This Phase 2 open-label, two-way study was conducted in adult subjects with epilepsy who were on stable regimens of anti-epileptic drugs (AEDs) and who were admitted to an Epilepsy Monitoring Unit (EMU), General Clinical Research Center (GCRC), or similar facility for evaluation of their seizures. All subjects received a single DBF 12.5 mg dose during the Interictal State and a single DBF 12.5 mg dose during the Ictal/peri-ictal state with at least 14 days washout between the 2 doses.
This was a Phase 2 multicenter, open-label, two-way study conducted in adult subjects to assess the bioavailability, pharmacokinetics, and safety of DBF during the Interictal Period and during the Ictal/peri-ictal Period, with a minimum of 14 days of washout between periods. Subjects had a clinical diagnosis of epilepsy (with generalized tonic-clonic seizures or focal seizures with impaired awareness) who were on stable regimens of anti-epileptic drugs and were scheduled for admission to an EMU, GCRC, or similar facility for evaluation. All subjects were to receive a single 12.5-mg dose of study drug, without regard to meals, during both Interictal Period and Ictal/peri-ictal Period. The treatment was identical for both periods. Treatment sequence was not randomized. The interictal period and ictal/peri-ictal could occur in either order as determined by seizure occurrence. Interictal Period: Subjects were considered to be in an interictal state if an interval of at least 3 hours had elapsed since any clinically observable postictal signs or symptoms (from the last observed seizure) and the subject had been seizure-free over this period. Subjects on electroencephalogram (EEG) video monitoring were to be considered to be in an interictal state if an interval of at least 3 hours had elapsed since there were any postictal electrical findings on EEG. Ictal/peri-ictal Period: For the purposes of this study, the ictal state was defined as an ongoing clinically observable seizure or seizure activity as verified via EEG. The periictal state was defined clinically as the subject's immediate postictal state following a generalized tonic-clonic (GTC) seizure or focal seizure with impaired awareness, and within 5 minutes following the last clonic jerk. For subjects on EEG video monitoring, the periictal state was to be defined as less than 5 minutes after cessation of seizure activity as verified via EEG.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
All subjects received a single dose of DBF 12.5 mg during the interictal state and during the ictal/peri-ictal state with at least 14 days washout between the 2 treatment periods
Arizona Health Sciences Center
Tucson, Arizona, United States
Rancho Research Institute
Downey, California, United States
Yale University School of Medicine-Comprehensive Epilepsy Center
New Haven, Connecticut, United States
Tmax Pharmacokinetic EndPoints
Observed time to reach maximum drug concentration (Tmax)
Time frame: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours
Cmax Pharmacokinetic EndPoints
Observed Peak Drug Concentration (Cmax)
Time frame: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours
Area Under the Plasma Concentration Curve Pharmacokinetic EndPoints
Area under the Plasma Concentration -time curve from time zero until the last measured time (AUC0-t)
Time frame: -2 to 0, 0.25, 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 192, 240 hours
Usability Endpoint - Successful Insertion/Placement of the Diazepam Buccal Film (DBF) on First Attempt
Number of subjects with unsuccessful insertion/placement of the DBF on first attempt at administration Number of subjects with successful insertion/placement of the DBF on first attempt at administration Placement is judged to be successful when film adheres to the center of buccal mucosa of either right or left cheek. Unsuccessful placements were followed by a subsequent successful insertion/placement of DBF
Time frame: Subject was observed for 15 minutes after initial film placement/adhesion
Usability Endpoint: Swallowing the Film Before Complete Disintegration/Dissolution
Was the film noted to have been swallowed by the subject ? Yes No Subjects were instructed to swallow any remnants of film still present in oral cavity 15 minutes after initial film placement. Results include subjects who swallowed film at any point during the 15 minutes immediately after initial film placement.
Time frame: Subject was observed for 15 minutes immediately following DBF placement/adhesion
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Purpose
TREATMENT
Masking
NONE
Enrollment
35
Hawaii Pacific Neuroscience
Honolulu, Hawaii, United States
Mid-Atlantic Epilepsy and Sleep Center
Bethesda, Maryland, United States
Saint Peter's University Hospital
New Brunswick, New Jersey, United States
University of Rochester Medical Center
Rochester, New York, United States
Onsite Clinical Solutions LLC
Charlotte, North Carolina, United States
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Austin Epilepsy Care Center
Austin, Texas, United States
...and 1 more locations
Usability Endpoint: Retention of Diazepam Buccal Film (DBF) From Placement to Complete Disintegration
Was the DBF spit out or blown out by the subject after placement on buccal mucosa or did the subject chew, talk, or move the DBF prior to complete disintegration/dissolution? Yes No
Time frame: Subject was observed for 15 minutes immediately following DBF placement/adhesion
Usability Endpoint: Exit of Saliva During the Time the Diazepam Buccal Film (DBF) Was Adhered to Buccal Mucosa
The observer documented if any saliva was seen to exit the mouth during the time the DBF was adhered to buccal mucosa
Time frame: Subject was observed for 15 minutes immediately following DBF placement/adhesion
Usability Endpoint: Amount of Saliva That Exited the Mouth After Film Placement
If Yes - saliva exited the mouth during the time, estimate in milliliters of the amount of saliva that exited the mouth after DBF placement on the buccal surface
Time frame: Subject was observed for 15 minutes immediately following DBF placement/adhesion