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

31. oktober 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Observasjonsmessig

Registrering (Antatt)

15

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

    • Bangkok
      • Pathum Wan, Bangkok, Thailand, 10330
        • King Chulalongkorn Memorial Hospital
        • Ta kontakt med:
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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.

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Observasjonsmodeller: CASE_ONLY
  • Tidsperspektiver: PROSPECTIVE

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Probability of target attainment for simulated levetiracetam dosing regimens
Tidsramme: 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).

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Levetiracetam plasma exposure based on the area under the concentration-time curve (AUC)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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).

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Samarbeidspartnere

Etterforskere

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

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

30. oktober 2026

Primær fullføring (Antatt)

30. september 2027

Studiet fullført (Antatt)

30. juni 2028

Datoer for studieregistrering

Først innsendt

14. oktober 2026

Først innsendt som oppfylte QC-kriteriene

31. oktober 2026

Først lagt ut (Faktiske)

5. november 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

31. oktober 2026

Sist bekreftet

1. oktober 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 0551/2026

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

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.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .