An Open-Label Extension Trial to Assess the Long-Term Safety of ZX008 (Fenfluramine Hydrochloride HCl) Oral Solution in Children and Young Adults With Dravet Syndrome
An Open-Label Extension Trial to Assess the Long-Term Safety of ZX008 (Fenfluramine Hydrochloride HCl) Oral Solution as an Adjunctive Therapy in Children and Young Adults With Dravet Syndrome
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Heidelberg, Australia
- Melbourne Brain Centre Austin Hospital
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South Brisbane, Australia
- Children's Health Queensland Hospital and Health Service at Lady Cilento Children's Hospital
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Westmead, Australia
- The Children's Hospital Westmead Dept. of Neurology and Neurosurgery
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Edegem, Belgium
- Universitair Ziekenhuis Antwerpen
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Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine
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Vancouver, Canada
- British Columbia Children's Hospital
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Dianalund, Denmark
- Danish National Epilepsy Centre
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Amiens, France
- CHU Amiens-Picardie Service De Neurologie Pediatrique
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Bordeaux, France
- CHU De Bordeaux Service De Pédiatrie Médicale
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Lille, France
- CHRU Lille Antenne Pédiatrique Du CIC - Hôpital Jeanne De Flandre
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Marseille, France
- HOPITAL DEL LA TIMONE - HOPITAL HENRI GASTAUT Hôpital De La Timone Neurologie Pédiatrique Pneumologie Pédiatrique Et Médecine Infantile
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Paris, France
- Hôpital Robert Debré Pôle: Pédiatrie Médicale Service: Neurologie Et Maladies Métaboliques
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Paris, France
- Hôpital Universitaire Necker-Enfants Malades Service de neurologie pédiatrique Centre de référence épilepsies rares (CReER)
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Berlin, Germany
- DRK Kliniken Berlin - Westend Epilepsiezentrum / Neuropaediatrie
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Bielefeld, Germany
- Krankenhaus Mara Epilepsie-Zentrum Bethel
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Freiburg, Germany
- Universitaetsklinikum Freiburg Zentrum fuer Kinder- und Jugendmedizin
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Jena, Germany
- Universitaetsklinikum Jena Klinik fuer Kinder- und Jugendmedizin Neuropaediatrie
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Kiel, Germany
- Universitaetsklinikum Schleswig-Holstein Campus Kiel Klinik fuer Neuropaediatrie
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Radeberg, Germany
- Kleinwachau Saechsisches Epilepsiezentrum Radeberg gemeinnuetzige GmbH
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Tübingen, Germany
- Universitaetsklinik fuer Kinder- und Jugendmedizin Abteilung III
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Vogtareuth, Germany
- Schoen Klinik Vogtareuth Neuropaediatrie und Neurologische Rehabilitation, Epilepsiezentrum fuer Kinder und Jugendlische, Tagesklinik fuer Neuropaediatrie
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Firenze, Italy
- AOU Anna Meyer Clinica di Neurologia Pediatrica
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Genova, Italy
- Istituto Pediatrico Giannina Gaslini Dipartimento di Neurologia
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Mantova, Italy
- A.O. Carlo Poma
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Milano, Italy
- Ospedale Fatebenefratelli e Oftalmico
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Milano, Italy
- Istituto Neurologica Carlo Besta
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Roma, Italy
- Policlinico A. Gemelli
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Roma, Italy
- U.O. Neurologia Dipartimento di Neuroscienze Ospedale Pediatrico Bambino Gesù
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Verona, Italy
- Ospedale Civile Maggiore di Borgo Trento - Ospedale della Donna e del Bambino
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Saitama, Japan
- Saitama Children's Medical Center
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Shizuoka, Japan
- National Epilepsy Center Shizuoka Institute of Epilepsy and Neurological Disorders
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Tokyo, Japan
- Tokyo Women's Medical University Hospital
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Heeze, Netherlands
- Kempenhaeghe
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Zwolle, Netherlands
- Stichting Epilepsie Instellingen Nederland
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Barcelona, Spain
- Hospital Sant Joan de Déu
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Madrid, Spain
- Hospital Ruber Internacional Primera Planta Servicio de Neurologia
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Pamplona, Spain
- Clinica Universitaria de Navarra Fase 4. Segunda planta, Consulta de Pediatria
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Birmingham, United Kingdom
- Birmingham Children Hospital NHS Foundation Trust
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Glasgow, United Kingdom
- Institute of Neurosciences Queen Elizabeth University Hospital
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Liverpool, United Kingdom
- Alder Hey Hospital
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London, United Kingdom
