Topiramate for the Prophylactic Treatment of Cyclic Vomiting Syndrome in Children

This study has been terminated.
(Insufficient potential subjects)
Sponsor:
Collaborator:
Ortho-McNeil Neurologics, Inc.
Information provided by:
Monarch Medical Research
ClinicalTrials.gov Identifier:
NCT00286988
First received: February 1, 2006
Last updated: January 5, 2011
Last verified: April 2007
  Purpose

The purpose of this study is to assess the effectiveness, tolerability and safety of oral topiramate for the preventative management of Cyclic Vomiting Syndrome. It is believed that topiramate will decrease the frequency, duration and severity of attacks experienced by children and adolescents with Cyclic Vomiting Syndrome.


Condition Intervention Phase
Vomiting
Drug: Topiramate
Phase 4

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Topiramate for the Prophylactic Treatment of Cyclic Vomiting Syndrome in Children

Resource links provided by NLM:


Further study details as provided by Monarch Medical Research:

Primary Outcome Measures:
  • Reduction of cycle frequency as measured by number of days between cycles.

Secondary Outcome Measures:
  • Decreased duration of attacks (measured in hours)
  • Decreased intensity of attacks (0-4 point scale; none, mild, moderate, severe, excruciating)
  • Decreased associated symptoms (0-4 point scales; none, mild, moderate, severe, excruciating)
  • Nausea
  • Vomiting
  • Headache
  • Abdominal pain
  • Decreased disability
  • PedMidas
  • Missed school (days per attack)
  • Missed work (parent(s)) (days per attack)
  • Decreased use of acute therapies (e.g. anti-emetics)
  • Decreased emergency department visits.

Estimated Enrollment: 12
Study Start Date: March 2006
Study Completion Date: June 2007
Primary Completion Date: May 2007 (Final data collection date for primary outcome measure)
Detailed Description:

There is very little controlled data on the preventative treatment for Cyclic Vomiting Syndrome. The existing evidence consists of small, retrospective clinical series that evaluate symptomatic responses to five medications including cyproheptadine, propranolol, amitriptyline, phenobarbital and pizotifen (n >10). These published data consist of uncontrolled or retrospective reports. In addition, varying inclusion criteria and outcomes (i.e. obtained by family recall) were used in these studies limiting the basis upon which to compare relative effectiveness.

During the prospective baseline period, the subject will maintain cyclical vomiting records in which all headache occurrences will be recorded and characterized. (Cyclical vomiting records will be maintained throughout the study). The purpose of this study is to assess the effectiveness, tolerability and safety of oral topiramate for the preventative management of Cyclic Vomiting Syndrome using a prospective design, established diagnostic criteria (ICHD 2004), and defined, objective primary and secondary endpoints.

  Eligibility

Ages Eligible for Study:   4 Years to 12 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Meet the2004 ICHD Criteria for Cyclical Vomiting.

    • 1 vomiting attack lasting > 24 hours duration for 3 consecutive months
  • 4-12 years of age.
  • If female, subjects must:

    1. be premenarchal or otherwise incapable of pregnancy, or
    2. have practiced one of the following methods of contraception for at least one month prior to study entry: hormonal contraceptives, spermicide and barrier, intrauterine device, partner sterility, or
    3. be practicing abstinence and agree to continue abstinence or to use an acceptable method of contraception (as listed above) should sexual activity commence.
  • Able to take oral medication in tablet form or sprinkle form
  • Subjects or their guardians must be willing and able to: a) read and comprehend written instructions, b) complete the assessment forms, c) return for regular visits, and d) adhere to medication regimens.
  • Subjects (or their legally acceptable representative) must have signed an informed consent document

Exclusion Criteria

  • Have taken topiramate within 14 days prior to the start of the prospective baseline period.
  • Have taken certain medications for cyclical vomiting prophylaxis
  • Have progressive neurological disorder or a structural disorder of the brain from birth, trauma or past infection.
  • Subjects who have taken any medications for migraine prophylaxis, within 2 weeks of the start of the prospective baseline period.
  • Subjects starting non-pharmacologic prophylactic approaches (e.g., acupuncture, biofeedback, chiropractic methods) within 1 month prior to Visit 1.
  • Require continuing treatment with anticonvulsant therapy for a non-migraine condition.
  • Significant major psychiatric disorder (e.g., major depression) or subjects receiving anti-psychotic medication.
  • History of attempted suicide or suicidal tendencies.
  • History of substance abuse.
  • Pregnant or lactating females.
  • Have clinically unstable neurological, cardiovascular, gastrointestinal, musculoskeletal, pulmonary or other disease.
  • Have any disease or condition that could compromise the function of those body systems that could result in altered absorption, excess accumulation, or impaired metabolism or excretion of the test medications (e.g., abnormal renal and/or hepatic function).
  • Have active liver disease.
  • Have received an investigational drug or used an investigational device within 30 days of study entry.
  • Employees of the investigator, study center, or sponsor (i.e., principal investigator, sub-investigator(s), study coordinators, other study staff, employees, or contractors of each), with direct involvement in the proposed study or other studies under the direction of that investigator, study center or sponsor, as well as family members of the employees or the investigator.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00286988

Locations
United States, Virginia
Monarch Medical Research - Child and Adolescent Neurology
Norfolk, Virginia, United States, 23510
Sponsors and Collaborators
Monarch Medical Research
Ortho-McNeil Neurologics, Inc.
Investigators
Principal Investigator: Donald W Lewis, MD Monarch Medical Research
  More Information

Additional Information:
Publications:
Responsible Party: Donald W Lewis, MD, Children's Specialty Group
ClinicalTrials.gov Identifier: NCT00286988     History of Changes
Other Study ID Numbers: TOPMAT-EME-4001
Study First Received: February 1, 2006
Last Updated: January 5, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by Monarch Medical Research:
Preventative
Open-Label
Safety/Efficacy

Additional relevant MeSH terms:
Vomiting
Signs and Symptoms, Digestive
Signs and Symptoms
Topiramate
Anticonvulsants
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions
Neuroprotective Agents
Protective Agents
Physiological Effects of Drugs
Anti-Obesity Agents

ClinicalTrials.gov processed this record on September 18, 2014