Safety and Efficacy of Gabapen for Pediatric (Regulatory Post Marketing Commitment Plan)
Special Investigation Of Gabapen For Pediatric (Regulatory Post Marketing Commitment Plan)
This investigation aims to understand the following issues in pediatric patients, as well as to assess the need of a special investigation and a post-marketing clinical study:
- The frequency of treatment related adverse events.
- The frequency of efficacy assessment.
- Treatment related unlisted adverse events in Japanese Package Insert.
- Risk factors likely to affect the frequency of treatment related adverse event.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- All the pediatric subjects (aged 3-15 years) whom an investigator prescribes the first gabapentin (tablets, syrup, and switch to syrup from tablet) should be registered consecutively until the number of subjects reaches target number in order to extract patients enrolled into the investigation at random.
Exclusion Criteria:
- Patients who have been enrolled in the drug use investigation of Gabapen tablets in adults (protocol No. A9451163).
- Patients who receive Gabapen tablets or syrup before, except for switched from tablets to syrup.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Gabapentin
Peadiatric subjects taking Gabapen Tablets and syrup.
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According to Japanese Package Insert: For infants and children aged 3 to 12 years, a daily dosage of 10 mg/kg of gabapentin should be administered orally in 3 divided doses on the first day of treatment, and an effective dosage of 20 mg/kg should be administered to them in 3 divided doses on day 2. From day 3 on, infants aged 3 to 4 years should be maintained on the dosage of 40 mg/kg, and children aged 5 to 12 years on the dosage of 25 to 35 mg/kg administered orally in 3 divided doses, respectively (the maximum daily dosage: 1800 mg).
Though the maintenance dosage may be adjusted depending on the patient's condition, the maximum daily dosage should be 50 mg/kg.
At any time point, dosage should not exceed that the dosage for adults and children aged 13 years.As for children aged 13 years or over is as same as administration for adult.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Treatment-Related Adverse Events
Time Frame: MAX 104 weeks
|
A treatment-related adverse event was any untoward medical occurrence attributed to gabapentin in a participant who received gabapentin.
Relatedness to gabapentin was assessed by the investigator and sponsor (Pfizer Japan Inc.).
|
MAX 104 weeks
|
|
Clinical Efficacy Rate
Time Frame: MAX 104 weeks
|
Clinical efficacy rate, which was defined as the percentage of participants who achieved clinical efficacy over the total number of efficacy analysis population, was presented along with the corresponding exact 2-sided 95% CI.
For the basis of efficacy evaluation, frequencies of epileptic seizure were recorded during the previous 4 weeks from the treatment start date, and that from the end date of assessment period.
Clinical efficacy was assessed according to the following categories: (1) effective, (2) not effective, or (3) not assessable.
|
MAX 104 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Treatment-Related Adverse Events Unexpected From Japanese Package Insert
Time Frame: MAX 104 weeks
|
A treatment-related adverse event was any untoward medical occurrence attributed to gabapentin in a participant who received gabapentin.
Expectedness of the adverse event was determined according to the Japanese package insert.
Relatedness to gabapentin was assessed by the investigator and sponsor (Pfizer Japan Inc.).
|
MAX 104 weeks
|
|
Number of Participants With Risk Factors for Treatment-Related Adverse Events
Time Frame: MAX 104 weeks
|
A treatment-related adverse event was any untoward medical occurrence attributed to gabapentin in a participant who received gabapentin.
Participants with treatment-related adverse events were counted by each candidate risk factor (including gender, age, and disease eligible for the survey) to assess whether these were risk factors for the treatment-related adverse events.
