EudraCT: 2018-003887-29 Objective:To evaluate the safety and efficacy of: MGCND00EP1 from MGC PHARMACEUTICALS d.o.o. Study Design: Randomized, double blind, placebo controlled parallel grouped study Sample Size: 103 subjects Study Population: Children from 1 year to 18 years of age Comparator Product :Placebo solution, oral IMP Product : MGCND00EP1 (each ml of solution containing 100 mg of cannabidiol and 5 mg of (-)-trans-Δ9- tetrahydrocannabinol as active substance) from MGC PHARMACEUTICALS D.O.O. According to dosing scheme up to 25 mg/kg BW per day or maximum daily dose 800 mg (whichever smaller) for 6 weeks titration and 6 weeks of treatment, oral administration
Subjects on regular therapy with anti-epileptic medications who have evidence from clinical monitoring that current therapy is insufficient, following failure of at least two AEDs for at least during the last 2 months will be enrolled into this study. Upon subjects/parents have consented to participation in the study and after baseline examinations, subjects will continue with current antiepileptic treatment, as clinically needed, for another 28 days at the same dose as before entering the study; drug accountability will be performed for verification of treatment compliance, and diary will be used to record data on epileptic seizures. After that, participating patients will be randomly assigned to MGCND00EP1 or placebo and take it as add on to previous treatment for 6 weeks as titration period and 6 weeks at maintenance dose, and then titrated down during next two weeks. Patients will continue previous anti- epileptic treatment throughout all the periods of the study. Day one - Screening and Enrollment Visit : Total 103 patients: Obtain informed consent from legal guardian. Screen potential subjects by inclusion and exclusion criteria. Visit 1: obtain medical and medication history, vital signs, physical and neurological exam, blood and urine tests, ECG, EEG, concomitant medications, questionnaires. Weeks 1-4 - AED Stabilization Period : Visit 2: vital signs, weight, physical and neurological exam, blood and urine tests, concomitant medications, questionnaires, monitor AEs, PK blood collection (subset of patients), randomize and dispense study drugs Patients will be randomized and will either get placebo or MGCND00EP1 (3:1 active:placebo) Weeks 5-10 - Dose titration period: Dose escalations (2 mg/kg body weight/day increments), as required, up to 25 mg/kg/day or 800 mg/day, the lower of the two, until stable dose is reached. Visit 3: vital signs, weight, physical and neurological exam, blood and urine tests, concomitant medications, questionnaires, collect and issue diaries, dispense study drug, monitor AEs Weeks 11-16 - Maintenance Period : Visit 4: vital signs,weight, physical and neurological exam, blood and urine tests, concomitant medications, questionnaires, PK sample collection (subset of patients), collect and issue diaries, dispense study drug, EEG, monitor AEs Weeks 17-18 - Tapering-off and Follow-up Period: Weekly phone call to determine taper dose at physician's discretion Visit 5: vital signs,weight, physical and neurological exam, blood and urine tests, concomitant medications, questionnaires, monitor AEs, collect diaries and unused drug Weeks 19-20 - Follow-up Period: Weekly phone calls Visits 6: vital signs,weight, physical and neurological exam, concomitant medications, monitor AEs, collect diaries .
Patients will take cannabis oil during the study
Patient will take carrier oil during the study
A standard 12-lead ECG will be recorded using digital ECG recording equipment provided to the investigational site. The ECG has to be performed prior to laboratory samplings at time points indicated in the Schedule of Assessments. The ECG recording will be reviewed by investigator and case of need consultation with cardiologist will be performed. The investigator has the final decision on the clinical significance of the ECG results.
Schneider Children's Medical Center of Israel
Petach Tikvah, Central District, Israel
University Children's Hospital Ljubljana University Medical Centre Ljubljana
Ljubljana, Slovenia
The proportion of patients showing a >50% reduction in frequency of seizures at week 12 of the study, in the treatment versus placebo groups
study drug overall efficiency as a seizure reducing treatment compared to placebo group
Time frame: 12 weeks
Change in number of epileptic seizures as documented by patient diaries (Visit 2 level compared to Visit 3 level and Visit 4) in treatment and placebo group.
study drug overall efficiency as a seizure reducing treatment
Time frame: 16 weeks
The incidence of adverse events will be summarized by organ class, severity and duration on weeks 12 and 18 of the study.
Adverse events assessment
Time frame: 12-18 weeks
Any change in physical examination, vital signs, lab tests results, ect will be collected and analyzed.
Improvement in vital signs, lab test results and physical examination
Time frame: 18 weeks
Change in duration of epileptic seizures as documented by patient diaries (Visit 2 level compared to Visit 3 level and Visit 4 level compared to Visit 2 level) by treatment group.
seizure frequency assessment
Time frame: 12-18 weeks
Change in score from Quality of Life in Childhood Epilepsy Questionnaire 55 (QOLCE-55 questionnaire) scoring 0-100 points, higher scoring indicates better condition. scoring will be compared between Visit 2 level and Visit 4 level.
QoL questionnaire assessment
Time frame: 18 weeks
Change in Clinical Global Impressions Scale (CGI scale) scoring 1-7 points, low scoring indicates better condition. Visit 2 level compared to Visit 4 level by treatment group.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
An EEG is an electrophysiological monitoring method that records the electrical activity and measures voltage fluctuations resulting from ionic current within the neurons of the brain. In clinical contexts, EEG refers to the recording of the brain's spontaneous electrical activity over a period of time.
safety blood tests - hematology\\blood count and biochemistry standard blood tests urinalysis - urine test analysis
CGI improvement by treatment group
Time frame: 18 weeks
Percentage of MGCND00EP1-treated patients who will develop a response to MGCND00EP1 (response will be defined as a reduction of seizures frequency by at least 25 % ) as compared between Visit 2 level and Visit 4 level
response to MGCND00EP1
Time frame: 18 weeks
Proportion of seizure-free patients between the placebo and treatment group on week 12 of treatment (including titration).
Proportion of seizure-free patients
Time frame: 12 weeks
Change in form of new seizures and emergency of new forms will be monitored during the trial
New seizure or seizure form emergency
Time frame: 18 weeks