- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02920060
Levetiracetam Versus Sodium Valproate in Children With Refractory Generalized Convulsive Status Epilepticus
Levetiracetam Versus Sodium Valproate in Children With Refractory Generalized Convulsive Status Epilepticus : An Open Randomized Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In our study patients were considered to have RSE if children were still having active convulsions despite receiving injection lorazepam intravenously at a dose of 0.1 mg/kg (max 4 mg) at a rate maximum upto 2 mg/min or intravenous diazepam at a dose of 0.2 - 0.3 mg/Kg (maximum 10 mg) slowly or intravenous midazolam at a dose of 0.15 - 0.2 mg/kg(max 5 mg). In case of children with difficult intravenous access buccal/nasal midazolam 0.2 - 0.3 mg/kg (maximum 5 mg) per rectal diazepam 0.5 mg/kg (maximum 10 mg) or intramuscular midazolam 0.2 mg/kg (maximum 5 mg). If seizure continued at 5 minutes, a repeat dose of benzodiazepine was given with same dose. At 10 minutes, if the seizure activity still remains intravenous phenytoin was given at a dose of 20mg/kg(maximum- 1000mg) at a rate of 1mg/kg/minute or intravenous fosphenytoin at 20mg PE/kg (if available) at a rate of 3mg PE/kg/minute.
Patients having seizure activity despite administration of above medications were considered to have RSE. Out of thousands of patients seen in outdoor and emergency ward, 80 patients were diagnosed to have RSE and met the inclusion criteria. After counselling the parents/guardians about the medications and obtaining a written informed consent they were randomized to into two groups : sodium valproate(V) and levetiracetam group(L), using a computer generated randomization chart. Forty patients in group V received intravenous valproic acid in dose of 20 mg/kg as loading dose at a rate of 40 mg/min after dilution with normal saline followed by maintenance dose of 10mg/kg/dose 8 hourly. In group L patients received intravenous levetiracetam as loading dose of 30 mg/kg at a rate of 50 mg/min followed by 20mg/kg/dose 12 hourly.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age - 1 year to 16 years
- Gender - male and female both
- Refractory generalized convulsive status epilepticus i.e. not responding to any two of the first line drugs
Exclusion Criteria:
- Patients with epilepsia partialis continua.
- Patients with definite history of any allergic reaction to intravenous levetiracetam or intravenous valproate, or any contraindications in giving these drugs.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Levetiracetam
patient in this group will receive intravenous levetiracetam as loading dose of 30 mg/kg at a rate of 50 mg/min
|
intravenous levetiracetam(30mg/kg bolus followed by 20mg/kg/dose IV 12 hourly).
Other Names:
|
ACTIVE_COMPARATOR: Sodium valproate
patients in this group will receive intravenous sodium valproate 20 mg/kg as loading dose at a rate of 40 mg/min
|
intravenous sodium valproate(20mg/kg bolus followed by 10 mg/kg/dose IV 8hrly)
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
cessation of convulsions (clinically evident motor activity)
Time Frame: 30 minutes
|
clinical cessation of convulsions, vitals monitoring
|
30 minutes
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
seizure activity at 24 hours of infusion
Time Frame: 24 hours
|
whether clinical convulsive activity cessation or not
|
24 hours
|
seizure recurrence
Time Frame: 24 hours
|
average number of seizure recurring after drug infusion within 24 hours
|
24 hours
|
additional number of drugs
Time Frame: 24 hours
|
number of additional drugs to control RSE within 24 hours of infusion
|
24 hours
|
time taken to control seizure activity
Time Frame: 24 hours
|
time needed to control convulsive activity from infusion time
|
24 hours
|
change in vital parameters after infusing interventional agent
Time Frame: 24 hours
|
vital parameters will be recorded every 15 minutes for the first 1 hour after the intervention began and mean value of vital parameters will be compared in two groups
|
24 hours
|
neurological outcome and seizure control
Time Frame: 1 month
|
to look for any neurological deficit or behavioural abnormality and seizure control at one month of follow-up
|
1 month
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Rajniti Prasad, MD, Banaras Hindu University
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 (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
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
- Enzyme Inhibitors
- Tranquilizing Agents
- Psychotropic Drugs
- GABA Agents
- Anticonvulsants
- Antimanic Agents
- Nootropic Agents
- Valproic Acid
- Levetiracetam
Other Study ID Numbers
- ECR/526/Inst/UP/2014
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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