No inferential analyses of risk factors were performed because of a small number of the events (5 events).
|
MAX 104 weeks
|
|
Number of Participants Who Responded to Treatment With Gabapentin by Baseline Severity of Epileptic Seizure
Time Frame: MAX 104 weeks
|
Participants who responded to the treatment with gabapentin were counted by the baseline severity of epileptic seizure (mild, moderate and severe) to assess whether the baseline severity of epileptic seizure was a factor affecting the treatment efficacy.
|
MAX 104 weeks
|
|
Number of Participants Who Responded to Treatment With Gabapentin by Baseline Frequency of Epileptic Seizure
Time Frame: MAX 104 weeks
|
Participants who responded to the treatment with gabapentin were counted by the baseline frequency of epileptic seizure (<=8 versus >8 episodes/per 4 weeks) to assess whether the baseline frequency of epileptic seizure was a factor affecting the treatment efficacy.
|
MAX 104 weeks
|
|
Number of Participants Who Responded to Treatment With Gabapentin by Number of Concomitant Antiepileptic Drugs at Baseline
Time Frame: MAX 104 weeks
|
Participants who responded to the treatment with gabapentin were counted by the number of concomitant epileptic drugs at baseline across 5 categories (no drug, 1 drug, 2 drugs, 3 drugs, and 4 or more drugs) to assess whether the number of concomitant epileptic drugs at baseline was a factor affecting the treatment efficacy.
|
MAX 104 weeks
|
|
Number of Participants Who Responded to Treatment With Gabapentin by Treatment Period
Time Frame: MAX 104 weeks
|
Participants who responded to the treatment with gabapentin were counted by the treatment period (non-long term [less than 1 year] or long term [1 year or more]) to assess whether the treatment period with gabapentin was a factor affecting the treatment efficacy.
|
MAX 104 weeks
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Key Treatment-Related Adverse Events (Central Nervous System Depressant Actions)
Time Frame: MAX 104 weeks
|
Central nervous system depressant actions including somnolence and ataxia were determined as key survey items by the sponsor (Pfizer Japan Inc.).
These events were defined according to MedDRA/J version 17.1 as the events classified in "psychiatric disorders" or "nervous system disorders" of the system organ classes, or those classified in "asthenia" or "gait disturbance" of the preferred terms.
A treatment-related adverse event was any untoward medical occurrence attributed to gabapentin in a participant who received gabapentin.
Relatedness to gabapentin was assessed by the investigator and sponsor.
|
MAX 104 weeks
|
|
Number of Participants With Key Treatment-Related Adverse Events (Aggressive Behaviors)
Time Frame: MAX 104 weeks
|
Aggressive behaviors including affect lability and hostility were determined as key survey items by the sponsor (Pfizer Japan Inc.).
These events were defined as the 101 preferred terms listed by pharmaceuticals and medical devices agency and classified according to MedDRA/J version 17.1.
A treatment-related adverse event was any untoward medical occurrence attributed to gabapentin in a participant who received gabapentin.
Relatedness to gabapentin was assessed by the investigator and sponsor.
|
MAX 104 weeks
|
|
Response Ratio (R Ratio)
Time Frame: MAX 104 weeks
|
R Ratio was calculated by the following formula, where B represented the baseline frequency of epileptic seizures during the previous 4 weeks from the treatment start date, whereas T represented the frequency of epileptic seizures during the previous 4 weeks from the end of assessment period: R Ratio = (T - B) / (T + B).
R Ratio is within the range of -1 to +1, and a negative value represents a reduction in the frequency of seizure.
|
MAX 104 weeks
|
|
Responder Rate
Time Frame: MAX 104 weeks
|
Responder rate, which was defined as the percentage of participants whose R ratio was - 0.333 or less, was presented along with the corresponding exact 2-sided 95% CI.
R ratio of - 0.333 or less corresponded to the decrease of epileptic seizure frequency by 50% or more.
|
MAX 104 weeks
|
|
Reduction From Baseline in Epileptic Seizure Frequency
Time Frame: MAX 104 weeks
|
Reduction from baseline in epileptic seizure frequency was defined by the following formula, where B represented the baseline frequency of epileptic seizures during the previous 4 weeks from the treatment start date, whereas T represented the frequency of epileptic seizures during the previous 4 weeks from the end of assessment period: Reduction from baseline in epileptic seizure frequency (%) = [(T-B) / B] X 100.
The median percentages were presented along with the corresponding minimum and maximum percentages.
|
MAX 104 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Epilepsy
- Epilepsies, Partial
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Anti-Anxiety Agents
- Anticonvulsants
- Antimanic Agents
- Gabapentin
Other Study ID Numbers
Other Study ID Numbers
- A9451175
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