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Pharmacokinetics and Optimal Dosing of Levetiracetam in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy (LEVCRRT)

31 oktober 2026 bijgewerkt door: Supanat Khueankaew, PharmD, Chulalongkorn University

Levetiracetam may be removed during continuous renal replacement therapy (CRRT), potentially affecting drug concentrations and seizure control. The optimal dosing regimen for critically ill patients receiving CRRT remains unclear. This observational study will investigate the pharmacokinetics of levetiracetam in critically ill adult patients receiving CRRT. Blood, CRRT effluent, and urine samples will be collected throughout one dosing interval to measure levetiracetam concentrations. The data will be used to develop a population pharmacokinetic model and perform pharmacokinetic/pharmacodynamic modeling and Monte Carlo simulations to evaluate dosing regimens and estimate the probability of achieving predefined drug concentration or exposure targets. The findings may help identify an appropriate levetiracetam dosing regimen for critically ill patients receiving CRRT.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Studietype

Observationeel

Inschrijving (Geschat)

15

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

    • Bangkok
      • Pathum Wan, Bangkok, Thailand, 10330
        • King Chulalongkorn Memorial Hospital
        • Contact:
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

Critically ill adult patients aged 18 years or older admitted to ICUs who receive levetiracetam during CRRT. Eligible patients must have received CRRT for at least 24 hours and meet the study's inclusion and exclusion criteria.

Beschrijving

Inclusion Criteria:

  • Adults aged 18 years or older.
  • Patients admitted to any ICUs.
  • Patients receiving CRRT for at least 24 hours.
  • Hemodynamically stable patients, defined as having a SBP of at least 90 mmHg or a MAP of at least 60 mmHg, with the norepinephrine dose remaining stable or increasing by no more than 0.1 mcg/kg/min during the preceding 6 hours.
  • Patients receiving intravenous or oral levetiracetam while receiving CRRT.
  • Patients admitted to any ICUs.
  • Patients receiving CRRT for at least 24 hours.

Exclusion Criteria:

  • Pregnant patients
  • Patients who are breastfeeding.
  • Patients with a known hypersensitivity to levetiracetam or who develop a hypersensitivity reaction requiring discontinuation of levetiracetam during the study.
  • Patients with cirrhosis classified as Child-Pugh-Turcotte class C.
  • Patients receiving extracorporeal membrane oxygenation (ECMO).
  • Patients who, or whose legally authorized representatives, do not provide informed consent for study participation.
  • Patients with an expected survival of less than 24 hours, as assessed by the attending physician.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Observatiemodellen: CASE_ONLY
  • Tijdsperspectieven: PROSPECTIVE

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
Critically Ill Adult Patients Receiving Levetiracetam During CRRT

Critically ill adult patients aged 18 years or older admitted to ICUs who receive levetiracetam during CRRT. Eligible participants must have received CRRT for at least 24 hours and meet the study's inclusion and exclusion criteria.

Levetiracetam administered as part of routine clinical care to critically ill adult patients receiving CRRT. The dose, dosing interval, and route of administration are determined by the treating physician. CRRT is prescribed and managed by the treating clinical team (nephrologist) as part of routine clinical care. The investigators do not assign or modify levetiracetam treatment or CRRT prescriptions for research purposes. Levetiracetam concentrations are measured in blood, CRRT effluent, and urine samples collected at protocol-specified time points to characterize its pharmacokinetic profile during CRRT.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Probability of target attainment for simulated levetiracetam dosing regimens
Tijdsspanne: At completion of population pharmacokinetic model development and Monte Carlo simulations (approximately 23 months after study start).

Monte Carlo simulations based on the developed population pharmacokinetic model will be used to estimate the probability of target attainment (PTA) for each simulated levetiracetam dosing regimen. Target attainment will be evaluated according to the prespecified therapeutic concentration and AUC target criteria in the study protocol. Results will be reported as the probability or percentage of simulated patients achieving the target for each dosing regimen.

At completion of population pharmacokinetic model development and Monte Carlo simulations (approximately 23 months after study start).

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Levetiracetam plasma exposure based on the area under the concentration-time curve (AUC)
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

Levetiracetam AUC will be estimated using noncompartmental analysis of concentration-time data collected over a single dosing interval. Simultaneous samples will be collected from the pre-filter, post-filter, and effluent ports before dosing and at 7 prespecified time points after intravenous or oral administration.

