Efficacy of Intravenous Levetiracetam in Neonatal Seizures (NEOLEV2)
A new anticonvulsant, levetiracetam will be studied to treat seizures in newborn infants. Current treatments for the brain damaging complication of neonatal seizures are unsatisfactory.
Monitoring for seizure detection will be tested at five (5) US sites and one (1) international site using the internet.
|Neonatal Seizures||Drug: Intravenous levetiracetam Drug: Intravenous phenobarbital||Phase 1 Phase 2|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Efficacy of Intravenous Levetiracetam in Neonatal Seizures: A Phase 2 Randomized Blinded Controlled Study of the Efficacy of Intravenous Levetiracetam (LEV) as First Line Treatment for Neonatal Seizures|
- To determine the efficacy of intravenous LEV in terminating neonatal seizures when given as first line therapy compared to phenobarbital [ Time Frame: 48 hours ]A head to head comparison of the efficacy of intravenous levetiracetam versus phenobarbital in the treatment of EEG proven neonatal seizures. Seizure burden will be assessed by duration and frequency of seizure events.
- To obtain dose escalation data by studying the additional efficacy of a further dose in non responders. [ Time Frame: 48 hours ]Determine the efficacy of higher dose levetiracetam compared to phenobarbital in reducing seizure burden.
- To evaluate the benefit of remote EEG monitoring [ Time Frame: 48 hours ]To prove the feasibility of centralized remote monitoring of continuous EEG monitoring in the NICU via the internet by documentation of remote accessibility of EEG recordings.
- Evaluation of the accuracy of neonatal seizure detection algorithm [ Time Frame: 48 Hours ]A novel neonatal seizure detection algorithm will be compared to the gold standard of two encephalographers reading 48 hours of neonatal video EEG in the measurement of seizure burden.
- Pharmacokinetic Data [ Time Frame: 48 hours ]To obtain additional pharmacokinetic data "Area under the plasma concentration versus time curve (AUC) and Peak Plasma Concentration (Cmax)" of intravenous levetiracetam to confirm findings from our previous pharmacokinetic study.
- Gather safety information on IV levetiracetam [ Time Frame: 48 Hours ]Safety information to be collected includes any adverse events and blood parameter monitoring with Complete Blood Count and Comprehensive Chemistry panels after 48 hours of treatment.
|Study Start Date:||March 2013|
|Estimated Study Completion Date:||July 2017|
|Estimated Primary Completion Date:||July 2017 (Final data collection date for primary outcome measure)|
Experimental: Intravenous levetiracetam
Intravenous levetiracetam 40 to 60 mg/kg loading dose. 10 mg/kg 8 hourly maintenance
Drug: Intravenous levetiracetam
Intravenous load of levetiracetam (40 to 60 mg/kg) following identification of EEG confirmed neonatal seizure.
Other Name: Keppra
Active Comparator: Intravenous phenobarbital
Intravenous phenobarbital 20 to 40 mg/kg load. 1.5 mg/kg 8 hourly maintenance
Drug: Intravenous phenobarbital
Intravenous load of phenobarbital (20 to 40 mg/kg)following EEG confirmation of seizure activity load.
Other Name: phenobarbitone
This project aims to improve the treatment of neonatal seizures. Current treatments are poorly effective and have significant side effects.
Levetiracetam (LEV) has great potential as a treatment for neonatal seizures but is not approved for use in children less than 2 years of age.
This study aims to obtain essential data regarding the efficacy and safety of LEV in this vulnerable and under researched population and simultaneously to develop EEG monitoring systems that facilitate seizure detection and research.
Specific aims are:
- To determine the efficacy of intravenous LEV in terminating neonatal seizures when given as first line therapy.
- To obtain dose escalation data by studying the additional efficacy of a further dose in non responders.
- To obtain additional pharmacokinetic data to confirm findings from our previous pharmacokinetic study.
- To obtain further safety data of LEV in neonates.
- To prove the feasibility of centralized remote monitoring of continuous EEG monitoring in the Neonatal Intensive Care Unit (NICU) via the internet and test a promising automated neonatal seizure detection algorithm.
The study design is a phase 2 randomized blinded controlled study.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01720667
|Contact: Richard H Haas, MDfirstname.lastname@example.org|
|Contact: Gail E Reiner, DNP, FNP-Cemail@example.com|
|United States, California|
|University of California, San Diego Medical Center / Neonatal Intensive Care Unit (NICU)||Recruiting|
|San Diego, California, United States, 92103|
|Contact: Richard H Haas, MD 858-822-6700 firstname.lastname@example.org|
|Contact: Gail E Reiner, DNP, FNP-C 619-471-9134 email@example.com|
|Principal Investigator: Richard H Haas, MD|
|Principal Investigator:||Richard H Haas, MD||University of California, San Diego|