- St. Thomas Hospital
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London, United Kingdom
- Great Ormond Street Hospital for Children NHS Foundation Trust
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Sheffield, United Kingdom
- Sheffield Children's Hospital
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Arizona
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Phoenix, Arizona, United States, 85016
- Phoenix Children's Hospital
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Tucson, Arizona, United States, 85718
- Center for Neurosciences - Tucson
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California
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Orange, California, United States, 92868
- Children's Hospital of Orange County
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San Diego, California, United States, 92123
- Rady Children's Hospital San Diego
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San Francisco, California, United States, 94158
- University of California San Francisco
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Colorado
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Aurora, Colorado, United States, 80045
- The Children's Hospital Colorado
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Florida
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Gulf Breeze, Florida, United States, 32561
- NW FL Clinical Research Group, LLC
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Miami, Florida, United States, 33155
- Miami Children's Hospital Brain Institute
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Orlando, Florida, United States, 32819
- Neurology and Epilepsy Research Center
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Georgia
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Atlanta, Georgia, United States, 30328
- Clinical Integrative Research Center of Atlanta, Panda Neurology
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Illinois
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Chicago, Illinois, United States, 60611
- Ann and Robert H. Lurie Children's Hospital of Chicago
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Boston, Massachusetts, United States, 02115
- Boston Children's Hospital
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Michigan
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Detroit, Michigan, United States, 48201
- Children's Hospital of Michigan
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Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
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Saint Paul, Minnesota, United States, 55102
- Minnesota Epilepsy Group, P.A.
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New Jersey
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Livingston, New Jersey, United States, 07039
- Institute of Neurology and Neurosurgery at St. Barnabus
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Ohio
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Cleveland, Ohio, United States, 44103
- University Hospitals Cleveland Medical Center
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Children's Hospital of Philadelphia
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Tennessee
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Memphis, Tennessee, United States, 38103
- Le Bonheur Children's Hospital
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Texas
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Fort Worth, Texas, United States, 76104
- Cook Children's Medical Center
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Utah
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Salt Lake City, Utah, United States, 84113
- University of Utah
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Washington
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Seattle, Washington, United States, 98105
- Seattle Children's Hospital
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Tacoma, Washington, United States, 98405
- MultiCare Institute for Research & Innovation
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Key Inclusion Criteria:
- Male or non-pregnant, non-lactating female, age 2 to 18 years, inclusive as of the day of the core study Screening Visit.
- Satisfactory completion of the core study in the opinion of the investigator and the sponsor.
- Subjects who are >18 to ≤35 years of age at the time of screening and did not participate in one of the core studies may be eligible for participation.
- A documented medical history to support a clinical diagnosis of Dravet syndrome, where convulsive seizures are not completely controlled by current antiepileptic drugs.
- Parent/caregiver is willing and able to be compliant with diary completion, visit schedule and study drug accountability.
- Subject's parent/caregiver has been compliant with diary completion during the core study, in the opinion of the investigator (eg, at least 90% compliant).
Key Exclusion Criteria:
- Current or past history of cardiovascular or cerebrovascular disease, myocardial infarction or stroke.
- Current cardiac valvulopathy or pulmonary hypertension that is clinically significant and warrants discontinuation of study medication.
- Current or past history of glaucoma.
- Moderate or severe hepatic impairment.
- Receiving concomitant therapy with: centrally-acting anorectic agents; monoamineoxidase inhibitors; any centrally-acting compound with clinically appreciable amount of serotonin agonist or antagonist properties, including serotonin reuptake inhibition; atomoxetine, or other centrally-acting noradrenergic agonist; cyproheptadine, and/or cytochrome P450 (CYP) 2D6/3A4/2B6 inhibitors/substrates.
