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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT04244175




Registration number
NCT04244175
Ethics application status
Date submitted
24/01/2020
Date registered
28/01/2020
Date last updated
8/04/2021

Titles & IDs
Public title
A Trial of the Efficacy and Safety of CVL-865 as Adjunctive Therapy in the Treatment of Focal Onset Seizures
Scientific title
A Randomized, Double-blind, Placebo-controlled, Parallel Group, Multicenter Trial of CVL-865 as Adjunctive Therapy in Adults With Drug-Resistant Focal Onset Seizures (REALIZE Trial)
Secondary ID [1] 0 0
2019-002576-14
Secondary ID [2] 0 0
CVL-865-SZ-001
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Seizures 0 0
Condition category
Condition code
Neurological 0 0 0 0
Epilepsy
Neurological 0 0 0 0
Other neurological disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - CVL-865
Treatment: Drugs - Placebo

Experimental: High Dose: CVL-865 25 mg - Participants will receive CVL-865 tablets orally twice daily (BID) up to the maximum dose of 25 milligrams (mg) until Day 92 during the treatment period.

Experimental: Low Dose: CVL-865 7.5 mg - Participants will receive CVL-865 tablets orally BID up to the maximum dose of 7.5 mg until Day 92 during the treatment period.

Placebo Comparator: Placebo - Participants will receive a placebo matched to CVL-865 tablets orally BID until Day 92 during the treatment period.


Treatment: Drugs: CVL-865
Participants will receive CVL-865 tablets orally BID up to the maximum dose of 7.5 mg BID or 25 mg BID during the treatment period.

