Post Stroke EpilepsyPhase 2NCT06597084
Anti-epileptogenic Effects of Eslicarbazepine Acetate
A Phase 2 study testing ESL 800 mg in people with Post Stroke Epilepsy, run by Bial - Portela C S.A. at 22 sites in 9 countries.
Trial summary
This study aims to assess if eslicarbazepine acetate (ESL) treatment (started within 96 hours after stroke occurrence and continued for 30 days) changes the incidence of unprovoked seizures (USs) within the first 6 months after randomisation as compared to placebo Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Post Stroke Epilepsy
- What is being tested?
- ESL 800 mg
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 129 participants
- Where
- 22 sitesin 9 countries
- Study dates
- 29 May 2019to 11 Sep 2023
- Phase
- Phase 2
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must meet ALL of the following criteria:
- Male or female patient aged 18 years or above;
- Acute intracerebral haemorrhage with a CAVE score ≥ 3 or acute ischaemic stroke with a SeLECT score ≥ 6, in each case confirmed by magnetic resonance imaging (MRI)/computed tomography (CT).
- Time of stroke occurrence is known and V1b is planned within 96 hours.
- Brain scan analysis has reliably excluded structural brain lesions that can mimic stroke, e.g. cerebral tumour or brain abscess, etc.
- a. Patient is able to give informed consent and to write and has signed written informed consent OR b. Patient is able to give informed consent, but unable to write and has provided verbal witnessed consent OR c. Patient is unable to give informed consent, but likely to regain this ability until V2, and the informed consent is deferred OR d. Patient is unable to give informed consent, but likely to regain this ability until V2, and patient's legal representative (according to the respective national/local requirements) has provided written informed consent.
Show all 9Show fewer
- Female patients without childbearing potential (2 years postmenopausal, bilateral oophorectomy or tubal ligation, or complete hysterectomy) are eligible. Female patients with childbearing potential must not be pregnant as confirmed by a negative pregnancy test and sexually active females must use a medically acceptable effective nonhormonal method of contraception up to the end of the current menstrual cycle after stopping treatment. Acceptable methods for women are surgical intervention (e.g. bilateral tubal occlusion), intrauterine device, double-barrier methods, true sexual abstinence (i.e. when this is in line with the preferred and usual lifestyle of the patient) and vasectomised male partner, provided that he is the sole partner of that patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
- V1b is within 96 hours after stroke occurrence. Inclusion criteria at V2 (only applicable for patients who were unable to give informed consent at V1a.)
- a. Patient is able to give informed consent and to write and has signed a written informed consent OR b. Patient is able to give informed consent, but unable to write and has provided verbal witnessed consent.
Who cannot join
- Patients are to be excluded from the trial for ANY ONE of the following reasons:
- Contraindication to ESL, i.e. known hypersensitivity to ingredients of ESL formulation or other carboxamide derivatives (e.g., oxcarbazepine, carbamazepine), or second or third degree atrioventricular (AV) block not corrected with a permanent pacemaker.
- Known Han Chinese or Thai ancestry.
- History of previous stroke (other than the one described in inclusion criteria no. 2 - 3).
- Sinus venous thrombosis.
- Spontaneous sub-arachnoid haemorrhage due to e.g. aneurysmatic or arteriovenous malformation.
Show all 19Show fewer
- History of USs prior to primary stroke.
- Impaired pre-stroke level of function, i.e. modified Rankin Scale (mRS) score > 3 prior to first stroke occurrence.
- History of AED use before primary stroke within the last 5 years as defined in the list of not allowed AEDs.
- Use of ESL, unless provided as IMP of this trial, and oxcarbazepine.
- Severe hepatic impairment.
- Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 (measured at V1a).
- Known or suspected acute or chronic alcoholism, delirium tremens, or toxic psychosis.
- History of suicidal ideation or suicide attempt within the past 3 years.
- Presence of any other significant or progressive/unstable medical condition that, in the opinion of the investigator, would compromise evaluation of the trial treatment or may jeopardise the patient's safety, compliance or adherence to protocol requirements, such as significant psychiatric, cardiovascular, respiratory, metabolic, endocrine, haematologic, infectious or neurological disease.
- For women: Pregnancy or breast-feeding.
