Cenobamate for Seizures

No longer recruiting at 140 trial locations
MK
EP
SC
SM
DP
DB
Overseen ByDenise Bonhomme
Age: Any Age
Sex: Any
Trial Phase: Phase 3
Sponsor: SK Life Science, Inc.
Must be taking: Anti-epileptic drugs
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new medication, cenobamate, to evaluate its safety and effectiveness in treating Primary Generalized Tonic-Clonic (PGTC) seizures, which cause muscle stiffness and jerking. Participants will take either cenobamate or a placebo (a sugar pill) while continuing their usual seizure medications. Suitable candidates should have experience with PGTC seizures and have experienced at least five of these seizures in the last 12 weeks. As a Phase 3 trial, this study represents the final step before FDA approval, offering a chance to contribute to a potentially groundbreaking treatment.

Do I have to stop taking my current medications for the trial?

No, you can continue taking your current anti-epileptic drugs (AEDs) during the trial. The protocol allows you to stay on 1 to 3 AEDs with fixed dosing regimens. However, certain medications like diazepam (except as a rescue medication) and others listed in the exclusion criteria cannot be taken. If you're on benzodiazepines, the dosage must remain unchanged throughout the study.

Will I have to stop taking my current medications?

No, you will not have to stop taking your current anti-epileptic drugs (AEDs). The trial allows you to continue your usual AEDs while participating.

Is there any evidence suggesting that cenobamate is likely to be safe for humans?

Research has shown that cenobamate is generally safe for patients. In one study, more than 60% of patients experienced a significant reduction in seizure frequency with cenobamate. This indicates the drug is effective and usually safe. Another study found that patients taking cenobamate had up to twice the reduction in seizures compared to those on a placebo. These results strongly suggest that cenobamate can be safely used, although it may have some side effects. Prospective trial participants should know that cenobamate has been tested in other studies and found to be effective and generally well-tolerated.12345

Why do researchers think this study treatment might be promising for seizures?

Cenobamate is unique because it works differently from most existing seizure medications. While many current options focus on altering neurotransmitter levels, cenobamate targets and modulates sodium channels and enhances GABA-A receptor currents, which could lead to better control of seizures. Researchers are excited about cenobamate because it has shown the potential for faster and more effective seizure reduction with a once-daily dosing regimen. This could mean more convenient and consistent seizure management for patients compared to some current treatments that require multiple doses throughout the day.

What evidence suggests that cenobamate might be an effective treatment for seizures?

Research has shown that cenobamate, which participants in this trial may receive, is a promising treatment for seizures. Studies indicate that this medication has reduced seizures in about 62% of people, with some experiencing their seizures cut in half. Notably, about 21% of patients taking the highest dose became completely seizure-free. These results suggest cenobamate can be very effective, especially for those who haven't had success with other treatments.12678

Who Is on the Research Team?

SM

Sunita Misra, MD

Principal Investigator

SK Life Science, Inc.

Are You a Good Fit for This Trial?

This trial is for males and females aged 12 or older with Primary Generalized Tonic-Clonic (PGTC) seizures, who are on a stable dose of up to three anti-epileptic drugs. They must not be pregnant, breastfeeding, have certain medical conditions or history of drug abuse. Participants need to use birth control if applicable and have had recent brain imaging tests.

Inclusion Criteria

You've had a CT scan or MRI within the past 10 years that showed you don't have a worsening condition causing epilepsy.
Written informed consent signed by the subject or legal guardian, or legally authorized representative (LAR), in accordance with the International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) guidelines.
You can follow a ketogenic diet if your condition is stable.
See 10 more

Exclusion Criteria

Subject has participated in previous cenobamate clinical studies.
You have a history of occasionally using benzodiazepines for emergency situations.
Subject has received an investigational drug or device within 30 days prior to Visit 1 (Screening/Baseline).
See 24 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-randomization

Baseline seizure frequency is established

4 weeks

Treatment

Participants receive cenobamate or placebo with a 10-week titration phase followed by a 12-week maintenance phase

22 weeks
Regular visits every 2 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including a one-week down titration

3 weeks
1 follow-up visit

Open-label extension (optional)

Eligible participants may opt into a continuation of treatment in an open-label safety study

What Are the Treatments Tested in This Trial?