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Volume of distribution of levetiracetam
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

The volume of distribution of levetiracetam will be estimated using noncompartmental pharmacokinetic analysis based on the administered dose, elimination rate constant, and AUC.

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Total clearance of levetiracetam
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

Total clearance of levetiracetam will be estimated using noncompartmental pharmacokinetic analysis based on the administered dose and AUC.

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Levetiracetam sieving and saturation coefficients during continuous renal replacement therapy (CRRT)
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

The sieving coefficient (SC) and saturation coefficient (SA) of levetiracetam will be determined using pre-filter, post-filter, and effluent concentrations to evaluate drug transfer across the CRRT filter under different CRRT modalities, including continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), and continuous venovenous hemodiafiltration (CVVHDF).

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Levetiracetam clearance by CRRT
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

Levetiracetam clearance by CRRT will be calculated based on pre-filter, post-filter, and effluent concentrations, together with replacement or dialysate flow rates according to the CRRT modality and dilution method, including CVVH, CVVHD, and CVVHDF.

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Renal clearance of levetiracetam
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

Renal clearance of levetiracetam will be calculated based on urinary levetiracetam concentrations, urine volume, and plasma levetiracetam concentrations.

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Non-renal clearance of levetiracetam
Tijdsspanne: From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.

Non-renal clearance of levetiracetam will be estimated from total systemic drug clearance after accounting for renal and CRRT clearance.

From predose (0 hours) to pre-next dose (e.g., 12 hours) after initiation of levetiracetam administration.
Population typical value of levetiracetam clearance
Tijdsspanne: Following completion of pharmacokinetic data collection and population pharmacokinetic analysis (approximately 23 months after study start).

The typical population value of levetiracetam clearance will be estimated using nonlinear mixed-effects modeling based on pre-filter and post-filter plasma concentration data collected from critically ill patients receiving CRRT.

Following completion of pharmacokinetic data collection and population pharmacokinetic analysis (approximately 23 months after study start).
Population typical value of levetiracetam volume of distribution
Tijdsspanne: Following completion of pharmacokinetic data collection and population pharmacokinetic analysis (approximately 23 months after study start).

The typical population value of levetiracetam volume of distribution will be estimated using nonlinear mixed-effects modeling based on pre-filter and post-filter plasma concentration data collected from critically ill patients receiving CRRT.

Following completion of pharmacokinetic data collection and population pharmacokinetic analysis (approximately 23 months after study start).
Population typical value of CRRT-mediated levetiracetam clearance
Tijdsspanne: Following completion of pharmacokinetic data collection and population pharmacokinetic analysis (approximately 23 months after study start).

The typical population value of CRRT-mediated levetiracetam clearance will be estimated using levetiracetam concentrations in plasma and effluent fluid, together with effluent flow rate, in critically ill patients receiving CRRT.

Following completion of pharmacokinetic data collection and population pharmacokinetic analysis (approximately 23 months after study start).

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Onderzoekers

  • Studie directeur: Weerachai Chaijamorn, BSc (Pharm), BCP, FACP, BCPS, Associate Professor, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

30 oktober 2026

Primaire voltooiing (Geschat)

30 september 2027

Studie voltooiing (Geschat)

30 juni 2028

Studieregistratiedata

Eerst ingediend

14 oktober 2026

Eerst ingediend dat voldeed aan de QC-criteria

31 oktober 2026

Eerst geplaatst (Werkelijk)

5 november 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

5 november 2026

Laatste update ingediend die voldeed aan QC-criteria

31 oktober 2026

Laatst geverifieerd

1 oktober 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • 0551/2026

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

The study team does not currently plan to share IPD with other researchers due to concerns regarding patient confidentiality, participant privacy, and the potential risk of re-identification. Access to study data will be restricted to researchers in the Pharmacometrics for Health Sciences Research Group, Faculty of Pharmaceutical Sciences, Chulalongkorn University, and individuals authorized in writing by the researchers. Any future proposal to share IPD will be reviewed for consistency with the informed consent, ethics committee requirements, institutional policies, and applicable laws.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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