- Previous enrolment in this trial or participation in any other investigational drug trial within the past 30 days (or 5 half-lives of IMP whichever is longer) prior to V1a.
- Persons committed to an institution by virtue of an order issued either by the judicial or other authorities.
- Employees of the investigator or trial centre, with direct involvement in the proposed trial or other studies under the direction of that investigator or trial centre, as well as family members of the employees or the investigator.
Trial locations and contacts
22 sites in 9 countries.
22 sites in 9 countries
Germany6 sites
Uniklinik RWTH Aachen, Klinik für Neurologie
Aachen, Pauwelsstr. 30, 52074
Universitatsklinikum Erlangen, Neurologische Klinik
Erlangen, Schwabachanlage 6, 91054
Universitatsklinikum Essen, Klinik fur Neurologie
Essen, Hufelandstr. 55, 45147
UKGM Universitatsklinikum Marburg, Klinik und Poliklinik fur Neurologie
Marburg, Baldingerstrabe, 35043
LMU Ludwig-Maximilians-Universitat, Munchen, Klinikum Grobhadern, Neurologische Klinik und Poliklinik, Experimentelle Neurologie
München, Marchioninistrabe 15, 81377
Neurologische Universitatsklinik
Tübingen, Hoppe-Seyler-Strabe 3, 72076
Austria5 sites
Medizinische Universität Innsbruck, Universitätsklinik für Neurologie
Innsbruck, Innrain 52, 6020
Klinikum am Wörthersee, Abteilung fur Neurologie
Klagenfurt, FeschnigstraBe 11, 9020
Kepler University Hospital, Med Campus III, Department of Neurology 2
Linz, Krankenhausstraße 9, 4021
Kepler University Hospital GmbH, Neuromed Campus, Department of Neurology 1
Linz, Wagner-Jauregg-Weg 15, 4020
Clinical Research Center Salzburg GmbH
Salzburg, Strubergasse 21, 5050
Italy3 sites
Azienda Sanitaria dell'Alto Adige - Ospedale di Merano
Merano, Via Rossini 5, 39012
Azienda Sanitaria Universitaria Integrata di Trieste - Ospedale Cattinara - Clinica Neurologica
Trieste, Strada Di Fiume 447, 34149
Clinica Neurologica e di Neuroriabllltazione - Azienda / Ospedallero-Universitarla S. Maria della Miserrcordia
Udine, P. Le S. Maria Della Misericordia, 15, 33100
Israel2 sites
Sheba Medical Center, Neurology Department, Stroke Unit
Ramat Gan, Emek Ha'ella 1, 5265601
Tel Aviv Sourasky Medical Center, Neurology Division
Tel Aviv, Weizmann 6, 64239
United Kingdom2 sites
King's College Hospital
London, Denmark Hill, SE5 9RS
Institute of Neurology
London, Queen Square, WC1N 3BG
France1 site
Hospices Civils de Lyon, Neurological Hospitals
Bron, Boulevard Pinel, 59, 69677
Portugal1 site
Centro Hospitalar Universitário Lisboa Norte, E.P.E. - Hospital Santa Maria - Serviço de Neurologia
Lisbon, Avenida Prof. Egas Moniz, 1649-035
Spain1 site
Hospital Universitario Fundación Jiménez Diaz
Madrid, Avda. de Los Reyes Catolicos, 2, 28040
Sweden1 site
Sahlgrenska universitetssjukhuset, Neurosjukvarden
Gothenburg, Bia Straket 7, 41345
About this study
Official title: Prevention of Epilepsy in Stroke Patients at High Risk of Developing Unprovoked Seizures: Anti-epileptogenic Effects of Eslicarbazepine Acetate
This study aims to assess if eslicarbazepine acetate (ESL) treatment (started within 96 hours after stroke occurrence and continued for 30 days) changes the incidence of unprovoked seizures (USs) within the first 6 months after randomisation as compared to placebo
Read the detailed description
This is a multicentre, double-blind, randomised, placebo-controlled, parallel-group trial in patients with acute intracerebral haemorrhage with a Cortical involvement, Age <65 years, Volume of intracerebral haemorrhage > 10 ml and Early seizure within 7 days after intracerebral haemorrhage (CAVE) score ≥ 3 or an acute ischaemic stroke with a SeLECT score ≥ 6.