Interventions

  • Cenobamate
  • Placebo
Trial Overview The study tests the safety and effectiveness of Cenobamate as an additional treatment for epilepsy against a placebo. Participants will take either Cenobamate or a sugar pill alongside their current medications over a period of 22 weeks, followed by a 3-week follow-up.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Placebo Group
Group I: CenobamateExperimental Treatment1 Intervention
Group II: PlaceboPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

SK Life Science, Inc.

Lead Sponsor

Trials
42
Recruited
8,900+

Published Research Related to This Trial

Cenobamate (XCOPRI®) is a newly approved oral medication for treating partial-onset seizures in adults, developed by SK Life Science Inc. and Arvelle Therapeutics.
The approval was based on positive results from two pivotal phase 2 trials, highlighting its efficacy as a neurotherapeutic option for epilepsy.
Cenobamate: First Approval.Keam, SJ.[2020]
Cenobamate significantly reduced seizure frequency in patients with uncontrolled focal seizures, with a 50% reduction achieved by more than double the number of patients compared to placebo (RR 2.06), particularly at the effective dose of 400 mg (RR 2.28).
The treatment was generally well tolerated, with most adverse events being mild to moderate, although a higher dropout rate was observed at the 400 mg dose compared to placebo (RR 2.09).
Efficacy and safety of cenobamate in patients with uncontrolled focal seizures: A meta-analysis.Zhang, L., Wang, J., Wang, C.[2021]
Cenobamate, an antiepileptic drug approved for focal seizures, demonstrated a favorable safety profile in a study involving 210 healthy subjects, with most treatment-emergent adverse events being mild and no deaths reported.
The pharmacokinetics of cenobamate support once-daily dosing, as it showed dose-proportional increases in plasma concentration and a long half-life of 30 to 76 hours, making it a convenient option for managing seizures.
Pharmacokinetics of Cenobamate: Results From Single and Multiple Oral Ascending-Dose Studies in Healthy Subjects.Vernillet, L., Greene, SA., Kamin, M.[2021]

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/40119878/
Real-world effectiveness and tolerability of cenobamate in ...The median number of seizures/month was 8.8. After 3 months of maintenance, the 50% responder rate (primary endpoint) was 49.3%; the median ...
Cenobamate (YKP3089) and Drug-Resistant EpilepsyCNB is a highly effective drug in managing focal onset seizures, with more than twenty percent of individuals with drug-resistant epilepsy achieving seizure ...
Efficacy and safety of Cenobamate: a multicenter ...288 patients (61.9 %) responded to treatment, achieving ≥50 % reduction in seizure frequency, including 77 patients (16.5 %) not experiencing ...
Long-Term, Real-World Study Results Show Xcopri Is Highly ...Long-Term, Real-World Study Results Show Xcopri Is Highly Effective as a Treatment for Reducing Seizures · 37.3% were 100% responders · 49.2% were ...
Efficacy and safety of Cenobamate: a multicenter ...Clinical trial has reported seizure freedom rates of up to 21 % among patients receiving the highest dose, compared to just 1 % in the placebo group [10].
Post-hoc analysis of YKP3089C017 randomized clinical trialSimilarly, in the NR patients, cenobamate 200 mg/day showed 53.0 % reduction in the seizure frequency compared with 34.5 % with cenobamate 400 mg/day, and the ...
NCT01397968 | Efficacy and Safety of YKP3089 in ...This study is to evaluate the efficacy of YKP3089 in reducing seizure frequency when compared to baseline in subjects with partial onset seizures not fully ...
XCOPRI® (cenobamate tablets) CV EfficacyPrimary outcome: Patients taking XCOPRI experienced up to 2x greater seizure reduction compared with placebo (55% XCOPRI 400 mg, 55% XCOPRI 200 mg, ...
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