamate who experienced at least one AE during the applicable observation period

    Measured: Through study completion, an average of 1 year

  7. Absolute frequency of patients with at least one ADR

    Absolute frequency of patients treated with cenobamate who experienced at least one ADR during the applicable observation period

    Measured: Through study completion, an average of 1 year

  8. Relative frequency of patients with at least one ADR

    Relative frequency of patients treated with cenobamate who experienced at least one ADR during the applicable observation period

    Measured: Through study completion, an average of 1 year

  9. Absolute frequency of patients treated with at least one SAE

    Absolute frequency of patients treated with at least one SAE during the applicable observation period

    Measured: Through study completion, an average of 1 year

  10. Relative frequency of patients treated with at least one SAE

    Relative frequency of patients treated with at least one SAE during the applicable observation period

    Measured: Through study completion, an average of 1 year

  11. Health-Related Quality of life (HRQoL)

    The Health-Related Quality of life (HRQoL) of patients will be assessed by means of the 31-item Quality Of Life In Epilepsy inventory (QOLIE-31).

    The 31-item Quality Of Life In Epilepsy inventory (QOLIE-31) is a patient self-reported instrument that contains 31 items grouped in seven multi-item scales ( "seizure worry", "overall QoL", "emotional well-being", "energy fatigue", "cognitive functioning", "medication effects" and "social functioning"). Different items in the QOLIE-31 have different ranges of precoded numeric values, so the scoring procedure requires conversion from raw, precoded numeric values to scores of 0-100 points, with higher scores reflecting better quality of life. The QOLIE-31 overall score is calculated by summing the product of each scale score times its weight and summing over all scales, according to the instructions obtained from copyright holders.

    Measured: 12, 24 and 52 weeks

  12. Patient Global functioning (CGI-S)

    The patient global functioning will be assessed by means of the Clinical Global Impression (CGI) Scales. The Early Clinical Drug Evaluation Program (ECDEU) version of the CGI is a 3-item clinician rated scale that measures illness severity (CGI-S), global improvement or change (CGI-I) and treatment response (efficacy index: CGI-E).

    The CGI-S score ranges from 1 (normal) through to 7 (amongst the most severely ill patients).

    The calculation of the scores will be performed according to the instructions obtained from copyright holders.

    Measured: 12, 24 and 52 weeks

  13. Patient Global functioning (CGI-I)

    The patient global functioning will be assessed by means of the Clinical Global Impression (CGI) Scales. The Early Clinical Drug Evaluation Program (ECDEU) version of the CGI is a 3-item clinician rated scale that measures illness severity (CGI-S), global improvement or change (CGI-I) and treatment response (efficacy index: CGI-E).

    The CGI-I score ranges from 1 (very much improved) through to 7 (very much worse).

    The calculation of the scores will be performed according to the instructions obtained from copyright holders.

    Measured: 12, 24 and 52 weeks

  14. Patient Global functioning (CGI-E)

    The patient global functioning will be assessed by means of the Clinical Global Impression (CGI) Scales. The Early Clinical Drug Evaluation Program (ECDEU) version of the CGI is a 3-item clinician rated scale that measures illness severity (CGI-S), global improvement or change (CGI-I) and treatment response (efficacy index: CGI-E).

    The CGI-E score should take account of both therapeutic effect and tolerance, and ranges from 0 (marked improvement and no toxicity) and 4 (unchanged or worse and toxicity outweigh the therapeutic effects). Each component of the CGI is rated separately; the instrument does not yield a global score.

    The calculation of the scores will be performed according to the instructions obtained from copyright holders.

    Measured: 12, 24 and 52 weeks

  15. Daytime Sleepiness

    Daytime Sleepiness will be assessed by means of the Epworth Sleepiness Scale (ESS). The ESS is a self-administered questionnaire with 8 questions. Respondents are asked to rate, on a 4-point scale (0-3), their usual chances of dozing off or falling asleep while engaged in eight different daily activities. The ESS score can range from 0 to 24. The higher the ESS score, the higher that person Average Sleep Propensity in Daily Life (ASP), or their daytime sleepiness across a wide range of activities in their daily lives.