At the first visit (screening/baseline, V1a), patients will undergo several examinations to check eligibility. The next visit (V1b) has to be performed within 96 hours after primary stroke occurrence. After eligibility has been confirmed, patients will be randomised (randomisation ratio 1:1) to treatment with ESL 800 mg (Group A) or placebo (Group B).
Patients will start treatment with the investigational medicinal product (IMP), i.e. ESL or placebo, within 96 hours after primary stroke occurrence at V1b. They will continue treatment until Day 30 after randomisation and then be tapered off. Thereafter, patients will be followed up until 18 months after randomisation. Patients can concomitantly receive antiepileptic therapies, except commercially available ESL or oxcarbazepine, until Day 30.
Concomitant antiepileptic therapies have to be discontinued and down-titration has to be started according to the respective Summary of Product Characteristics (SmPC). If the antiepileptic drugs (AEDs)/benzodiazepine are not already discontinued before, downtitration must be started on Day 31 at the latest.
If one or more AS(s) occur(s) within 7 days after primary stroke, this will not result in change of IMP dose. Patients having a first US will discontinue IMP treatment and will be treated at the discretion of the investigator until 18 months after randomisation, except with commercially available ESL.
Further visits will be performed 7 days (V2, on-site), 37 days (V3, on-site), 12 weeks (V4, telephone), 26 weeks (V5, on-site), 38 weeks (V6, telephone), 52 weeks (V7, on-site), 64 weeks (V8, telephone) and 78 weeks (End of Trial (EoT) visit, on-site) after V1b.
- Conditions
- Post Stroke Epilepsy
- Being tested
- ESL 800 mg, Placebo
- Keywords
- Prophylaxis, Post-stroke, Epilepsy, BIA 2-093, Unprovoked seizures, Eslicarbazepine acetate, Anti-epileptogenic, Bial - Portela & Ca, S.A.
- Medical subject headings
- Epilepsy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ESL 800 mgDrug
Also called Eslicarbazepine acetate, BIA 2-093
800 mg ESL tablets for oral administration. In case a patient is unable to swallow the whole tablet, the tablet can be crushed or divided into equal doses at the score line.
PlaceboDrug
Placebo tablets for oral administration, matching the test product. In case a patient is unable to swallow the whole tablet, the tablet can be crushed or divided into equal doses at the score line.
| Study group | Role | What they receive |
|---|---|---|
| Group A | Experimental | ESL 800 mg Receives: Drug: ESL 800 mg |
| Group B | Placebo comparator | Placebo Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of Patients Who Experience the First Unprovoked Seizures (US) Within the First 6 Months After Randomisation (Failure Rate)
Deaths before the first US or patients without evaluable assessment of the primary endpoint will be counted as treatment failures. To show that ESL (Group A) is superior to placebo (Group B), the primary null hypothesis will be tested against the alternative hypothesis
Measured: First 6 months after randomisation
Secondary outcomes (19)
Proportion of Patients Who Experience the First US During the First 12 Months After Randomisation
Deaths before the first US or patients without evaluable assessment of the primary endpoint will be counted as treatment failures. To show that ESL (Group A) is superior to placebo (Group B), the primary null hypothesis will be tested against the alternative hypothesis
Measured: First 12 months after randomisation
Proportion of Patients Who Experience the First US During the Course of the Trial
Deaths before the first US or patients without evaluable assessment of the primary endpoint will be counted as treatment failures. To show that ESL (Group A) is superior to placebo (Group B), the primary null hypothesis will be tested against the alternative hypothesis
Measured: Until 18 months after randomisation
Number of Acute Symptomatic Seizure (ASS)
Number of ASSs will be summarised by means of descriptive statistics
Measured: During the first 7 days after stroke
Probability of Failure at 6, 12, and 18 Months After Randomization
The time to first US after randomisation will be analysed and presented by means of the Kaplan-Meier estimate after 6, 12 and 18 months for the failure time. The time to first US will be analysed from the day of randomisation.
Measured: Over 18 months follow-up period
Time to First US After Stroke Occurrence.
Analysis of time to first US will be performed using the day of stroke (before randomisation) as Day 1.