Treatment: Drugs: Placebo
Participants will receive CVL-865 matched placebo tablet orally BID during the treatment period.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Response Ratio (RRatio) - Response Ratio (RRatio), calculated as RRatio=(T-B)/(T+B) ×100, where T represents the focal onset seizure frequency rate per week in the Maintenance Phase and B represents the focal onset seizure frequency rate per week in the Baseline Period.
Timepoint [1] 0 0
Day 71
Secondary outcome [1] 0 0
Change From Baseline in Focal Onset Seizure Frequency per Week over the Maintenance Phase - Seizure frequency is defined as the total number of focal onset seizures over the treatment period of interest divided by the total number of days with no missing seizure counts in the corresponding period multiplied by 7.
Timepoint [1] 0 0
Baseline up to Day 71
Secondary outcome [2] 0 0
Percentage of Participants with 50 Percent (%) Responder Rate - Defined as the percent of participants with at least a 50% reduction in the Maintenance Phase focal onset seizure frequency rate relative to the Baseline Period.
Timepoint [2] 0 0
Day 71
Secondary outcome [3] 0 0
Percentage of Seizure-free Participants - Seizure freedom is defined as the absence of all seizure regardless of seizure type.
Timepoint [3] 0 0
Baseline up to Day 71
Secondary outcome [4] 0 0
Seizure Rate over Time - Seizure frequency is defined as the total number of focal onset seizures over the treatment period of interest divided by the total number of days with no missing seizure counts in the corresponding period multiplied by 7.
Timepoint [4] 0 0
Baseline up to Day 71
Secondary outcome [5] 0 0
Patient's Global Impression of Change (PGIC) Score at Days 15, 43 and 71 - The self-report measure Patient's Global Impression of Change (PGIC) reflects a participant's belief about the efficacy of treatment. It is a 7-point scale depicting a participant's rating of overall improvement where 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse and 7 = very much worse.
Timepoint [5] 0 0
Baseline, Day 15, 43 and 71
Secondary outcome [6] 0 0
Change from Baseline in Clinical Global Impression-Severity of Symptoms Scale (CGI-S) Score at Day 15, 43 and 71 - The CGI-S is an observer-rated scale that will be used to measure symptom severity. It is a 7-point scale depicting a participants rating of overall improvement. Participants rate their change as 0 = not assessed; 1 = normal, not at all ill; 2 = borderline ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; and 7 = among the most extremely ill participants.
Timepoint [6] 0 0
Baseline, Day 15, 43 and 71
Secondary outcome [7] 0 0
Change From Baseline in Clinical Global Impression-Improvement Scale (CGI-I) Score at Day 15, 43 and 71 - The CGI-I is an observer-rated scale that will be used to measure the participant's symptom severity compared with before initiation of treatment with IMP. It is a 7-point scale depicting a participant's change from baseline in symptom severity using the following response choices: 0 = not assessed, 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse.
Timepoint [7] 0 0
Baseline, Day 15, 43 and 71
Secondary outcome [8] 0 0
Change from Baseline in Quality of Life in Epilepsy -31 (QOLIE-31) Overall Score at Day 71 - The Quality of Life in Epilepsy - 31 (QOLIE-31) contains 7 multi-item scales that tap the following health concepts: emotional well-being, social functioning, energy/fatigue, cognitive functioning, seizure worry, medication effects, and overall quality of life. A QOLIE-31 overall score is obtained using a weighted average of the multi-item scale scores. The QOLIE-31 also includes a single item that assessed overall health. The QoLIE-31 score range is from 0 to 100 with a higher score indicating a better outcome for quality of life.
Timepoint [8] 0 0
Baseline, Day 71
Secondary outcome [9] 0 0
Change from Baseline in Health Utilities Index (HUI) Utility Score at Day 71 - The Health Utilities Index (HUI) is a rating scale used to measure general health status and health-related quality of life. In HUI, utility values range from -0.03 and -0.36 for the HUI-2 and HUI-3, respectively, to 1.00. A health utility value of 1.00 indicates perfect health while a score of 0.00 indicates death.
Timepoint [9] 0 0
Baseline, Day 71
Secondary outcome [10] 0 0
Number of Participants with Clinically Significant Changes in Electrocardiogram (ECGs) - 12-lead ECGs recordings will be obtained after the participant has been supine and at rest for at least 5 minutes.
Timepoint [10] 0 0
Baseline to Day 92 or early termination
Secondary outcome [11] 0 0
Number of Participants with Clinically Significant Changes in Vital Sign Measurements - Vital signs will be measured with the participant in a sitting/semi-recumbent position after 5 minutes rest and will include temperature, systolic and diastolic blood pressure, and heart rate.
Timepoint [11] 0 0
Baseline to Day 92 or early termination (ET)
Secondary outcome [12] 0 0
Number of Participants with Clinically Significant Changes in Physical and Neurological Examination Results - Number of participants with clinically significant changes in physical and neurological examination results will be assessed.
Timepoint [12] 0 0
Baseline to Day 92 or early termination (ET)
Secondary outcome [13] 0 0
Number of Participants With Positive Response to Columbia Suicide-Severity Rating Scale (C-SSRS) - The C-SSRS rates an individual's degree of suicidal ideation (SI) on a scale, ranging from "wish to be dead" to "active suicidal ideation with specific plan and intent." The scale identifies SI severity and intensity, which may be indicative of an individual's intent to commit suicide. C-SSRS SI severity subscale ranges from 0 (no SI) to 5 (active SI with plan and intent).
Timepoint [13] 0 0
From first dose of study drug up to Day 120 (follow up period)
Secondary outcome [14] 0 0
Number of Participants with Positive Response to Modified Clinical Institute Withdrawal Assessment - Benzodiazepines (mCIWA-B) - The modified Clinical Institute Withdrawal Assessment - Benzodiazepines (mCIWA-B) is a sensitive instrument to measure withdrawal under conditions where there is a taper of medication (rather than abrupt discontinuation). It consists of 17-items that monitor the type and severity of BZD withdrawal symptoms such as irritability, fatigue, appetite, and sleeplessness. The total score ranges from 1 to 68 with higher scores indicating more severe withdrawal.
Timepoint [14] 0 0
Day 71 up to Day 120
Secondary outcome [15] 0 0
Number of Participants With Treatment Emergent Adverse Event (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs) - TEAEs will include abuse-related AEs and AEs related to medication handling irregularities (MHIs). Number of Participants With TEAEs and TESAEs will be assessed.
Timepoint [15] 0 0
From first dose of study drug up to Day 120 (follow up period)
Secondary outcome [16] 0 0
Plasma Concentrations of CVL-865 - Plasma concentration of CVL-865 at Day 15, Day 43, Day 71, Day 92 and/or early termination (ET) will be assessed.
Timepoint [16] 0 0
Day 15, Day 43, Day 71, Day 92 and/or early termination (ET)

Eligibility
Key inclusion criteria
- Participants with a diagnosis of epilepsy with focal onset, as defined in the
International League Against Epilepsy (ILAE) Classification of Seizures, focal aware
(except participants with only focal aware seizures without a motor component), focal
impaired awareness, and focal to bilateral tonic-clonic seizures for at least 2 years
prior to signing the Informed Consent Form (ICF)

- Participants must have history of an average of 4 or more spontaneous and observable
focal onset, as defined in the ILAE Classification of Seizures, focal aware (except
participants with only focal aware seizures without a motor component), focal impaired
awareness, and focal to bilateral tonic-clonic seizures per 28-day period for at least
3 months (84 days) prior to signing the ICF

- Participants who have tried and failed at least 2 appropriate Anti- epileptic drugs
(AEDs) in the past and also currently taking 1 to 3 permitted AEDs at a stable dose
for 4 Weeks prior to the Screening Visit

- Participants with a minimum of 8 focal onset, focal aware, focal impaired awareness,
or focal to bilateral tonic-clonic seizures during the 8 week baseline period with no
21-day period free of any of these seizure types

- Participants must have had magnetic resonance imaging or contrast enhance computed
tomography scan of the brain that demonstrated no progressive structural central
nervous system abnormality at the time of the diagnosis of epilepsy

- Participants must have a body mass index (BMI) of 17.5 to 40.0 kilogram per meter
square (kg/m^2) and a total body weight greater than (>) 50 kilograms (kg) [110 pounds
(lbs)]

- Women of childbearing potential must agree to use an effective method of contraception
from signing of informed consent throughout the duration of the study and for 30 days
post last dose

- Male must agree to use condom during treatment and until the end of relevant systemic
exposure in the male participant for 94 days following the last dose with
Investigational Manufacturing Product (IMP)
Minimum age
18 Years
Maximum age
75 Years
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
- Participants with (genetic) idiopathic generalized epilepsies or combined generalized
and focal epilepsies, including a history of Lennox-Gastaut Syndrome

- Participants with a history of seizures over the past 12 months that occur at such a
high frequency they cannot be counted (eg, repetitive seizures, cluster seizures)

- Participants with a history of psychogenic non-epileptic seizures within the year
prior to signing the ICF

- Participants with a history of status epilepticus within 5 years prior to signing the
ICF

- Participants with a history of neurosurgery for seizures less than 1 year prior to
signing the ICF, or radiosurgery less than 2 years prior to signing the ICF

- Participants with a current history of significant cardiovascular, pulmonary,
gastrointestinal, renal, hepatic, metabolic, hematological, immunological, or
neurological (excluding focal onset epilepsy) disease

- Participants who test positive for human immunodeficiency virus (HIV), hepatitis B
and/or or hepatitis C infection

- Participants with a 12-lead ECG demonstrating : QT interval corrected for heart rate
using Fridericia's formula >450 milliseconds (msec) (average of 3 ECGs obtained at the
Screening Visit); QRS interval >120 msec at the Screening Visit assessed by central
reader

- Participants with abnormal laboratory test results which includes (Aspartate
aminotransferase (AST) or Alanine aminotransferase (ALT) elevated to >2 × Upper limit
of normal range (ULN); Total bilirubin greater than or equal to (>=)1.5 × ULN;
Females: Hemoglobin <11 gram per deciliter (g/dL); Males: hemoglobin <12 g/dL; White
blood cell (WBC) count <3.0 x 10 power 9 per liter (10^9/L); Neutrophil count <2.0 x
10^9/L; Platelet count <150 × 10^9/L

- Use of prohibited medications as listed in the protocol in the absence of appropriate
washout phase or the likelihood of requiring treatment during the study period with
drugs not permitted by the study protocol

- Participants taking any drug that is a sensitive P-glycoprotein (P-gp) and Breast
cancer resistance protein (BCRP) substrate

- Female participants who are breastfeeding and/or who have a positive pregnancy test
result prior to receiving IMP

- Participants who are known to be allergic or hypersensitive to the IMP or any of its
components

- Participants who have participated in any clinical trial within 60 days prior to
signing the ICF or who have participated in more than 2 clinical trials within the
year prior to signing the ICF

- Participants with difficulty swallowing

- Participants who answer "Yes" on the C-SSRS Suicidal Ideation Item 4 (Active Suicidal
Ideation with Some Intent to Act, Without Specific Plan) and whose most recent episode
meeting criteria for this C-SSRS Item 4 occurred within the last 6 months, OR Subjects
who answer "Yes" on the C-SSRS Suicidal Ideation Item 5 (Active Suicidal Ideation with
Specific Plan and Intent) and whose most recent episode meeting criteria for this
CSSRS Item 5 occurred within the last 6 months OR Subjects who answer "Yes" on any of
the 5 C-SSRS Suicidal Behavior Items (actual attempt, interrupted attempt, aborted
attempt, preparatory acts, or behavior) and whose most recent episode meeting criteria
for any of these 5 C-SSRS Suicidal Behavior Items occurred in the last 2 years

