Trial Outcomes & Findings for Study of Lacosamide as an Adjunctive Drug Treatment for Epilepsy in Patients With Brain Tumors (NCT NCT02276053)

NCT ID: NCT02276053

Last Updated: 2020-06-01

Results Overview

A responder is a patient experiencing a 50 % or greater reduction in partial onset seizure frequency from Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Recruitment status

COMPLETED

Target enrollment

93 participants

Primary outcome timeframe

Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Results posted on

2020-06-01

Participant Flow

The study started to enroll patients in November 2014 and concluded in December 2017.

The Participant Flow refers to the Safety Set (SS), which was defined as all patients included in the study receiving treatment with LCM at least once in the study.

Participant milestones

Participant milestones
Measure
Lacosamide
Patients with brain tumor-related epilepsy (BTRE), secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of lacosamide (LCM) treatment, routinely treated with lacosamide as add on to one or two baseline anti-epileptic drugs (AEDs) and who were included in the Safety Set (SS).
Overall Study
STARTED
93
Overall Study
COMPLETED
79
Overall Study
NOT COMPLETED
14

Reasons for withdrawal

Reasons for withdrawal
Measure
Lacosamide
Patients with brain tumor-related epilepsy (BTRE), secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of lacosamide (LCM) treatment, routinely treated with lacosamide as add on to one or two baseline anti-epileptic drugs (AEDs) and who were included in the Safety Set (SS).
Overall Study
Death
2
Overall Study
Adverse Event
5
Overall Study
Lack of Efficacy
2
Overall Study
Withdrawal by Subject
1
Overall Study
Patient does not meet selection criteria
3
Overall Study
Patient needs to increase baseline AED
1

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Lacosamide
n=93 Participants
Patients with brain tumor-related epilepsy (BTRE), secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of lacosamide (LCM) treatment, routinely treated with lacosamide as add on to one or two baseline anti-epileptic drugs (AEDs) and who were included in the Safety Set (SS).
Age, Categorical
<=18 years
1 Participants
n=93 Participants
Age, Categorical
Between 18 and 65 years
82 Participants
n=93 Participants
Age, Categorical
>=65 years
10 Participants
n=93 Participants
Age, Continuous
44.5 years
STANDARD_DEVIATION 14.7 • n=93 Participants
Sex: Female, Male
Female
43 Participants
n=93 Participants
Sex: Female, Male
Male
50 Participants
n=93 Participants

PRIMARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

A responder is a patient experiencing a 50 % or greater reduction in partial onset seizure frequency from Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=86 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Percentage of Patients With Response at the End of the 6-month Observation Period
76.7 percentage of patients
Interval 66.4 to 85.2

PRIMARY outcome

Timeframe: Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

The Patient Global Impression of Change scale is a seven-point scale for patients to rate their general health status at the end of the study compared to how they felt before entering the study. Scores 1 to 3 mean improvement, score 4 means no change, and scores 5 to 7 mean worsening. The category 'Improved' represents the sum of Very Much Improved, Much Improved, and Minimally Improved. The category 'Worsened' represents the sum of Minimally Worse, Much Worse, and Very Much Worse.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=76 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Patient Global Impression of Change (PGIC) Rating at Visit 3
Improved
49 Participants
Patient Global Impression of Change (PGIC) Rating at Visit 3
No change
17 Participants
Patient Global Impression of Change (PGIC) Rating at Visit 3
Worsened
10 Participants

SECONDARY outcome

Timeframe: Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Safety Set (SS), which included all patients who received treatment with lacosamide (LCM) at least once in the study.

The retention rate was defined as the percentage of patients remaining in the study and on Lacosamide treatment for 6 months (6 month retention rate).

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=93 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Percentage of Patients With Retention on Lacosamide (LCM) at the End of the 6-month Observation Period
63.4 percentage of patients

SECONDARY outcome

Timeframe: From first dose to discontinuation, over a 6-month Observation Period

Population: The analysis was performed on the Safety Set (SS), which included all patients who received treatment with lacosamide (LCM) at least once in the study.

