Rufinamide Given as Adjunctive Therapy in Participants With Refractory Partial Seizures
Condition: Epilepsy
MeSH terms: Seizures
Intervention: Placebo; Rufinamide
Intervention description: For the 12-day Titration Phase, one matching placebo tablet will be administered twice daily and increased by 1 matching placebo tablet every 3 days up to maximum of 4 matching placebo tablets twice daily (placebo tablet matched to rufinamide total daily dose of 3200 mg). For the 12 week maintenance phase, 4 placebo tablets matching to rufinamide maintenance doses of 1600 mg twice daily (3200 mg total daily dose) will be administered. Similar to the dose reduction permitted in the rufinamide group, participants in placebo group will be allowed only during the Titration Phase to have the dose reduced to 3 placebo tablets twice daily.; For the titration phase, Rufinamide will be administered orally in doses starting with 400 mg twice daily and increased every 3 days in 400 mg twice daily increments up to 1600 mg twice daily (total daily dose 3200 mg). For the Maintenance Phase, maintenance doses of 1600 mg twice daily (3200 mg total daily dose) will be administered. Participants unable to tolerate the target dose (3200 mg/day) will be allowed only during the Titration Phase to have the dose reduced to 3 tablets twice daily (corresponding to a dose of 2400 mg/day in the rufinamide group).
Intervention MeSH terms: Rufinamide
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Enrollment: 356.0
Sex: All
Minimum age: 12 Years
Maximum age: 80 Years
Healthy volunteers: No

Summary:

      To evaluate the effect of rufinamide on total partial seizure frequency in adolescent and
      adult participants (12 to 80 years, inclusive) with refractory partial onset seizures
      maintained on a maximum of 3 stable antiepileptic drugs (AEDs).
    

Eligibility criteria:

        INCLUSION CRITERIA

          1. Male and female patients between 12 and 80 years of age, inclusive.

          2. Diagnosis of epilepsy with partial-onset seizures with or without secondarily
             generalized seizures according with the International League Against Epilepsy
             Classification of Epileptic Seizures (1981). Diagnosis should have been established by
             clinical history, electroencephalogram (EEG) and computed tomography/magnetic
             resonance imaging (CT/MRI) of the brain performed within the last 10 years and
             consistent with localization-related epilepsy.

          3. Non-controlled partial seizures despite having been treated with at least two
             different antiepileptic drugs (given concurrently or sequentially) for at least two
             years.

          4. Patient willing to participate and written consent signed by patient or legal guardian
             prior to entering the study or undergoing any study procedures. If the written consent
             is provided by a legal guardian because the patient is unable to do so, assent of the
             patient must also be obtained.

          5. Reliability and willingness of patients to make themselves available for the study
             period, and ability to record seizures and report adverse events themselves or have a
             caregiver who can record seizures and report adverse events.

          6. Female patients of non-childbearing potential by reason of surgery, radiation, or
             menopause (at least one year post onset); or of childbearing potential using two
             approved methods of contraception (such as an intrauterine device [IUD], implant, oral
             contraceptive, or barrier method plus spermicide). Use of a low-dose estrogen oral
             contraceptive ("minipill") alone will not be permitted. Female patients of
             childbearing potential must have a confirmed negative serum pregnancy test at
             screening and a negative urine pregnancy test prior to randomization, and agree to
             continue to use two approved methods of contraception through the follow-up visit
             (Visit 8) or for 30 days after their final dose of study medication, whichever is
             longer.

          7. At least six seizures during the prospective Baseline Phase (56 days) with no 21-day
             seizure-free periods. Simple partial seizures without motor signs will not be included
             in determining this criterion.

          8. Current treatment with a maximum of three approved antiepileptic drugs, and no
             evidence of non-compliance with ongoing AED therapy.

          9. Stable dose(s) of the same AED(s) for one month prior to screening.

         10. If using a vagal nerve stimulator, it must have been implanted for at least six months
             prior to randomization. Stimulator parameters may not be changed for at least one
             month prior to screening or thereafter during the study. Magnet use will be allowed,
             but must be documented throughout the study. A vagal nerve stimulator will not be
             counted as an AED for the purpose of inclusion into the trial.

        EXCLUSION CRITERIA:

          1. Participation in a study involving administration of an investigational compound
             within one month of Visit 1 (Screening), or within five half-lives of the previous
             investigational compound, whichever is longer; or any prior exposure to rufinamide.

          2. Presence of non-motor simple partial seizures only.

          3. Presence of generalized epilepsies or seizures, such as absences, myoclonic
             epilepsies, Lennox-Gastaut syndrome.

          4. History of status epilepticus in the past year or seizure clusters where individual
             seizures cannot be counted.

          5. Evidence of clinically significant disease (cardiac, respiratory, gastrointestinal,
             hepatic, hematologic or renal disease, etc.) that in the opinion of the Investigator
             could affect the patient's safety or trial conduct.

          6. Clinically significant ECG abnormality.

          7. Patients with a diagnosis of major active psychiatric disease will be excluded from
             the study. However, those patients who are only taking a stable dose of either a
             selective serotonin reuptake inhibitor (SSRI) antidepressant drug or a serotonin and
             norepinephrine reuptake inhibitor (SNRI) antidepressant drug for a diagnosed
             depressive disorder can be included as long as they have been on the SSRI or SNRI for
             a period of two months or longer before randomization. Other antidepressant
             medications will not be allowed.

          8. Progressive central nervous system (CNS) disease, including degenerative CNS diseases
             and progressive tumors.

          9. Occurrence of psychogenic seizures in the previous year.

         10. History of drug abuse and/or positive finding on urinary drug screening, other than
             prescribed medication

         11. History of alcohol abuse in the past two years.

         12. History of suicide attempt within the previous 10 years.

         13. Multiple drug allergies (dermatological, hematological or organ toxicity) or more than
             one severe drug reaction(s).

         14. Concomitant use of felbamate or use of felbamate within two months prior to Visit 1.

         15. Frequent need of rescue benzodiazepines (more than once a month).

         16. Patients with a known hypersensitivity to rufinamide, triazole derivatives, or to any
             excipients used in the formulation.

         17. Concomitant use of vigabatrin. Patients who took vigabatrin in the past must be off
             vigabatrin for at least five months prior to Visit 1 and must not have evidence of a
             clinically significant abnormality in a visual perimetry test.

         18. All Patients with a diagnosis of Congenital Short QT Syndrome. Patients with a family
             history of Congenital Short QT Syndrome may be excluded on the basis of the
             Investigator's clinical judgment.