- Currently taking carbamazepine, oxcarbamazepine, eslicarbazepine, phenobarbital, or phenytoin, or has taken any of these within the past 30 days, as maintenance therapy.
- A clinically significant condition, or has had clinically relevant symptoms or a clinically significant illness at Visit 1, other than epilepsy, that would negatively impact study participation, collection of study data, or pose a risk to the subject.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: ZX008
ZX008 is supplied as an oral solution in a concentration of 2.5 mg/mL.
Subjects will be titrated to an effective dose beginning with 0.2 mg/kg/day (maximum: 30 mg/day).
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) During the Open-label Extension (OLE) Treatment Period
Time Frame: From Day 1 to End of OLE Treatment Period - End of Study (EOS) Visit (Month 42)
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Treatment-emergent adverse events (TEAE) were defined as any AEs that based on start date information occurs after the first intake of study treatment.
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From Day 1 to End of OLE Treatment Period - End of Study (EOS) Visit (Month 42)
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Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) Leading to Withdrawal From Investigational Medicinal Product (IMP) During the OLE Treatment Period
Time Frame: From Day 1 to End of OLE Treatment Period - EOS Visit (Month 42)
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A TEAE was defined as any AE that based on start date information occurs after the first intake of study treatment.
Percentage of participants with TEAEs leading to withdrawal from IMP during OLE Treatment Period were reported.
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From Day 1 to End of OLE Treatment Period - EOS Visit (Month 42)
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Percentage of Participants With Serious Treatment-emergent Adverse Events (TEAEs) During the OLE Treatment Period
Time Frame: From Day 1 to End of OLE Treatment Period - EOS Visit (Month 42)
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Serious Adverse event (SAE) was defined as any untoward medical occurrence that at any dose: • results in death, • is life-threatening threatening, • results in initial inpatient hospitalization or prolongation of hospitalization, •results in persistent or significant disability or incapacity, • results in a congenital anomaly/birth defect, • results in any medically significant event that did not meet any of the other 5 SAE criteria, but which was judged by a physician to potentially jeopardize the participant or require medical or surgical intervention to prevent one of the above outcomes listed as an SAE criterion.
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From Day 1 to End of OLE Treatment Period - EOS Visit (Month 42)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Change From Baseline (Core) in Convulsive Seizure Frequency Per 28 Days From Day 1 to End of Study (EOS) Visit (Month 42) in the OLE Treatment Period
Time Frame: From Day 1 to End of OLE Treatment Period (EOS Visit - up to Month 42), compared to Baseline (Core)
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Baseline (Core) was defined as Baseline prior to double-blind treatment in the core studies (ZX008-1501/ZX008-1502, and ZX008-1504 Cohort 2).
Participants in 1504- Cohort 1 and de novo participants (who entered 1503 without having been in any of the core studies) did not have a Baseline (Core), and were not included in the analysis of this outcome measure.
The total number of convulsive seizures from Day 1 to EOS was divided by the total number of days from Day 1 to EOS with nonmissing diary data and the result was then multiplied by 28 to get a 28-day convulsive seizure frequency (CSF).
The change from Baseline for any individual participant was calculated by subtracting the Baseline (Core) from the post-baseline value.
Monthly (28 day) CSF was based on electronic diary data obtained for each participant.
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From Day 1 to End of OLE Treatment Period (EOS Visit - up to Month 42), compared to Baseline (Core)
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Change From Baseline (Core) in Convulsive Seizure Frequency Per 28 Days From Month 2 to EOS (Month 42) in the OLE Treatment Period
Time Frame: From Month 2 to End of OLE Treatment Period (EOS Visit - up to Month 42), compared to Baseline (Core)
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Baseline (Core) was defined as Baseline prior to double-blind treatment in the core studies.
Participants in 1504-Cohort 1 and de novo participants did not have a Baseline (Core), and were not included in the analysis of this outcome measure.
The total number of convulsive seizures from Month 2 to EOS was divided by the total number of days from Month 2 to EOS with nonmissing diary data and the result was then multiplied by 28 to get a 28-day CSF.
The change from Baseline for any individual participant was calculated by subtracting the Baseline (Core) from the post-baseline value.