Time between first dose of LCM to discontinuation of LCM treatment was measured in days.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=93 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Time to Discontinuation of Lacosamide (LCM) Treatment From the Date of First Dose of LCM
NA days
Due to low number of participants with events, Kaplan-Meier estimation of percentage of event-free subjects was high and corresponding standard error was small, preventing estimation of median time to event and 95% confidence interval boundaries.

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

EQ-5D-5L: 5 Level EuroQol-5 Dimension Quality of Life Assessment is a patient-completed questionnaire for patients to rate their quality of life status in five questions and a 0 (no pain) - 100 (worst pain) score vertical visual analogue scale. The Change from Baseline is calculated for this endpoint, negative values indicate improvement and positive values indicate worsening.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=72 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in the 5 Level EuroQol-5 Dimension Quality of Life Assessment (EQ-5D-5L) Visual Analogue Scale (VAS) Score
1.3 scores on a scale
Standard Deviation 16.4

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

EQ-5D-5L: 5 Level EuroQol-5 descriptive system comprises the following five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression with five response levels for each dimension: no problems, slight problems, moderate problems, severe problems and extreme problems. This 5-dimension health status is converted into a numerical utility value using the UK value set, as per EuroQOL guidelines. The utility score ranges from 0 to 1 (0=worst imaginable health state, 1=best imaginable health state). The Change from Baseline is calculated for this endpoint, negative values indicate worsening and positive values indicate improvement.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=73 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in the 5 Level EuroQol-5 Dimension Quality of Life Assessment (EQ-5D-5L) Change in Utility as Converted From the 5 Dimensions
-0.01 scores on a scale
Standard Deviation 0.20

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

MDASI-BT is a 2-part patient completed questionnaire where patients have to answer 22 questions about their brain tumor-related symptoms and 6 questions about how these symptoms interfere with their life. The mean core symptom severity is derived as the mean of the 13 core symptom items, the mean module symptom severity is derived as the mean of the 9 brain tumor specific symptom items and the mean total symptom severity is derived as the mean of all 22 symptom items. The mean interference is derived as the mean of the 6 interference items. For each score, at least 50% of the items needs to be answered for the score to be calculated. Mean core, mean module and mean total symptom severity scores are ranging from 0 to 10 (0=not present 10=as bad as you can imagine). Mean interference score is ranging from 0 to 10 (0= did not interfere 10= interfered completely). The Change from Baseline is calculated, negative values indicate improvement, positive values indicate worsening.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=73 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in the M.D. Anderson Symptom Inventory - Brain Tumor (MDASI-BT)
Mean core symptom severity
0.1 scores on a scale
Standard Deviation 1.3
Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in the M.D. Anderson Symptom Inventory - Brain Tumor (MDASI-BT)
Mean module symptom severity
-0.1 scores on a scale
Standard Deviation 1.6
Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in the M.D. Anderson Symptom Inventory - Brain Tumor (MDASI-BT)
Mean total severity
0.0 scores on a scale
Standard Deviation 1.2
Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in the M.D. Anderson Symptom Inventory - Brain Tumor (MDASI-BT)
Mean interference
-0.5 scores on a scale
Standard Deviation 2.4

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

The actual change in seizure frequency from Baseline to Month 6 is calculated as the seizure frequency at Month 6 minus the seizure frequence at Baseline. The seizure frequency at each time point is calculated as number of seizures per 28 days.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=78 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Actual Change From Visit 1 (Baseline) to Visit 3 (Month 6 or End of Observation Period) in Seizure Frequency (Seizures Per 28 Days)
-2.9 seizures per 28 days
Interval -9.1 to -0.9

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

The percentage change from Baseline to Month 6 in seizure frequency is the actual change in seizure frequency for this period compared to the Baseline seizure frequency, which is considered 100 %.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=78 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Percentage Change From Baseline in Seizure Frequency
-85.2 percent change
Interval -100.0 to -55.5

SECONDARY outcome

Timeframe: Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

Percentage of patients achieving a seizure-free status at the end of the 6-month Observation Period.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=86 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Percentage of Patients With Seizure-free Status (Yes/No) at the End of the 6-month Observational Period
34.9 percentage of patients
Interval 24.9 to 45.9

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Safety Set (SS), which included all patients who received treatment with lacosamide (LCM) at least once in the study.

