Lorazepam for the Treatment of Status Epilepticus or Repetitive Status Epilepticus in Japan

A Multi-center, Open-label, Non-controlled Study To Evaluate The Efficacy And Safety Of Lorazepam Intravenously Administered In Subjects With Status Epilepticus Or Repetitive Status Epilepticus

The purpose of this study is to determine the efficacy, safety and pharmacokinetics of Lorazepam on Japanese patients with Status Epilepticus or Repetitive Status Eplilepticus.

Study Overview

• Status: Completed
• Conditions: Status Epilepticus
• Intervention / Treatment: Drug: Lorazepam

• Study Type: Interventional
• Enrollment (Actual): 26
• Phase: Phase 3

Contacts and Locations

Study Locations

• Japan
  • Fukuoka, Japan, 814-0180
    • Fukuoka University Hospital
  • Fukuoka, Japan, 813-0017
    • Fukuoka Children's Hospital
  • Fukuoka, Japan, 814-0001
    • Fukuoka Sanno Hospital
  • Gifu, Japan, 500-8717
    • Gifu Prefectural General Medical Center
  • Saitama, Japan, 339-8551
    • Saitama Children's Medical Center
  • Aichi
    • Obu-shi, Aichi, Japan, 474-8710
      • Aichi Children's Health and Medical Center
  • Fukuoka
    • Koga, Fukuoka, Japan, 811-3195
      • National Hospital Organization Fukuoka-Higashi Medical Center
  • Hokkaido
    • Sapporo, Hokkaido, Japan, 060-8570
      • Nakamura Memorial Hospital
    • Sapporo, Hokkaido, Japan, 063-0005
      • National Hospital Organization Hokkaido Medical Center
    • Sapporo, Hokkaido, Japan, 006-0041
      • Hokkaido Medical Center for Child Health and Rehabilitation
  • Hyogo
    • Kobe, Hyogo, Japan, 650-0047
      • Hyogo Prefectural Kobe Children's Hospital
  • Miyagi
    • Sendai, Miyagi, Japan, 980-8574
      • Tohoku University Hospital
  • Nagasaki
    • Ohmura, Nagasaki, Japan, 856-8562
      • National Hospital Organization Nagasaki Medical Center
  • Niigata
    • Niigata-shi, Niigata, Japan, 950-2085
      • National Nishi-Niigata Central Hospital / Pediatrics
  • Okayama
    • Okayama-shi, Okayama, Japan, 700-8558
      • Okayama University Hospital / Child Neurology
  • Osaka
    • Izumi, Osaka, Japan, 594-1101
      • Osaka Medical Center and Research Institute for Maternal and Child Health
    • Miyakojima-ku, Osaka, Japan, 534-0021
      • Osaka City General Hospital Pediatric Neurology
  • Shizuoka
    • Shizuoka-city, Shizuoka, Japan, 420-8688
      • NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Tokyo
    • Kodaira, Tokyo, Japan, 187-8551
      • National Center of Neurology and Psychiatry
  • Yamanashi
    • Kofu, Yamanashi, Japan, 400-8506
      • Yamanashi Prefectural Central Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 months and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects with status epilepticus or repetitive status epilepticus / cluster seizure who have seizures that can be evaluated by investigator's visual observations based on motor symptoms or who have seizures that can be evaluated by EEG.
• Subjects with status epilepticus accompanied by generalized seizure, partial seizure or secondarily generalized seizure lasting 5 minutes or longer
• Subjects with repetitive status epilepticus / cluster seizure accompanied by not less than 3 consecutive episodes of generalized seizure, partial seizure or secondarily generalized seizure in 1 hour.
• Subjects not younger than 3 months (either gender is eligible for the study)

Exclusion Criteria:

• Subjects with known or suspected recurrent seizures due to illegal drug or alcohol withdrawal
• Subjects with known history of hypersensitivity to lorazepam or benzodiazepine
• Subjects with a known history of benzodiazepine abuse.
• Subjects currently receiving lorazepam
• Subjects with angle-closure glaucoma
• Subjects with myasthenia gravis
• Subjects with either of aspartate transaminase, alanine transaminase, total bilirubin, blood urea nitrogen, or creatinine at screening visit exceeding 2x the upper limit of normal of the institutional reference value (if the data is available)
• Subjects with white blood cell count less than 3000/mm3 or neutrophil count less than 1500/mm3 at screening visit (if the data is available)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Lorazepam; Lorazepam intravenous formulation