The secondary objective and endpoint "Time to first US after stroke occurrence" was decided to be deleted as it is closely related to the forth secondary endpoint "Time to first US after randomisation" and therefore would not really have any additional value.
Measured: Over 18 months follow-up period
Number and 4-week Rate of USs (4-week Rate of USs Was Omitted With SAP, Final Version 1.0, 22 NOV 2023).
The total number and rate of USs, standardised per 4 weeks, in all patients and in patients with US(s) only will be summarised by means of descriptive statistics.
The secondary objective and endpoint "4-week rate of USs" was decided to be deleted as this information will not be meaningful for this trial.
Measured: Over 18 months follow-up period
Barthel Index (BI) Original 10-item Version
The Barthel Index at baseline and post-baseline visits of each patient will be calculated adding the individual scores from each item. Baseline is the value assessed before first IMP intake. Endpoint is the last non-missing value collected after the first IMP intake. The BI is a widely used score to measure the performance in activities of daily living of patients with stroke and other neuromuscular or musculoskeletal disorders in the following 10 categories:
- Feeding (scored as 0, 5, 10)
- Moving from a wheelchair to a bed and back again (scored as 0, 5, 10, 15)
- Personal hygiene (scored as 0, 5)
- Getting on and off the toilet (scored as 0, 5, 10)
- Self-bathing (scored as 0, 5)
- Walking on a level surface (scored as 0, 5, 10, 15)
- Ascending and descending stairs (scored as 0, 5, 10)
- Dressing (scored as 0, 5, 10)
- Controlling bowels (scored as 0, 5, 10)
- Controlling bladder (scored as 0, 5, 10) The minimum value means with help and maximum independent
Measured: Barthel Index data is collected at Baseline, V3 (+37 days), V5 (+26 weeks), V7 (+52 weeks), End of trial visit (EOT, +78 weeks) or Early discontinuation visit (EDV, on average 30 days), and Endpoint (18 months).
National Institutes of Health Stroke Scale (NIHSS)
The NIHSS is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficits.
The following questions will be asked:
1a. Level of Consciousness (LOC) (scored as 0, 1, 2, 3)
1b. LOC Questions (scored as 0, 1, 2)
1c. LOC Commands (scored as 0, 1, 2) 2. Best Gaze (scored as 0, 1, 2) 3. Visual (scored as 0, 1, 2, 3) 4. Facial Palsy (scored as 0, 1, 2, 3) 5a. Motor Arm (Left Arm) (scored as 0, 1, 2, 3, 4) 5b. Motor Arm (Right Arm) (scored as 0, 1, 2, 3, 4) 6a. Motor Leg (Left Leg) (scored as 0, 1, 2, 3, 4) 6b. Motor Right (Right Leg) (scored as 0, 1, 2, 3, 4) 7. Limb Ataxia (scored as 0, 1, 2) 8. Sensory (scored as 0, 1, 2) 9. Best Language (scored as 0, 1, 2, 3) 10. Dysarthria (scored as 0, 1, 2) 11. Extinction and Inattention (formerly Neglect) (scored as 0, 1, 2) The sum of all 15 individual scores will provide the patient's total NIHSS score where 0 is "no stroke symptoms" and 42 is "severe stroke".
Measured: National Institutes of Health Stroke Scale (NIHSS) data is collected at Baseline, V3 (+37 days), V5 (+26 weeks), V7 (+52 weeks), End of trial visit (EOT, +78 weeks) or Early discontinuation visit (EDV, on average 30 days), and Endpoint (18 months).
Patient Health Questionnaire (PHQ-9)
The PHQ-9 can be used for screening, diagnosing and measuring the severity of depression in stroke patients. The patient will rate on a scale from 0 (not at all) to 3 (nearly every day) how often each of the 9 symptoms occurred during the past 2 weeks. The individual scores from each item of the PHQ-9 will be added to calculate the total PHQ-9 score for each time of examination.
Measured: Over 18 months follow-up period
Overall Survival at 6, 12, and 18 Months After Randomization
Overall survival (time to death relative to the date of randomization) will be analysed and presented by means of the Kaplan-Meier estimates (including censored data e.g. withdrawals) after 6 months (Day 182), 12 months (Day 365) and 18 months (Day 547) for the survival rates.
