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Study of TAK-935 as an Adjunctive Therapy in Participants With Developmental and/or Epileptic Encephalopathies

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03166215
Recruitment Status : Completed
First Posted : May 25, 2017
Results First Posted : January 10, 2020
Last Update Posted : January 10, 2020
Sponsor:
Collaborator:
Ovid Therapeutics Inc.
Information provided by (Responsible Party):
Takeda

Tracking Information
First Submitted Date  ICMJE May 23, 2017
First Posted Date  ICMJE May 25, 2017
Results First Submitted Date  ICMJE September 17, 2019
Results First Posted Date  ICMJE January 10, 2020
Last Update Posted Date January 10, 2020
Actual Study Start Date  ICMJE August 17, 2017
Actual Primary Completion Date September 19, 2018   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: December 23, 2019)
Percentage of Participants With at Least One Treatment-Emergent Adverse Event (TEAE), as Reported by the Participants or Participant's Caregivers or Observed by the Investigator, After TAK-935 Treatment [ Time Frame: From first dose up to 30 days post last dose (approximately up to 120 days) ]
An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (eg, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug
Original Primary Outcome Measures  ICMJE
 (submitted: May 23, 2017)
Percentage of Participants who Experience at least 1 Treatment-Emergent Adverse Event (TEAE) [ Time Frame: Baseline up to Day 121 ]
An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (eg, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A TEAE is defined as an adverse event with an onset that occurs after receiving study drug.
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: December 23, 2019)
  • Drug Clearance (CL) and Intercompartmental Clearance (Q) for TAK-935 Calculated Using the Observed Value of the Last Quantifiable Concentration [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • Apparent Volume of Distribution (Vz/F) of Central Compartment (Vc) and Peripheral Compartment (Vp) for TAK-935 Calculated Using the Observed Value of the Last Quantifiable Concentration [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • Absorption Rate Constant (Ka) for TAK-935 [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • Cmax,ss: Maximum Observed Plasma Concentration for TAK-935 at Steady State [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • AUC0-tau,ss: Area Under the Plasma Concentration-time Curve Over the Dosing Interval for TAK-935 at Steady State [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • Cav,ss: Average Plasma Concentration During a Dosing Interval at Steady State for TAK-935 [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • Ctrough,ss: Plasma Concentration Immediately Prior to Dosing for TAK-935 at Steady State [ Time Frame: Days 1, 11, 21; Days 31, 41 and 85 pre-dose ]
  • Percentage of Participants With at Least 1 Markedly Abnormal Value for Clinical Laboratory Evaluations After TAK-935 [ Time Frame: From first dose up to last dose (up to Day 85) ]
    Clinical Laboratory parameters: hematology, serum chemistry and urinalysis. Participants with at least 1 markedly abnormal values during treatment period were reported: Erythrocytes: <0.8xLLN->1.5xULN, Hematocrit: <0.8x LLN >1.2xULN,Hemoglobin: <0.8xLLN->1.2xULN Leukocytes: <0.5xLLN, Platelets (10^9/L): <75x10^9/L->600x10^9/L, Prothrombin Ratio: >1.5xULN, Alanine Aminotransferase: >3xULN, Albumin:<25 g/L, Alkaline Phosphatase: >3xULN,Alpha-1 Acid Glycoprotein: <47 mg/DL->125 mg/DL, Aspartate Aminotransferase:>3xULN, Bicarbonate:<8.0 mmol/L, Calcium:<1.75 mmol/L->2.88 mmol/L, Chloride:<75 mmol/L->126 mmol/L, Cholesterol: >7.72,Creatine Kinase:>5xULN, Creatinine:>177 umol/L, Gamma Glutamyl Transferase: >3xULN, Glucose:<2.8 mmol/L- >19.4 mmol/L,HDL Cholesterol: <1.04 mmol/L->1.55 mmol/L, LDL Cholesterol: <1.30 mmol/L->4.14 mmol/L, Potassium:<3.0 mmol/L->6.0 mEq/L, Protein:<0.8xLLN->1.2 x ULN, Sodium: <130 mmol/L->150 mmol/L, Triglycerides: >2.5xULN, Urea Nitrogen: >10.7 mmol/L.
  • Percentage of Participants With at Least 1 Markedly Abnormal Value for Vital Signs After TAK-935 [ Time Frame: From first dose up to 30 days post last dose (approximately up 120 days) ]
    Vital signs included heart rate, blood pressure and body temperature. markedly abnormal values during treatment period were categorized as: heart rate 1,3 and 5 min standing (beats/min) <50->120, systolic blood pressure 1,3 and 5 min standing (mmHg) <85->180, diastolic blood pressure 1,3 and 5 min standing (mmHg) <50->110 and body temperature (degree centigrade) <35.6- >37.7. Only categories with values have been reported.
  • Percentage of Participants With at Least 1 Markedly Abnormal Value for Electrocardiogram (ECG) Parameters After TAK-935 [ Time Frame: From first dose up to last dose (up to Day 85) ]
    A 12-lead ECG was performed. Markedly abnormal values during treatment period were categorized as: ECG ventricular rate <50->120, PR Interval, (msec) <=80->=200, QRS Duration, (msec) <=80->=180, QT Interval, (msec) <=50->=460, QTcF Interval, (msec) <=50->=500 OR >=30 change from baseline and >=450 milliseconds, RR interval <600->=1440.
Original Secondary Outcome Measures  ICMJE
 (submitted: May 23, 2017)
  • Cav,ss: Average Plasma Concentration During a Dosing Interval at Steady-state for TAK-935 [ Time Frame: Day 1 pre-dose and at multiple timepoints (up to 5 hours) post-dose; Days 11 and 21 pre-dose and 1-hour post-dose; Days 31, 41, and 85 pre-dose ]
  • Percentage of Participants who Experience at least one Markedly Abnormal Laboratory Value, Vital Signs, Body Weight/Body Mass Index (BMI), and Electrocardiogram (ECG) Reported as AEs [ Time Frame: Baseline up to Day 121 ]
    The percentage of participants with any markedly abnormal standard safety laboratory values will be collected throughout study. Vital signs will include oral body temperature, sitting blood pressure (after the participant has rested for at least 5 minutes), and heart rate (bpm). Change relative to baseline in participant's weight and BMI (weight in kilograms/[height in centimeters^2]) will be measured throughout study. Change relative to baseline in electrocardiograms will be measured throughout study.
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Study of TAK-935 as an Adjunctive Therapy in Participants With Developmental and/or Epileptic Encephalopathies
Official Title  ICMJE A Phase 1b/2a Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Dose-Escalation Study With an Open-Label Part to Examine the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of TAK-935 as an Adjunctive Therapy in Subjects With Developmental and/or Epileptic Encephalopathies
Brief Summary The purpose of this study is to characterize the multiple-dose safety and tolerability profile of TAK-935 in adult participants with developmental and/or epileptic encephalopathies.
Detailed Description