    Measured: 12, 24 and 52 weeks

  16. Hospital Anxiety and Depression

    Anxiety and depression symptoms will be assessed by means of the the Hospital Anxiety and Depression Scale (HADS). This is a patient self-reported instrument consisting of 14 items that provide scores on two specific subscales: "Anxiety" subscale (HADS-A, 7 items) and "Depression" subscale (HADS-D, 7 items).

    All items were scored on a 4-point Likert scale from 0 ("never") to 3 ("almost every day") referring to overt symptoms within the last week. Total scores range from 0 to 21 points for each subscale, with higher scores indicating higher levels of symptoms.

    Measured: 12, 24 and 52 weeks

  17. Retention with cenobamate

    Retention with cenobamate will be assessed by calculating the frequency of patients still on treatment with cenobamate at 52 weeks of treatment initiation.

    Measured: 52 weeks

Timeline

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

  1. First posted16 May 2023
  2. Study start24 Jan 2023
  3. Primary completionDec 2025 (estimated)
  4. Study completionDec 2025 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
936 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05859854
Sponsor's protocol ID
153(A)IM21348
Acronym
BLESS
Status last verified
May 2025
First submitted
26 Apr 2023
Last updated
8 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Lattanzi S, d'Orsi G, Di Claudio MT, D'Aniello A, Sensi SL, Dono F, Panebianco M, Sicurella L, Di Liberto A, Novara A, Di Bonaventura C, Bonanni P, Liguori C, Ranzato F, Gambardella A, Bisulli F, Pulitano P, Pauletto G, Tartara E, Vatti G, Assenza G, Giordano A, Vaudano AE, Mazza G, La Neve A, Pignatta P, Beretta S, Pezzella M, Cecconi M, Pizzanelli C, Andreone V, Vollono C, Puligheddu M, Gangitano M, Audenino D, Foschi N, Fallica E, Boero G, Stokelj D, Pasolini MP, Tramacere L, Strigaro G, Ferlazzo E, Zanoni T, Penza P, Elia M, Quadri S, De Maria G, Santo Sabato M, Giuliano L, Galli R, Labate A, Dainese F, Falcicchio G, De Simone R, Procaccini M, Villano V, Camattari G, Andreis D, Simoni L, Di Gennaro G; BLESS Study Group. Beyond seizure control: Non-seizure-related outcomes in focal-onset epilepsy treated with adjunctive cenobamate. Third interim results from the BLESS study. Epilepsia. 2026 Oct 15. doi: 10.1002/epi.70501. Online ahead of print.

    PubMed 42879242
  • Lattanzi S, Ranzato F, Di Bonaventura C, Bonanni P, Gambardella A, Tartara E, Assenza G, Procaccini M, Falsetto N, Villano V, Camattari G, Ori A, Di Gennaro G; BLESS Study Group. Effectiveness and Safety of Adjunctive Cenobamate in People with Focal-Onset Epilepsy: Evidence from the First Interim Analysis of the BLESS Study. Neurol Ther. 2024 Aug;13(4):1203-1217. doi: 10.1007/s40120-024-00634-5. Epub 2024 Jun 8.

    PubMed 38850402

Questions about this trial

What is this clinical trial studying?

An observational study of Epilepsy and Focal-Onset Seizure, run by Aziende Chimiche Riunite Angelini Francesco S.p.A at 10 sites in Italy.

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 6 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: under way, not looking for participants, as of the sponsor's last update on 8 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in Italy. 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.

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?

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?

Absolute frequency of patients achieving a 50 % or greater reduction in the seizure frequency (overall) (time frame: 12, 24 and 52 weeks of cenobamate treatment initiation). The study lists 6 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 NCT05859854, 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 8 Sep 2025.

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