Measured: Over 18 months follow-up period
Treatment Emergent Adverse Events (TEAEs) Incl. Findings From Physical and Neurological Examinations
Adverse events (AEs) not considered treatment-emergent according to this definition or with missing data will be medically reviewed during the data review meeting and will be considered treatment emergent if appropriate
Measured: Over 18 months follow-up period
Clinically Significant Haematology Abnormalities
Based on haemoglobin, haematocrit, red blood cell count (RBC), white blood cell count (WBC), differential - neutrophils, eosinophils, lymphocytes, monocytes and basophils, and platelet count. All laboratory values will be classified as normal or abnormal according to the laboratories normal ranges and as clinically significant according to the assessment of the investigator. For these tests, approximately 12 mL of blood will be collected at each blood withdrawal.
Measured: Over 18 months follow-up period
Clinically Significant Biochemistry Abnormalities, Including eGFR (Estimated Glomerular Filtration Rate) and Coagulation
The biochemistry analysis is based on sodium (will be monitored for signs of hyponatraemia), potassium, chloride, calcium, phosphate, blood urea nitrogen, aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), alkaline phosphatase, creatine phosphokinase (CPK), creatinine, glucose, C-reactive protein, albumin, total protein, total cholesterol, low-density lipoproteincholesterol, high-density lipoprotein-cholesterol, triglycerides, and total bilirubin (bilirubin will be fractionated direct/indirect if elevated). eGFR will be estimated based on serum creatinine value using the according CKD-EPI formula using age, sex and race. Coagulation is based on international normalised ratio and activated partial thromboplastin time (aPTT). All laboratory values will be classified as normal or abnormal according to the laboratories normal ranges and as clinically significant according to the assessment of the investigator.
Measured: Over 18 months follow-up period
Clinically Significant Urinalysis Abnormalities
The urinalysis is based on pH, specific gravity, protein, blood, glucose, ketones, bilirubin, urobilinogen (local dipstick). Microscopy and other appropriate tests (as needed) will be performed if dipstick indicates any significant abnormality. All laboratory values will be classified as normal or abnormal according to the laboratories normal ranges and as clinically significant according to the assessment of the investigator.
Measured: Over 18 months follow-up period
Clinically Significant Vital Sign Abnormalities: Blood Pressure
The systolic and diastolic blood pressure (mmHg) were to be measured after the patient had rested for at least 5 minutes. Painful procedures, like drawing blood, had to be performed after vital signs measurements (not before). The analyses of variables for vital sign parameters will focus on the evaluation of the change from baseline to the scheduled time points after baseline. Descriptive statistics of the time course and of changes from baseline to each post-baseline time point will be presented by treatment group.
Measured: Over 18 months follow-up period
Clinically Significant Vital Sign Abnormalities: Heart Rate
The Heart Rate (bpm) were to be measured after the patient had rested for at least 5 minutes. Painful procedures, like drawing blood, had to be performed after vital signs measurements (not before). The analyses of variables for vital sign parameters will focus on the evaluation of the change from baseline to the scheduled time points after baseline. Descriptive statistics of the time course and of changes from baseline to each post-baseline time point will be presented by treatment group.
Measured: Over 18 months follow-up period
Electrocardiogram (ECG)
The ECG equipment is to be calibrated to 1 cm/mV and recording is to be done at 25 mm/sec and performed for a minimum of 10 sec. At V1a the investigator should examine the ECG for signs of cardiac disease that should exclude the patient from the trial. An assessment of normal or abnormal will be recorded and if the ECG abnormality is considered clinically significant, the abnormality will be documented in the electronic case report form (eCRF). If an ECG was done after primary stroke, the results should be used and the examination does not need to be repeated at V1a. After each recording of a simultaneous 12-lead resting ECG, a copy of the originally printed ECG records will be printed, assessed and filed by the investigator, in order to ensure that maintenance of the data will not be affected by thermolability of the paper.
Measured: A standard 12-lead electrocardiogram (ECG) is performed at Baseline, V2 (+7 days), V3 (+37 days), Early discontinuation visit (if EDV performed before V3, on average 30 days).