The drug being tested in this study is called TAK-935. TAK-935 is being tested to treat people who have developmental and/or epileptic encephalopathies. This study will look at safety, tolerability and pharmacokinetics of people who take TAK-935. Study drug will be administered in a double-blind manner in Part 1 and in an open-label manner in Part 2.

The study will enroll approximately 20 participants. Participants will be randomly assigned (by chance, like flipping a coin) to one of the two treatment groups in Part 1-which will remain undisclosed to the participant and study doctor during the study (unless there is an urgent medical need):

  • TAK-935
  • Placebo (dummy inactive pill) - this is a tablet that looks like the study drug but has no active ingredient

Participants will receive placebo or 100 milligram (mg) TAK-935 tablets, orally or through stable G-tube/PEG tube, BID, in Part 1 (Day 1) and dose will be increased to 200 mg (Day 11) BID and to 300 mg (Day 21) BID in dose titration period. All participants who complete the Double-Blind Treatment Period in Part 1 will have the option to continue directly into the Open-Label Treatment Period in Part 2 where they will receive TAK-935 as two 100 mg tablets (total dose is 200 mg TAK-935) orally or through G-tube/PEG tube, BID and dose will be increased to three 100 mg tablets (total dose is 300 mg TAK-935), orally, BID (Day 41). This dose level will be maintained until the final visit (Day 85) for the dose de-escalation phase.

This multi-center trial will be conducted in North America. The overall time to participate in this study is 121 days excluding screening period of 30-41 days. Participants will make multiple visits to the clinic, and a follow-up phone call will be conducted on Day 91 and at the end of the 30-day follow-up period (Day 121), participants will return to the clinic for a follow-up assessment.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Condition  ICMJE Developmental and/or Epileptic Encephalopathies
Intervention  ICMJE
  • Drug: TAK-935
    TAK-935 tablets.
  • Drug: Placebo
    TAK-935 placebo-matching tablets.
Study Arms  ICMJE
  • Placebo Comparator: Part 1: Placebo
    TAK-935 matching-placebo tablets, orally or through gastrostomy tube (G-tube)/ percutaneous endoscopic gastrostomy (PEG) tube, twice daily (BID) from Days 1 to 30 in dose titration period.
    Intervention: Drug: TAK-935
  • Experimental: Part 1: TAK-935
    TAK-935 100 mg, tablet, orally or through G-tube/PEG tube, BID from Days 1 to 10 followed by TAK-935 100 mg tablets x2, orally or through G-tube/PEG tube, BID from Days 11 to 20 followed by TAK-935 100 mg tablets x3, orally or through G-tube/PEG tube, BID from Days 21 to 30 in dose titration period. The dose of TAK-935 was escalated or de-escalated during Part 1 as per investigator's discretion.
    Intervention: Drug: Placebo
  • Experimental: Part 2: TAK-935
    TAK-935 100 mg tablets x2, orally or through G-tube/PEG tube, BID from Days 31 to 40 followed by TAK-935 100 mg tablets x1, x2 or x3, orally or through G-tube/PEG tube, BID from Days 31 to Day 85 as per investigator's discretion in the maintenance period. At the end of Part 2, the dose of TAK-935 was de-escalated until discontinuation.
    Intervention: Drug: TAK-935
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: November 2, 2018)
18
Original Estimated Enrollment  ICMJE
 (submitted: May 23, 2017)
20
Actual Study Completion Date  ICMJE September 19, 2018
Actual Primary Completion Date September 19, 2018   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Has a documented clinical diagnosis of developmental and/or epileptic encephalopathies with countable bilateral motor seizures, defined as an average of greater than or equal to (>=) 2 per month during the past 3 months, based on the investigator's assessment, and a monthly average of >=1 per month during the Baseline Period, based on the seizure diary record.
  2. Has been taking 1 to 4 antiepileptic drug (AEDs) at a stable dose for >=4 weeks before Screening and the participant or participant's legally acceptable representative is willing to keep the regimen(s) stable throughout the study.
  3. Has an average of >=1 bilateral motor seizure per month during the 4-week Baseline Period (that is., drop seizures, tonic-clonic, tonic, bilateral clonic, atonic, myoclonic-atonic, myoclonic-tonic-clonic, focal seizures with bilateral hyperkinetic motor features).
  4. Must agree to not post any participant's personal medical data related to the study or information related to the study on any web site or social media site (example, Facebook, Twitter) until the study has been completed.
  5. For participants with G-tube/PEG tube, G-tubes/PEG tubes should have been placed and been functioning for at least 3 months prior to screening. Naso-gastric tubes are not allowed.