Discontinuation rate due to ADRs is the number of patients that discontinued from the study and from LCM treatment due to ADRs during the 6 months of observation.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=93 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Discontinuation Rate of Lacosamide (LCM) Due to Adverse Drug Reactions (ADRs)
5 Participants

SECONDARY outcome

Timeframe: Visit 1 (Baseline) to Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Safety Set (SS), which included all patients who received treatment with lacosamide (LCM) at least once in the study.

Discontinuation rate due to lack of effectiveness is the number of patients that discontinued from the study and from LCM treatment due to lack of effectiveness during the 6 months of observation.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=93 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Discontinuation Rate of Lacosamide (LCM) Due to Lack of Effectiveness
7 Participants

SECONDARY outcome

Timeframe: Visit 3 (Month 6 or end of Observation Period)

Population: The analysis was performed on the Full Analysis Set (FAS), which included all patients in the Safety Set (SS) who had at least 1 post Baseline Patient Global Impression of Change (PGIC) or seizure assessment.

The Clinical Global Impression of Change is a seven-point scale for the treating physician to rate the patient's general health status at the end of the study compared to how the patient felt before entering the study. Scores 1 to 3 mean improvement, score 4 means no change, and scores 5 to 7 mean worsening. The category 'Improved' represents the sum of Very Much Improved, Much Improved, and Minimally Improved. The category 'Worsened' represents the sum of Minimally Worse, Much Worse, and Very Much Worse.

Outcome measures

Outcome measures
Measure
Lacosamide (FAS)
n=81 Participants
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the Full Analysis Set (FAS), having at least one post-Baseline Patient Global Impression of Change or seizure assessment.
Clinical Global Impression of Change (CGIC) Rating at Visit 3 (Month 6 or End of Observation Period)
Impoved
52 Participants
Clinical Global Impression of Change (CGIC) Rating at Visit 3 (Month 6 or End of Observation Period)
No change
19 Participants
Clinical Global Impression of Change (CGIC) Rating at Visit 3 (Month 6 or End of Observation Period)
Worsened
10 Participants

Adverse Events

Lacosamide (SS)

Serious events: 5 serious events
Other events: 9 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Lacosamide (SS)
n=93 participants at risk
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the SS.
Hepatobiliary disorders
Cholestasis
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Investigations
Blood alkaline phosphatase increased
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Investigations
Gamma-glutamyltransferase increased
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Brain neoplasm
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Nervous system disorders
Brain oedema
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Nervous system disorders
Coma
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Nervous system disorders
Headache
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Nervous system disorders
Partial seizures
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Nervous system disorders
Status epilepticus
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6
Nervous system disorders
Syncope
1.1%
1/93 • Number of events 1 • From Baseline and up to month 6

Other adverse events

Other adverse events
Measure
Lacosamide (SS)
n=93 participants at risk
Patients with BTRE, secondary to low-grade glioma (WHO Grade 1 to 2) and with at least 1 partial-onset seizure in the 8 weeks prior to start of LCM treatment, routinely treated with lacosamide as add on to one or two baseline AEDs and who were included in the SS.
Ear and labyrinth disorders
Vertigo
5.4%
5/93 • Number of events 5 • From Baseline and up to month 6
Nervous system disorders
Headache
5.4%
5/93 • Number of events 5 • From Baseline and up to month 6

Additional Information

UCB

Cares

Phone: +1844 599

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60