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Sponsored by: |
Dutch Epilepsy Clinics Foundation |
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Information provided by: | Dutch Epilepsy Clinics Foundation |
ClinicalTrials.gov Identifier: | NCT00208520 |
Most patients are prescribed valproate as their first antiepileptic drug. It is unknown which is the best second-line drug when patients do not become seizure free on valproate. This has led the Dutch Epilepsy Clinics Foundation (SEIN) to start the SLICE study. Adult patients with partial and/or tonic-clonic seizures, insufficiently responding to valproate, are recruited for this study. These patients are randomized to receive one of three other drugs. Patients wil initially use this drug next to valproate. Neurologists of more than 20 general hospitals en neurologists of SEIN are participating in this study.
Condition | Intervention |
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Adults With Tonic Clonic Seizures and/or Partial Seizures |
Drug: Carbamazepine Drug: Lamotrigine Drug: Levetiracetam |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Second-Line Treatment Choice for Epilepsy |
Estimated Enrollment: | 60 |
Study Start Date: | July 2003 |
Estimated Study Completion Date: | June 2007 |
The purpose of the project is to compare several antiepileptic drugs given to adult patients with epilepsy after they have not become seizure free on valproate as a first-line antiepileptic drug. The drugs will first be evaluated in combination with valproate and in case of success (being a seizure reduction of more than 50%) will also be evaluated in monotherapy.
Patients who did not become seizure free on valproate will be identified by neurologists in the participating hospitals. When these patients are willing to participate, they are randomized to one of three drugs: carbamazepine, lamotrigine and levetiracetam. In phase 1 of the project they keep on using valproate. The randomized second-line drugs will be titrated to a first dose level and the effectiveness of the combinations will be evaluated. When seizures persist and adverse effects allow it, the add-on drug is titrated to a second dose level and again the effectiveness of the combination is evaluated. When seizures still continue and adverse effects allow it, the add-on drug is titrated to a third and final dose level. When a patient does not become seizure free on a combination on that final level or adverse effects have prevented a dose increase to a higher level, that combination has failed in phase 1. When the patients does become seizure free on his or her combination, the combination is deemed a success for that patient. A patient will proceed to phase 2, when he or she has at least experienced a 50% seizure reduction.
In phase 2 of the project the second-line drug will be given in monotherapy. This means that valproate will be withdrawn. The dose of the second drug will be increased accordingly. The effectiveness of the drugs in monotherapy will be evaluated. The combined results of phase 1 and 2 will enable us to interpret the results. When all patients who became seizure free on a combination in phase 1, stay seizure free in phase 2, the efficacy of the combination should be attributed to the add-on drug. When these patients all develop seizures again, the efficacy of the combination should be attributed to the combination.
The primary outcome measure is percentage seizure free. Secondary outcome measures are adverse effects and the results of clinimetric epilepsy scales. Serum levels will be measured during the project. The projected sample size for each group has been lowered from 75 patients per group to 20 patients per group.
At this moment, neurologists of about 20 general hospitals are collaborating in this project. Inclusion of patients will continue until June 2006. The follow-up of patients and analysis of results will be carried until the projected end of the project.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Netherlands | |
Dutch Epilepsy Clinics Foundation | |
Zwolle, Netherlands, 8025 BV |
Principal Investigator: | Charles L Deckers, MD, PhD | Dutch Epilepsy Clinics Foundation |
Study ID Numbers: | CMO 2002/183 |
Study First Received: | September 13, 2005 |
Last Updated: | September 11, 2006 |
ClinicalTrials.gov Identifier: | NCT00208520 |
Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Epilepsy Valproate Levetiracetam Lamotrigine Carbamazepine |
Calcium, Dietary Signs and Symptoms Carbamazepine Epilepsy Seizures Lamotrigine |
Neurologic Manifestations Central Nervous System Diseases Etiracetam Brain Diseases Valproic Acid |
Nootropic Agents Tranquilizing Agents Molecular Mechanisms of Pharmacological Action Nervous System Diseases Physiological Effects of Drugs Psychotropic Drugs Calcium Channel Blockers Central Nervous System Depressants Cardiovascular Agents Antimanic Agents |
Pharmacologic Actions Membrane Transport Modulators Analgesics, Non-Narcotic Sensory System Agents Therapeutic Uses Analgesics Peripheral Nervous System Agents Central Nervous System Agents Anticonvulsants |