Suicidal Ideation and Behaviour, Assessed by PHQ-9 (Question 9)
The individual scores from each item of the PHQ-9 will be added to calculate the total PHQ-9 score for each time of examination.Over the last 2 weeks, how often have you been bothered by any of the following problems?
- Little interest or pleasure in doing things
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling bad about yourself - or that you are a failure or have let yourself or your family down
- Trouble concentrating on things, such as reading the newspaper or watching television
- Moving or speaking so slowly that other could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual
- Thoughts that you would be better off dead or of hurting yourself in some way The individual scores from each item of the PHQ-9 will be added to calculate the total PHQ-9 score for each time of examination.
Measured: The PHQ-9 will be collected at Baseline, V3 (+37 Days), V5 (+26 weeks), V7 (+52 weeks), End of trial visit (EOT, +78 weeks) or Early discontinuation visit (if EDV performed before V3, on average 30 days), and Endpoint (18 months).
Number of Participants With and Without Seizures Based on Electroencephalogram (EEG)
Routine EEG assessment (standard 10-20 set of electrodes, digital recording with 256 Hz sampling rate) for a minimum of 20 min will be performed at the discretion of the investigator. The EEG will be performed as exploratory analysis to support the development of a predictor for the development of post-stroke epilepsy and is therefore an optional assessment. All EEG analyses will be presented for the EEG analysis subset (all patients in the full analysis set with a baseline and a post-baseline EEG recording available). EEG parameters will be evaluated exploratively using descriptive statistics.
For this outcome was decided that results would be possibly explored in an manuscript.
Measured: Two recordings were provided: one carried out before in the initial phase of enrollment into the trial at V1a (< 96 hours) and the second one after termination of eslicarpazepine acetate intake (EOT, +78 weeks).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Sep 2024
- Study start29 May 2019
- Primary completion11 Sep 2023
- Study completion11 Sep 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Post Stroke EpilepsyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 129 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bial - Portela C S.A.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Eugen Trinka, MD MSc FRCP, Principal investigator, Universitätsklinik für NeurologieMatthias Koepp, MD PhD FRCP, Principal investigator, UCL Institute of Neurology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06597084
- Sponsor's protocol ID
- BIA-2093-213
- Other IDs
- 2018-002747-29, 2018
- Status last verified
- Apr 2025
- First submitted
- 3 Sep 2024
- Last updated
- 2 May 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prevention of Epilepsy in Stroke Patients at High Risk of Developing Unprovoked Seizures: Anti-epileptogenic Effects of Eslicarbazepine Acetate
- ClinicalTrials.gov ID
- NCT06597084
- Acronym / sponsor ID
- BIA-2093-213
- Conditions
- Post Stroke Epilepsy
- Keywords
- Prophylaxis, Post-stroke, Epilepsy, BIA 2-093, Unprovoked seizures, Eslicarbazepine acetate, Anti-epileptogenic, Bial - Portela & Ca, S.A.
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 129 participants (actual)
- Lead sponsor
- Bial - Portela C S.A.Industry (pharma, biotech, devices)
- Study start
- 29 May 2019 (actual)
- Primary completion
- 11 Sep 2023 (actual)
- Study completion
- 11 Sep 2023 (actual)
- First posted
- 19 Sep 2024 (actual)
- Results
- Posted 2 May 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to assess if eslicarbazepine acetate (ESL) treatment (started within 96 hours after stroke occurrence and continued for 30 days) changes the incidence of unprovoked seizures (USs) within the first 6 months after randomisation as compared to placebo
Detailed description
This is a multicentre, double-blind, randomised, placebo-controlled, parallel-group trial in patients with acute intracerebral haemorrhage with a Cortical involvement, Age <65 years, Volume of intracerebral haemorrhage > 10 ml and Early seizure within 7 days after intracerebral haemorrhage (CAVE) score ≥ 3 or an acute ischaemic stroke with a SeLECT score ≥ 6.
At the first visit (screening/baseline, V1a), patients will undergo several examinations to check eligibility. The next visit (V1b) has to be performed within 96 hours after primary stroke occurrence. After eligibility has been confirmed, patients will be randomised (randomisation ratio 1:1) to treatment with ESL 800 mg (Group A) or placebo (Group B).
