This is a pilot, open-label, phase II study. The main objective of the study is to demonstrate that Cannabidiol (CBD), used in addition to current anti-seizure medications (ASMs) reduces the number and/or severity of motor (generalized, focal, or both) seizures in children and young adults with rare disease-associated severe epilepsy. Secondary objectives include assessment of safety and tolerability, changes in behaviour, cognition and sleep, pharmacokinetic interaction with concurrent ASMs.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Cannabidiol will be administered orally twice daily into equally divided doses. The starting dose is 2.5 mg/kg twice daily. The dose can be gradually increased to 5 mg/kg twice daily, which is the recommended maintenance dose, up to a maximum dose of 10 mg/kg twice daily, according to tolerability and clinical response. Following titration, subjects will continue treatment over a 20-week maintenance period. The total treatment duration from the beginning of the titration period till the end of the maintenance period will be 24 weeks.
Change in number of generalized and/or focal motor-onset seizure frequency
percentage change per 28 days from the 4-week baseline period in generalized and/or focal motor-onset seizure frequency during the 24-week treatment period
Time frame: 24 weeks
Change in severity of generalized and/or focal motor-onset seizure frequency
a score will be established for each patient, based on review and comparison of all baseline-EEG/7-weeks control-EEG and baseline-EEG/15-weeks control-EEG, with values ranging from 0 (= worsened EEG), to a maximum of 2 (= improved); 1 will be assigned if the EEG trace is unmodified
Time frame: 24 weeks
Incidence of adverse events
Adverse events reporting according to Common Terminology Criteria for Adverse Events (CTCAE) from 1 (mild) to 5 (death)
Time frame: 24 weeks
Body weight
Measurement of body weight for tolerability monitoring
Time frame: 24 weeks
Maximum Plasma Concentraion [Cmax] of concurrent ASMs
blood levels of concurrent ASMs will be taken at baseline and every 4 weeks
Time frame: 24 weeks
Number of subjects considered treatment responders
Number of subjects with a ≥25%, ≥50% ≥75% reduction in motor (generalized, focal, or both) seizures from baseline
Time frame: 24 weeks
Number of subjects who are free of motor (generalized, focal, or both) seizures
Number of subjects who are free of motor (generalized, focal, or both) seizures
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Time frame: 24 weeks
Longest period of seizure freedom
Longest period of seizure freedom
Time frame: 24 weeks
Number of patients experiencing a >25% worsening, -25 to +25% no change, 25-50% improvement, 50-75% improvement or >75% improvement in total seizures from baseline
Number of patients experiencing a \>25% worsening, -25 to +25% no change, 25-50% improvement, 50-75% improvement or \>75% improvement in total seizures from baseline
Time frame: 24 weeks
Changes from baseline in number of inpatient hospitalizations due to epilepsy
Changes from baseline in number of inpatient hospitalizations due to epilepsy
Time frame: 24 weeks
Change in severity of seizures will be assessed using a pediatric adaptation of the Chalfont Seizure Severity Scale
Change in severity of seizures will be assessed using a pediatric adaptation of the Chalfont Seizure Severity Scale (from 1 minimum severity to \>100 max severity)
Time frame: 24 weeks
Change from baseline to 6-months after treatment initiation in number of seizure-free days
Change from baseline to 6-months after treatment initiation in number of seizure-free days
Time frame: 24 weeks