- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00884052
Pharmacokinetic and Safety Trial of Intravenous Levetiracetam in the Treatment of Neonatal Seizures (Keppra)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In adults, drug clearance is less than half of the glomerular filtration rate and the drug half-life is 6-8 hours. Renal function in infants at birth is characterized by immature glomerular filtration and is only 20% that of older children. The specific esterase responsible for levetiracetam hydrolysis has not been identified and its expression in newborn infants is unknown. Depending on its activity, the expected infant total levetiracetam clearance will likely be between 15-45% of older populations. However, due to immaturity in levetiracetam clearance in infants, accumulation with multiple dosing is possible. Therefore the maintenance dose is reduced compared to older children according to the anticipated impaired clearance.
These anticipated differences in levetiracetam clearance and volume of distribution, will likely result in a prolonged drug half-life of 10-30 hours in infants. This prolonged elimination will require longer sampling to adequately characterize levetiracetam pharmacodynamics in this population.
The primary intent of the data analysis is to determine levetiracetam pharmacokinetics in newborn infants and predict the dosage necessary to maintain concentrations similar to those seen with effective therapy in other populations. Graphs of serum concentration vs. time will be plotted for levetiracetam for each infant. Mean serum drug concentration vs. time curves will also be constructed. Summary statistics (i.e., n, mean, standard deviation, minimum, maximum, and coefficient of variation) will be calculated for serum concentrations for each time point and each dose level.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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California
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San Diego, California, United States, 92103
- University of California, San Diego Medical Center / Neonatal Intensive Care Unit (NICU)
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Newborns admitted to the UCSD, Children's Hospital or Sharp Mary Birch NICUs with seizures.
- Term infants (gestational age greater than or equal to 37 weeks.
- > 2500 grams (max blood for study 6mL =3%).
- Postnatal age 14 days or less.
- Serum creatinine less than 1.2 at time of enrollment.
- Received loading dose of phenobarbital 20mg/kg.
- Are still experiencing either clinical or electroencephalographic seizures despite this therapy.
- For whom parental consent to participate in the study is obtained.
Exclusion Criteria:
- Biochemical abnormality - hypoglycemia, hypocalcemia-that when treated result in seizure cessation.
- Severe hypoxic ischemic injury likely to result in imminent death
- The only significant exclusions that will be made in recruitment and enrollment will be the exclusion of infants who are judged by the attending neonatologist to be so critically ill that death is imminent and benefit from neonatal intensive care is very unlikely.
- No rule-based criteria, (using lab or clinical parameters) adequately capture the complete nature of this clinical assessment.
- In general any child receiving active treatment with head cooling will not be excluded.
- Mechanical ventilation and/or the use of inotropic agents to support blood pressure will not be exclusion criteria.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: levetiracetam dose escalation
6 Babies in Phase 1-Received Dose 1: 20 mg/kg; 5 mg/kg daily 12 Babies in Phase 2-Received Dose 2: 40 mg/kg; 10 mg/kg/day
|
20 mg/kg loading dose; 5 mg/kg daily for 7 days.
Other Names:
40 mg/kg IV load; 10 mg/kg/day maintenance
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Drug Clearance
Time Frame: Day 1 and Day 7
|
Day 1 and Day 7
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Drug Half Life
Time Frame: Day 1 and Day 7
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Day 1 and Day 7
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Levetiracetam Treated Number of Participants With Serious Adverse Events
Time Frame: 7 Days
|
7 Days
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Richard Haas, MD, University of Calfornia, San Diego
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Thrasher 02825-1
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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