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 2
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
27/01/2020
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/04/2022
Actual
Sample size
Target
150
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
Recruitment hospital [1] 0 0
Camperdown, New South Wales - Camperdown
Recruitment hospital [2] 0 0
Randwick, New South Wales - Randwick
Recruitment hospital [3] 0 0
Westmead, New South Wales - Westmead
Recruitment hospital [4] 0 0
Herston, Queensland - Herston
Recruitment hospital [5] 0 0
Bedford Park, SA - Bedford Park
Recruitment hospital [6] 0 0
Box Hill, Victoria - Box Hill
Recruitment hospital [7] 0 0
Fitzroy, Victoria - Fitzroy
Recruitment hospital [8] 0 0
Heidelberg, Victoria - Heidelberg
Recruitment hospital [9] 0 0
Melbourne, Victoria - Melbourne
Recruitment hospital [10] 0 0
Parkville, Victoria - Parkville
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
2031 - Randwick
Recruitment postcode(s) [3] 0 0
2145 - Westmead
Recruitment postcode(s) [4] 0 0
4029 - Herston
Recruitment postcode(s) [5] 0 0
5042 - Bedford Park
Recruitment postcode(s) [6] 0 0
3128 - Box Hill
Recruitment postcode(s) [7] 0 0
3065 - Fitzroy
Recruitment postcode(s) [8] 0 0
3084 - Heidelberg
Recruitment postcode(s) [9] 0 0
3004 - Melbourne
Recruitment postcode(s) [10] 0 0
3050 - Parkville
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
United States of America
State/province [2] 0 0
Colorado
Country [3] 0 0
United States of America
State/province [3] 0 0
Connecticut
Country [4] 0 0
United States of America
State/province [4] 0 0
Florida
Country [5] 0 0
United States of America
State/province [5] 0 0
Georgia
Country [6] 0 0
United States of America
State/province [6] 0 0
Hawaii
Country [7] 0 0
United States of America
State/province [7] 0 0
Idaho
Country [8] 0 0
United States of America
State/province [8] 0 0
Illinois
Country [9] 0 0
United States of America
State/province [9] 0 0
Kentucky
Country [10] 0 0
United States of America
State/province [10] 0 0
Maine
Country [11] 0 0
United States of America
State/province [11] 0 0
Maryland
Country [12] 0 0
United States of America
State/province [12] 0 0
Massachusetts
Country [13] 0 0
United States of America
State/province [13] 0 0
Missouri
Country [14] 0 0
United States of America
State/province [14] 0 0
New Jersey
Country [15] 0 0
United States of America
State/province [15] 0 0
New York
Country [16] 0 0
United States of America
State/province [16] 0 0
Ohio
Country [17] 0 0
United States of America
State/province [17] 0 0
Oklahoma
Country [18] 0 0
United States of America
State/province [18] 0 0
Pennsylvania
Country [19] 0 0
United States of America
State/province [19] 0 0
South Carolina
Country [20] 0 0
United States of America
State/province [20] 0 0
Tennessee
Country [21] 0 0
United States of America
State/province [21] 0 0
Washington
Country [22] 0 0
Spain
State/province [22] 0 0
Andalusia
Country [23] 0 0
Spain
State/province [23] 0 0
Catalonia
Country [24] 0 0
Spain
State/province [24] 0 0
Barcelona
Country [25] 0 0
Spain
State/province [25] 0 0
Madrid
Country [26] 0 0
Spain
State/province [26] 0 0
Sevilla
Country [27] 0 0
Spain
State/province [27] 0 0
Valencia

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Cerevel Therapeutics, LLC
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to assess the efficacy, safety, and tolerability profile of
CVL-865 as adjunctive treatment in participants with drug-resistant focal onset seizures.
Trial website
https://clinicaltrials.gov/show/NCT04244175
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Julie Jordan, MD
Address 0 0
Cerevel Therapeutics, LLC
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
For IPD and results data, please see https://clinicaltrials.gov/show/NCT04244175