Open-label study to assess the pharmacokinetics of a single diazepam buccal film (DBF) dose in 3 age cohorts of pediatric patients with epilepsy (age 2-5 years, age 6-11 years, and age 12-16 years). Subjects in the 6-11 years and 12-16 years age cohorts received a single DBF dose during the interictal period (Period A) and ictal/peri-ictal period (Period B) with at least 14 days washout between doses. Subjects in the age 2-5 years age cohort received a single DBF dose only during the ictal/peri-ictal period (Period B).
This was a Phase 2 multicenter, open-label, two-way study conducted in male and female pediatric subjects (aged 2 to 16 years) with a clinical diagnosis of epilepsy who were scheduled to be admitted to an Epilepsy Monitoring Unit (EMU), a general clinical research center (GCRC), or similar facility for evaluation of seizures and who complied with all remaining protocol eligibility criteria. To ensure that 16 to 18 subjects would complete the study across 3 age ranges (2 to 5 years, 6 to 11 years, and 12 to 16 years), a minimum of 24 subjects were to be enrolled (8 in each age cohort). Subjects in the 6 to 11 years and 12 to 16 years age cohorts received a single dose of DBF during the interictal period (Period A) and ictal/peri-ictal period (Period B) with at least 14 days washout between doses. Subjects in the age 2 to 5 years age cohort received a single dose of DBF only during the ictal/peri-ictal period (Period B). DBF was provided in a range of doses from 5 to 17.5 mg. The appropriate dose of DBF was assigned on the basis of age and weight using an interactive web response system during check-in. Period A (interictal administration): 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) 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. Period B (ictal/peri-ictal administration): For the purpose of this study, the ictal state was defined as an ongoing clinically observable seizure or seizure activity as verified via EEG. The peri-ictal 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 monitoring, the peri-ictal state was to be defined as less than 5 minutes after cessation of seizure activity as verified via EEG. .
Study Type
Subjects received a single DBF dose determined by age and body weight during the interictal state and during the ictal/peri-ictal period with at least 14 days washout between doses.
University of Arizona
Tucson, Arizona, United States
NW FL Clinical Research Group, LLC
Gulf Breeze, Florida, United States
Children's St. Peters University Hospital
New Brunswick, New Jersey, United States
Area Under the Concentration Time Curve (AUC) 0 to 4 Hours Post-dose
AUC calculated from time 0 (dosing) to 4 hours post-dose in both Period A (interictal administration) and Period B (ictal/peri-ictal administration)
Time frame: Time 0 (dosing), 0.25, 0.5, 1, 1.5, 2, 4 hours post-dose
Area Under the Concentration Time Curve (AUC) From 0 to 2 Hours Post-dose
AUC calculated from time 0 (dosing) to 2 hours post-dose in both Period A (interictal administration) and Period B (ictal/peri-ictal administration)Period A (interictal administration) and Period B (ictal/peri-ictal administration)
Time frame: Time 0 (dosing), 0.25, 0.5, 1, 1.5, 2 hours post-dose
Time When Maximum Plasma Concentration Was Observed (Tmax) 0 to 2 Hours Post-dose
Tmax calculated from time 0 (dosing) to 2 hours post-dose in both Period A (interictal administration) and Period B (ictal/peri-ictal administration)
Time frame: Time 0 (dosing), 0.25, 0.5, 1, 1.5, 2 hours post-dose
Time When Maximum Plasma Concentration Was Observed (Tmax) 0-4 Hours Post-Dose
Tmax calculated from dosing (Time 0) to 4 hours post-dose in both Period A (interictal administration) and Period B (ictal/peri-ictal administration)
Time frame: Time 0 (dosing), 0.25, 0.5, 1, 1.5, 2, 4 hours post-dose
Observed Maximum Plasma Concentration (Cmax) 0-2 Hours
Maximum observed plasma concentration measured from Time 0 to 2 hours post-dose in Period A (interictal administration) and Period B (ictal/peri-ictal administration)
Time frame: Time 0 (dosing), 0.25, 0.5, 1, 1.5, 2 hours post-dose
Observed Maximum Plasma Concentration (Cmax) From Time 0 (Dosing) to 4 Hours Post-dose
Maximum observed plasma concentration from Time 0 to 4 hours post-dose in Period A (interictal administration) and Period B (ictal/peri-ictal administration)
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INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Icahn School of Medicine at Mount Sinai
New York, New York, United States
University of Rochester
Rochester, New York, United States
Onsite Clinical Solutions LLC
Charlotte, North Carolina, United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Dell Children's Medical Center
Austin, Texas, United States
Austin Epilepsy Care Center
Austin, Texas, United States
Virginia Commonwealth University
Richmond, Virginia, United States
Time frame: Time 0 (dosing), 0.25, 0.5, 1, 1.5, 2, 4 hours post-dose
Usability of Diazepam Buccal Film: Number of Subjects Who Spit Out/Moved/Chewed the Film After it Adhered (Stuck) to Buccal Mucosa During Period A and Period B.
Was DBF spit out or blown out by the subject after adherence to the buccal mucosa or did the subject chew, talk or move the DBF prior to complete disintegration/dissolution?
Time frame: Period A and Period B from the time of first attempt at DBF insertion to 15 minutes after insertion.
Usability of Diazepam Buccal Film: Unsuccessful Attempts
Number of subjects with any unsuccessful DBF insertion attempts (All analyzed subjects with an unsuccessful attempt ultimately had a successful attempt at dosing)
Time frame: Period A and Period B from the time of first attempt at DBF insertion to 15 minutes after insertion.
Usability Endpoint : Amount of Saliva That Exited the Mouth After DBF Dosing
Estimation of the amount of saliva exiting the mouth in mL after DBF dosing in Period A and Period B
Time frame: Period A and Period B from the time of first attempt at DBF insertion to 15 minutes after insertion.
Number of Subjects Who Swallowed DBF After Initial Insertion
Number of subjects who swallowed DBF during Period A and/or Period B
Time frame: Period A and Period B from the time of first attempt at DBF insertion to 15 minutes after insertion.