Drug: Lorazepam; intravenous administration. Dosage for adult subjects (16 years aged and over): 4 mg Dosage for pediatric subjects (3 months to < 16 years): 0.05 mg/kg (but not exceeding 4 mg) Frequency: Intravenous administration of lorazepam. Subjects whose seizure does not stop or recurs within 10 minutes after the initial dose may receive the same amount of lorazepam injection no earlier than 10 minutes following the initial dose. Also, subjects whose seizure stops within 10 minutes after the initial dose, but recurs thereafter (within 12 hours) may receive the same amount of lorazepam injection; a total of 2 doses will be permitted in this study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Participants Who Achieved Seizure Free Interval of At Least 30 Minutes After Initial Dose (Dose 1) of Study Drug	Participants with clinical benefit were defined as participants whose initial seizure stopped within 10 minutes after initial dose (Dose 1) and who continued seizure-free for at least 30 minutes after the completion of initial dose (Dose 1).	30 minutes post Dose 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Participants Who Achieved Seizure Free Interval of At Least 30 Minutes After Any Dose of Study Drug	Percentage of participants whose initial seizure stopped within 10 minutes after the administration of study drug (either Dose 1 or 2 [in 10 to 30 minutes from the initial dose]) and who continued seizure-free for at least 30 minutes were analyzed and reported in this outcome measure.	30 minutes post Dose 1 or 2
Percentage of Participants Who Achieved Seizure Free Interval of At Least 12 Hours After Administration (Either Initial or Any Dose) of Study Drug	Percentage of participants whose seizures stopped within 10 minutes after the administration of initial dose (Dose 1) of study drug and after any study drug dose (either Dose 1 or Dose 2 [in 10 to 30 minutes from the initial dose]), who continued to be seizure-free for at least 12 hours post-dose were analyzed and reported in this outcome measure.	12 hour post Dose 1; 12 hour post Dose 1 or 2
Percentage of Participants Who Achieved Seizure Free Interval of At Least 24 Hours After Administration (Either Initial or Any Dose) of Study Drug	Percentage of participants whose seizures stopped within 10 minutes after the administration of initial dose (Dose 1) of study drug and after any study drug dose (either Dose 1 or Dose 2 [in 10 to 30 minutes from the initial dose]), who continued to be seizure-free for at least 24 hours post-dose were analyzed and reported in this outcome measure.	24 hour post Dose 1; 24 hour post Dose 1 or 2
Time to Resolution of Seizures From The Administration (Either Initial or Any Dose) of Study Drug	Time to resolution (in minutes) was defined as the duration between the administration of study drug until the seizure resolved without receiving the prohibited medications.	10 minutes post Dose 1; 10 minutes post Dose 1 or 2
Time to Relapse Following The Administration (Either Initial or Any Dose) of Study Drug	Time to relapse (in minutes) was defined as duration from the time of study drug administration to the time of relapse, as determined by investigator. Participants whose seizure stops within 10 minutes without receiving the prohibited medications were analyzed in this outcome measure.	24 hour post Dose 1; 24 hour post Dose 1 or 2
Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)	An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug to the end of study (Day 12), that were absent before treatment or that worsened relative to pre-treatment state. AEs include both serious and non-serious adverse events.	Baseline up to 7 days after last dose of study drug administration (up to 12 days)

Collaborators and Investigators

• Sponsor: Pfizer

Publications and helpful links

Helpful Links

• To obtain contact information for a study center near you, click here.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2014
• Primary Completion (Actual): August 1, 2016
• Study Completion (Actual): August 1, 2016

Study Registration Dates

• First Submitted: September 10, 2014
• First Submitted That Met QC Criteria: September 10, 2014
• First Posted (Estimate): September 12, 2014

Study Record Updates

• Last Update Posted (Actual): February 18, 2019
• Last Update Submitted That Met QC Criteria: October 11, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: Status Epilepticus; Lorazepam
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Seizures; Status Epilepticus; Physiological Effects of Drugs; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Central Nervous System Depressants; Autonomic Agents; Peripheral Nervous System Agents; Antiemetics; Gastrointestinal Agents; Tranquilizing Agents; Psychotropic Drugs; Hypnotics and Sedatives; Anti-Anxiety Agents; GABA Modulators; GABA Agents; Anticonvulsants; Lorazepam
• Other Study ID Numbers: B3541002; 2017-000125-13 (EudraCT Number)