Patients will start treatment with the investigational medicinal product (IMP), i.e. ESL or placebo, within 96 hours after primary stroke occurrence at V1b. They will continue treatment until Day 30 after randomisation and then be tapered off. Thereafter, patients will be followed up until 18 months after randomisation. Patients can concomitantly receive antiepileptic therapies, except commercially available ESL or oxcarbazepine, until Day 30.
Concomitant antiepileptic therapies have to be discontinued and down-titration has to be started according to the respective Summary of Product Characteristics (SmPC). If the antiepileptic drugs (AEDs)/benzodiazepine are not already discontinued before, downtitration must be started on Day 31 at the latest.
If one or more AS(s) occur(s) within 7 days after primary stroke, this will not result in change of IMP dose. Patients having a first US will discontinue IMP treatment and will be treated at the discretion of the investigator until 18 months after randomisation, except with commercially available ESL.
Further visits will be performed 7 days (V2, on-site), 37 days (V3, on-site), 12 weeks (V4, telephone), 26 weeks (V5, on-site), 38 weeks (V6, telephone), 52 weeks (V7, on-site), 64 weeks (V8, telephone) and 78 weeks (End of Trial (EoT) visit, on-site) after V1b.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A | Experimental | Drug: ESL 800 mgESL 800 mg |
| Group B | Placebo comparator | Drug: PlaceboPlacebo |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Male or female patient aged 18 years or above;
- Acute intracerebral haemorrhage with a CAVE score ≥ 3 or acute ischaemic stroke with a SeLECT score ≥ 6, in each case confirmed by magnetic resonance imaging (MRI)/computed tomography (CT).
- Time of stroke occurrence is known and V1b is planned within 96 hours.
- Brain scan analysis has reliably excluded structural brain lesions that can mimic stroke, e.g. cerebral tumour or brain abscess, etc.
- a. Patient is able to give informed consent and to write and has signed written informed consent OR b. Patient is able to give informed consent, but unable to write and has provided verbal witnessed consent OR c. Patient is unable to give informed consent, but likely to regain this ability until V2, and the informed consent is deferred OR d. Patient is unable to give informed consent, but likely to regain this ability until V2, and patient's legal representative (according to the respective national/local requirements) has provided written informed consent.
Key exclusion criteria (19 listed)
- Contraindication to ESL, i.e. known hypersensitivity to ingredients of ESL formulation or other carboxamide derivatives (e.g., oxcarbazepine, carbamazepine), or second or third degree atrioventricular (AV) block not corrected with a permanent pacemaker.
- Known Han Chinese or Thai ancestry.
- History of previous stroke (other than the one described in inclusion criteria no. 2 - 3).
- Sinus venous thrombosis.
- Spontaneous sub-arachnoid haemorrhage due to e.g. aneurysmatic or arteriovenous malformation.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ESL 800 mgAlso: Eslicarbazepine acetate, BIA 2-093800 mg ESL tablets for oral administration. In case a patient is unable to swallow the whole tablet, the tablet can be crushed or divided into equal doses at the score line. | Drug | Group A |
| PlaceboPlacebo tablets for oral administration, matching the test product. In case a patient is unable to swallow the whole tablet, the tablet can be crushed or divided into equal doses at the score line. | Drug | Group B |
Primary outcome
Proportion of Patients Who Experience the First Unprovoked Seizures (US) Within the First 6 Months After Randomisation (Failure Rate)
Time frame: First 6 months after randomisation
Deaths before the first US or patients without evaluable assessment of the primary endpoint will be counted as treatment failures. To show that ESL (Group A) is superior to placebo (Group B), the primary null hypothesis will be tested against the alternative hypothesis
19 secondary outcomes
Proportion of Patients Who Experience the First US During the First 12 Months After Randomisation
Time frame: First 12 months after randomisation
Proportion of Patients Who Experience the First US During the Course of the Trial
Time frame: Until 18 months after randomisation
Number of Acute Symptomatic Seizure (ASS)
Time frame: During the first 7 days after stroke
Probability of Failure at 6, 12, and 18 Months After Randomization
Time frame: Over 18 months follow-up period
Time to First US After Stroke Occurrence.
Time frame: Over 18 months follow-up period
Number and 4-week Rate of USs (4-week Rate of USs Was Omitted With SAP, Final Version 1.0, 22 NOV 2023).