Monthly (28 day) CSF was based on electronic diary data obtained for each participant.
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From Month 2 to End of OLE Treatment Period (EOS Visit - up to Month 42), compared to Baseline (Core)
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Convulsive Seizure Frequency (CSF) Per 28 Days During the OLE Treatment Period (to Month 36)
Time Frame: At Month 1, Month 2, Month 3, Month 4-6, Month 7-9, Month 10-12, Month 13-15, Month 16-18, Month 19-21, Month 22-24, Month 25-27, Month 28-30, Month 31-33, and Month 34-36
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Monthly (28 day) CSF was based on electronic diary data obtained for each participant.
The total number of convulsive seizures in the ith interval (CSF in OLE, where, i=1, 2, 3, … , 14 ) was divided by the total number of days in the ith interval with nonmissing diary data and the result was then multiplied by 28 to get a 28-day CSF of OLE.
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At Month 1, Month 2, Month 3, Month 4-6, Month 7-9, Month 10-12, Month 13-15, Month 16-18, Month 19-21, Month 22-24, Month 25-27, Month 28-30, Month 31-33, and Month 34-36
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Convulsive Seizure Frequency (CSF) by Mean Daily Dose During the Overall OLE Treatment Period
Time Frame: From Day 1 to End of OLE Treatment Period - End of Study (EOS) Visit (Month 42)
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Convulsive seizure frequency over time, reported as per 28 days was analyzed by the actual dose administered.
Participants were grouped into low (0.2 to <0.4 mg/kg), medium (0.4 to <0.6 mg/kg), and high dose (>0.6 mg/kg) groups depending on their mean daily doses of ZX008 during the OLE Treatment period.
For each participant, the seizure frequency per 28 days was calculated as the number of seizures recorded during the period, divided by the number of days in the period and multiplied by 28.
The convulsive seizure frequency was calculated from all available data collected.
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From Day 1 to End of OLE Treatment Period - End of Study (EOS) Visit (Month 42)
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Percentage of Participants With Changes in Antiepileptic Drug (AED) Medications During First 6 Months of OLE Treatment Period
Time Frame: At Month 1, 2, 3, 4 , 5, and 6 of OLE Treatment Period
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Participants in the study were required to be on stable background therapy for the first 6 months of treatment, after which background AEDs could be reduced or withdrawn so long as one background AED remained.
The percentage of participants who had changes in dose or type of concomitant AED medications during the first, second, third, fourth, fifth, and sixth months were analyzed and reported.
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At Month 1, 2, 3, 4 , 5, and 6 of OLE Treatment Period
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: UCB Cares, 001 844 599 2273
Publications and helpful links
General Publications
- Cross JH, Galer BS, Gil-Nagel A, Devinsky O, Ceulemans B, Lagae L, Schoonjans AS, Donner E, Wirrell E, Kothare S, Agarwal A, Lock M, Gammaitoni AR. Impact of fenfluramine on the expected SUDEP mortality rates in patients with Dravet syndrome. Seizure. 2021 Dec;93:154-159. doi: 10.1016/j.seizure.2021.10.024. Epub 2021 Nov 2.
- Scheffer IE, Nabbout R, Lagae L, Devinsky O, Auvin S, Thiele EA, Wirrell EC, Polster T, Specchio N, Pringsheim M, Imai K, Lock MD, Langlois M, Roper RZ, Lothe A, Sullivan J. Long-term safety and effectiveness of fenfluramine in children and adults with Dravet syndrome. Epilepsia. 2025 Jun;66(6):1919-1932. doi: 10.1111/epi.18342. Epub 2025 Mar 12.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Estimated)
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
- Epileptic Syndromes
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Pathologic Processes
- Disease
- Epilepsy, Generalized
- Epilepsy
- Syndrome
- Epilepsies, Myoclonic
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Neurotransmitter Agents
- Membrane Transport Modulators
- Neurotransmitter Uptake Inhibitors
- Serotonin Agents
- Selective Serotonin Reuptake Inhibitors
- Fenfluramine
Other Study ID Numbers
Other Study ID Numbers
- ZX008-1503
- 2016-002804-14 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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