Exclusion Criteria:

  1. Has received TAK-935 in a previous clinical study or as a therapeutic agent.
  2. Was admitted to a medical facility for treatment of status epilepticus requiring mechanical respiration within 3 months before Screening.
  3. Had a vagal nerve stimulator implanted within 6 months before Screening and settings have been changed within 1 month of the Screening Visit and/or anticipated to change during the study.
  4. Is on ketogenic diet that has been started within 6 months of the Screening Visit, has been changed within 1 month of the Screening Visit, or is anticipated to change during the study.
  5. Has degenerative eye disease.
  6. Has a history of suicidal behavior or any suicidal ideation of type 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) at Screening. If the participant is unable to comply with the C-SSRS due to developmental status, a parent proxy may be used for the completion of the C-SSRS. The Investigator may also use clinical judgment, which must then be documented in the source document.
  7. Positive for human immunodeficiency virus, hepatitis B, or hepatitis C infections. (Note that participants who have been vaccinated against hepatitis B [hepatitis B surface antibody (Ab)-positive] who are negative for other markers of prior hepatitis B infection [example, negative for hepatitis B core Ab] are eligible. Also note that participants who are positive for hepatitis C Ab are eligible as long as they have a negative hepatitis C viral load by quantitative polymerase chain reaction [qPCR]).
  8. Has an abnormal and clinically significant ECG at Screening in the opinion of the investigator, for example, second or third degree heart block or a corrected QT interval (QTc) greater than (>) 450 millisecond (msec). Entry of any participant with an abnormal but not clinically significant ECG must be approved and documented by signature by the principal investigator or appropriately qualified delegate.
  9. Has abnormal clinical laboratory test results at Screening that suggest a clinically significant underlying disease. If the participant has alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >2.5*the upper limit of normal (ULN), the Medical Monitor should be consulted.
  10. Has received any excluded medications, procedures, or treatments during the time periods.
  11. Has any a history of alcohol, opioid, or other drug use disorder, as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, within the previous 2 years before Screening. Medical marijuana use is allowed.
  12. Has unstable, clinically significant neurologic (other than the disease being studied), psychiatric, cardiovascular, pulmonary, hepatic, renal, metabolic, gastrointestinal, urologic, immunologic, hematopoietic, or endocrine disease or other abnormality, which may impact the ability of the participant to participate or potentially confound the study results.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 65 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03166215
Other Study ID Numbers  ICMJE TAK-935-2001
U1111-1192-7890 ( Other Identifier: WHO )
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Yes
Plan Description: Takeda makes patient-level, de-identified data sets and associated documents available for all interventional studies after applicable marketing approvals and commercial availability have been received (or program is completely terminated), an opportunity for the primary publication of the research and final report development has been allowed, and other criteria have been met as set forth in Takeda's Data Sharing Policy (see www.TakedaClinicalTrials.com for details). To obtain access, researchers must submit a legitimate academic research proposal for adjudication by an independent review panel, who will review the scientific merit of the research and the requestor's qualifications and conflict of interest that can result in potential bias. Once approved, qualified researchers who sign a data sharing agreement are provided access to these data in a secure research environment.
Responsible Party Takeda
Study Sponsor  ICMJE Takeda
Collaborators  ICMJE Ovid Therapeutics Inc.
Investigators  ICMJE
Study Director: Medical Monitor Clinical Science Takeda
PRS Account Takeda
Verification Date December 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP