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Study Comparing Best Medical Practice With or Without VNS Therapy in Pharmacoresistant Partial Epilepsy Patients

This study has been terminated.
(Insufficient enrollment)
Sponsor:
Information provided by (Responsible Party):
Cyberonics, Inc.
ClinicalTrials.gov Identifier:
NCT00522418
First received: August 27, 2007
Last updated: January 9, 2015
Last verified: October 2012
  Purpose
This is a post-market medical device study. This study will compare best medical practice with or without adjunctive VNS Therapy in patients who are 16 years and older with pharmacoresistant partial epilepsy.

Condition Intervention Phase
Epilepsy
Partial Epilepsy
Device: Vagal Nerve Simulation (VNS) Therapy
Drug: Best Medical Practive
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Open Prospective Randomised Long-Term Effectiveness Study, Comparing Best Medical Practice With or Without Adjunctive VNS Therapy in Patients 16 Years and Older With Pharmaco-resistant Partial Epilepsy

Resource links provided by NLM:


Further study details as provided by Cyberonics, Inc.:

Primary Outcome Measures:
  • Overall Quality of Life in Epilepsy-89 (QOLIE-89) Score in Patients With Baseline & at Least One Post-baseline QOLIE Assessment [ Time Frame: Mean change from baseline QOLIE-89 Overall Score at 12 months ]
    QOLIE-89 contains 17 multi-item measures of overall quality of life, emotional well-being, role limitations due to emotional problems, social support, social isolation, energy/fatigue, worry about seizure, medication effects, health discouragement, work/driving/social function, attention/concentration, language, memory, physical function, pain, role limitations due to physical problems, and health perceptions. Range of values 0-100. Higher scores reflect better quality of life; lower ones, worse quality of life.


Secondary Outcome Measures:
  • Response Rate [ Time Frame: Number of Responders at 12 Months ]
    Response Rate is defined as the percent of participants who are responders. A Responder is defined as participants with a reduction of at least 50% or 75% in seizure frequency from baseline to the seizure count evaluation period.

  • Percent of Patients That Are Seizure Free [ Time Frame: 3, 6, 9, 12, 15, 18, 21, 24 months ]
    Percent of patients that are seizure free as defined by no seizures during the preceding follow-up period.

  • Mean Percent Change in Seizure Frequency [ Time Frame: Mean percent change from baseline in seizure frequency at 12 months ]
    Percent change in total seizuires per week from baseline at 12 months

  • Seizure Free Days [ Time Frame: From the patient's last seizure to the study exit date ]
    Seizure free days is defined as the time from last seizure to study exit date.

  • Seizure Free Days Over the Last 6 Months [ Time Frame: Over the last 6 months ]
  • Change From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D) Score [ Time Frame: Mean change from baseline CES-D Score at 12 months ]
    The Center for Epidemiologic Studies Depression Scale (CES-D) includes 20 items comprising six scales reflecting major dimensions of depression: depressed mood, feelings of guilt and worthlessness, feelings of helplessness and hopelessness, psychomotor retardation, loss of appetite, and sleep disturbance. Possible range of scores is 0 to 60, higher scores indicate more depressive symptoms.

  • Change From Baseline in Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Score [ Time Frame: Mean change from baseline NDDI-E Score at 12 months ]
    The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a 6-item questionnaire validated to screen for depression in people with epilepsy. Scores range from 6 to 24, with higher scores indicating more depressive symptoms.

  • Mean Change From Beginning of Intervention Clinical Global Impression-Improvement Scale (CGI-I) Score at 12 Months [ Time Frame: Mean change from baseline CGI-I Score at 12 months ]
    The Clinical Global Impression scale (CGI-I) is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention Scores range from 1-7: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.

  • Change From Baseline in Adverse Event Profile (AEP) Score [ Time Frame: Mean change from baseline AEP Score at 12 months ]
    Adverse Events Profile (AEP) is a 19-item scale used as a systematic measure of adverse effects from antiepileptic drugs (AEDs). Scores range from 19-76; higher scores indicate high prevelance and severity of adverse events.

  • Changes in Anti-epileptic Drugs (AEDs) [ Time Frame: Change from baseline in number of AEDs at 12 months ]
    Change from baseline in number of AED medications by visit

  • Retention Rate [ Time Frame: At 12 and 24 months ]
    Percent of participants who were compliant with the protocol.

  • Treatment Emergent Adverse Events, Device Complications, and Premature Study Withdrawal [ Time Frame: At 12 and 24 months ]
    Number of participants with treatment emergent adverse events, device complications, and premature Study withdrawal.

  • Quality of Life in Epilepsy - 89 Items(QOLIE-89)in Patients With Less Than a 50% Reduction in Seizures [ Time Frame: At 12 and 24 months ]
    QOLIE-89 contains 17 multi-item measures of overall quality of life, emotional well-being, role limitations due to emotional problems, social support, social isolation, energy/fatigue, worry about seizure, medication effects, health discouragement, work/driving/social function, attention/concentration, language, memory, physical function, pain, role limitations due to physical problems, and health perceptions. Range of values 0-100. Higher scores reflect better quality of life; lower ones, worse quality of life.

  • Centre for Epidemiologic Studies Depression Scale (CES-D) in Patients With Less Then a 50% Reduction [ Time Frame: At 12 and 24 months ]
    The Center for Epidemiologic Studies Depression Scale (CES-D) includes 20 items comprising six scales reflecting major dimensions of depression: depressed mood, feelings of guilt and worthlessness, feelings of helplessness and hopelessness, psychomotor retardation, loss of appetite, and sleep disturbance. Possible range of scores is 0 to 60, higher scores indicate more depressive symptoms.

  • Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) in Patients With Less Then a 50% Reduction in Seizures [ Time Frame: At 12 and 24 months ]
    The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a 6-item questionnaire validated to screen for depression in people with epilepsy. Scores range from 6 to 24, with higher scores indicating more depressive symptoms.

  • Adverse Event Profile (AEP) in Patients With Less Then a 50% Reduction in Seizures [ Time Frame: At 12 and 24 months ]
    Adverse Events Profile (AEP) is a 19-item scale used as a systematic measure of adverse effects from antiepileptic drugs (AEDs). Scores range from 19-76; higher scores indicate high prevelance and severity of adverse events.

  • Change in the Number of Anti-epileptic Drugs Prescribed [ Time Frame: At 12 and 24 months ]
    Changes in Anti-Epileptic Drugs (AEDs) in patients with less then a 50% reduction in seizures

  • Percent of Participants Who Were Compliant With the Protocol [ Time Frame: At 12 and 24 months ]
    Retention rate in patients with less then a 50% reduction in seizures

  • Change From Baseline in QOLIE-89 Measures: Subgroup Analysis of Population With Baseline Adverse Event Profile Score >= 40 [ Time Frame: Change from baseline up to 12 months ]
    QOLIE-89 contains 17 multi-item measures of overall quality of life. Range of values 0-100. Higher scores reflect better quality of life; lower ones, worse quality of life. Adverse Events Profile (AEP) is a 19-item scale used as a systematic measure of adverse effects from antiepileptic drugs (AEDs). Scores range from 19-76; higher scores indicate high prevelance and severity of adverse events.

  • Change From Baseline in QOLIE-89 Measures: Subgroup Analysis of Population With Baseline Adverse Event Profile Score < 40 [ Time Frame: Change from baseline up to 12 months ]
    QOLIE-89 contains 17 multi-item measures of overall quality of life. Range of values 0-100. Higher scores reflect better quality of life; lower ones, worse quality of life. Adverse Events Profile (AEP) is a 19-item scale used as a systematic measure of adverse effects from antiepileptic drugs (AEDs). Scores range from 19-76; higher scores indicate high prevelance and severity of adverse events.

  • Clinical Global Impressions Scale (CGI) in Patients With Less Then a 50% Reduction in Seizures [ Time Frame: At 12 and 24 months ]
    The Clinical Global Impression scale (CGI-I)is a 7 point scale that requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention Scores range from 1-7: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.


Enrollment: 122
Study Start Date: February 2006
Study Completion Date: July 2008
Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: VNS Therapy
VNS Therapy + Best Medical Practice
Device: Vagal Nerve Simulation (VNS) Therapy
VNS Therapy + Best Medical Practice including anti-epileptic drugs
Active Comparator: Best Medical Practice
Best Medical Practice
Drug: Best Medical Practive
Best Medical Practice including anti-Epileptic Drugs

Detailed Description:
This is a post-market medical device study. This study will compare best medical practice with or without adjunctive VNS Therapy in patients who are 16 years and older with pharmaco-resistant partial epilepsy. The Sponsor, Cyberonics, provides funding for this study. Patients are followed for 26 months, 24 of those months are following the initiation of treatment. No study sites will be permitted to enroll study subjects until Institutional Review Board (IRB)/Ethics Committee (EC) approval has been received.
  Eligibility

Ages Eligible for Study:   16 Years and older   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Patient has confirmed partial onset seizures.
  • Seizure activity is not adequately controlled by patient's current AED regimen.
  • Patient is between 16 and 75 years of age.
  • Patient is able to give accurate seizure counts and health outcomes information. Patient is able to complete study instruments with minimal assistance.
  • Patient has previously failed at least 3 AEDs in single or combination use.
  • During baseline evaluation period, patient should take at least 1 AED.
  • Patient should have confirmed epilepsy for a minimum of 2 years.
  • Patient's AED regimen is stable for at least 1 month prior to enrolment.
  • Patient has at least 1 objective partial onset seizure per month during the 2 months prior to enrolment.
  • Patient or legal guardian understands study procedures and has voluntarily signed an informed consent in accordance with institutional and local regulatory policies.

Exclusion Criteria:

  • Patient has pseudoseizures or a history of pseudoseizures.
  • Patient has idiopathic generalised epilepsy or unclassified epilepsy.
  • Patient has ever received direct brain stimulation (cerebella or thalamic) for treatment of epilepsy.
  • Patient has had a unilateral or bilateral cervical vagotomy.
  • Patient has a history of non-compliance with the completion of a seizure diary.
  • Patient has taken an investigational drug within a period of 3 months prior to inclusion.
  • Patient is currently using another investigational medical device.
  • Patient has a significant cardiac or pulmonary condition currently under treatment.
  • Patient has previously undergone brain surgery.
  • Patient has a demand cardiac pacemaker, implantable defibrillator, or other implantable stimulator.
  • Patient currently lives more than 2 hours from the study site or plans to relocate to a location more than 2 hours from the study site within one year of enrolment in the Study.
  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: NCT00522418

  Show 48 Study Locations
Sponsors and Collaborators
Cyberonics, Inc.
Investigators
Principal Investigator: Phillippe Ryvlin, MD Hopital Neurologique, Lyon, France
Study Director: Sophie Leyman, MD Cyberonics Europe
  More Information

Publications:

Responsible Party: Cyberonics, Inc.
ClinicalTrials.gov Identifier: NCT00522418     History of Changes
Other Study ID Numbers: E-100
Study First Received: August 27, 2007
Results First Received: April 2, 2010
Last Updated: January 9, 2015

Keywords provided by Cyberonics, Inc.:
Epilepsy
VNS Therapy

Additional relevant MeSH terms:
Epilepsy
Epilepsies, Partial
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases

ClinicalTrials.gov processed this record on May 22, 2017