Time frame: Over 18 months follow-up period
Barthel Index (BI) Original 10-item Version
Time frame: Barthel Index data is collected at Baseline, V3 (+37 days), V5 (+26 weeks), V7 (+52 weeks), End of trial visit (EOT, +78 weeks) or Early discontinuation visit (EDV, on average 30 days), and Endpoint (18 months).
National Institutes of Health Stroke Scale (NIHSS)
Time frame: National Institutes of Health Stroke Scale (NIHSS) data is collected at Baseline, V3 (+37 days), V5 (+26 weeks), V7 (+52 weeks), End of trial visit (EOT, +78 weeks) or Early discontinuation visit (EDV, on average 30 days), and Endpoint (18 months).
Patient Health Questionnaire (PHQ-9)
Time frame: Over 18 months follow-up period
Overall Survival at 6, 12, and 18 Months After Randomization
Time frame: Over 18 months follow-up period
Treatment Emergent Adverse Events (TEAEs) Incl. Findings From Physical and Neurological Examinations
Time frame: Over 18 months follow-up period
Clinically Significant Haematology Abnormalities
Time frame: Over 18 months follow-up period
Clinically Significant Biochemistry Abnormalities, Including eGFR (Estimated Glomerular Filtration Rate) and Coagulation
Time frame: Over 18 months follow-up period
Clinically Significant Urinalysis Abnormalities
Time frame: Over 18 months follow-up period
Clinically Significant Vital Sign Abnormalities: Blood Pressure
Time frame: Over 18 months follow-up period
Clinically Significant Vital Sign Abnormalities: Heart Rate
Time frame: Over 18 months follow-up period
Electrocardiogram (ECG)
Time frame: A standard 12-lead electrocardiogram (ECG) is performed at Baseline, V2 (+7 days), V3 (+37 days), Early discontinuation visit (if EDV performed before V3, on average 30 days).
Suicidal Ideation and Behaviour, Assessed by PHQ-9 (Question 9)
Time frame: The PHQ-9 will be collected at Baseline, V3 (+37 Days), V5 (+26 weeks), V7 (+52 weeks), End of trial visit (EOT, +78 weeks) or Early discontinuation visit (if EDV performed before V3, on average 30 days), and Endpoint (18 months).
Number of Participants With and Without Seizures Based on Electroencephalogram (EEG)
Time frame: Two recordings were provided: one carried out before in the initial phase of enrollment into the trial at V1a (< 96 hours) and the second one after termination of eslicarpazepine acetate intake (EOT, +78 weeks).
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 May 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
Related trials for Post Stroke Epilepsy
RecruitingObservational study
Rare Disease Patient Registry & Natural History Study - Coordination of Rare Diseases at Sanford
Rare Disorders, Undiagnosed Disorders
RecruitingObservational study
Long-Term Epilepsy Outcomes in Children With a History of Perinatal Stroke
Perinatal Stroke, Epilepsy
RecruitingObservational study
Predisposing Factors for Post-stroke Epilepsy
Post Stroke Epilepsy, Stroke
Not yet recruitingPhase 3
Edaravone Dexborneol for Post-Stroke Epilepsy
Post-stroke Epilepsy, Post-stroke Seizure
Active, not recruitingObservational study
Neonatal Seizure Registry, GEnetics of Post-Neonatal Epilepsy
Neonatal Seizure, Hypoxic-Ischemic Encephalopathy
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Eugen Trinka, MD MSc FRCP principal investigator
Universitätsklinik für Neurologie
Matthias Koepp, MD PhD FRCP principal investigator
UCL Institute of Neurology
22 sites in 9 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing ESL 800 mg in people with Post Stroke Epilepsy, run by Bial - Portela C S.A. at 22 sites in 9 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 9 inclusion and 19 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 2 May 2025. 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 Germany, Austria, Italy, Israel, United Kingdom and 4 more countries. 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?
Yes. Results are posted in the registry (first posted 2 May 2025). 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?
Proportion of Patients Who Experience the First Unprovoked Seizures (US) Within the First 6 Months After Randomisation (Failure Rate) (time frame: First 6 months after randomisation). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 2 May 2025.