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Comparing The Effect On Cognition Of Adjunctive Therapy With Zonisamide Versus Sodium Valproate

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00713622
Recruitment Status : Completed
First Posted : July 11, 2008
Last Update Posted : November 3, 2015
Information provided by (Responsible Party):
Eisai Inc. ( Eisai Limited )

Brief Summary:
Zonisamide (Zonegran) and sodium valproate (Epilim) are both medicines approved to treat epilepsy. The purpose of this study is to find out the extent to which zonisamide may affect memory and concentration, compared to sodium valproate.

Condition or disease Intervention/treatment Phase
Epilepsy Drug: Zonisamide Drug: Sodium valproate Phase 4

Detailed Description:

Zonisamide (Zonegran) and sodium valproate (Epilim) are both medicines approved to treat epilepsy.

The purpose of this study is to find out the extent to which zonisamide may affect memory and concentration, compared to sodium valproate. This will be investigated using cognitive tests which are performed on a computer screen. Either zonisamide or sodium valproate will be added as a second medicine to the one patients are currently taking, carbamazepine (Tegretol), which will be continued throughout the study.

It is planned that about 80 people across Europe will take part in this study. For the purpose of the study, patients will need to go to the study doctor's clinic 4 times and have 5 telephone calls. Involvement in the study might be as long as 20 weeks, but it could be as short as 12 weeks. The length of the study and number of visits will depend on whether patients have an accurate recording of previous seizures already, how many seizures they have during the study, and whether they decide to continue or to stop treatment after the study is completed.

Adult subjects with a clinical diagnosis of non-symptomatic (i.e., idiopathic or unknown cause) localisation-related epilepsy, with partial onset seizures with or without secondary generalisation, who are receiving fixed dose carbamazepine as their only therapy or can be transferred to carbamazepine (as their only therapy) in the two months before the study baseline. Subjects must require addition of another anti-epileptic drug (AED) to their anti-epileptic therapy, either because they continue to have seizures (i.e., are not controlled), or because they wish to switch to another AED for other reasons (e.g., they tolerate another drug better).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 2 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicentre, Randomised, Active Comparator, Parallel Group Study To Compare The Effect On Cognition Of Adjunctive Therapy With Zonisamide Versus Sodium Valproate
Study Start Date : June 2008
Actual Primary Completion Date : December 2008
Actual Study Completion Date : April 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Epilepsy

Arm Intervention/treatment
Active Comparator: 1 Drug: Zonisamide
Capsules of 25mg, 50mg and 100mg zonisamide will be supplied. Dosing will be twice a day.
Other Name: Zonegran

Active Comparator: 2 Drug: Sodium valproate
Crushable tablets of 100mg and enteric coated tablets of 200mg and 500mg will be supplied. Dosing will start at 600mg/day, increasing to the minimally effective dose, the maximum tolerated dose, or 2500mg/day, whichever is the lowest.
Other Name: Epilim

Primary Outcome Measures :
  1. Percent change from Baseline in 28-day seizure frequency at Week 12; response rate at 12 weeks. [ Time Frame: Change from baseline to Week 12 in the Computerised Visual Searching Task Reaction Time (CVST) from the Ferum Psyche (FePsy) cognitive battery, which measures central information processing speed conducted at visits 2, 5 and 8. ]

Secondary Outcome Measures :
  1. Safety will be assessed by the incidence of AEs and serious adverse events (SAEs); incidence of withdrawal for treatment emergent adverse events (TEAEs); physical and neurological examinations. [ Time Frame: Visits 1 and Visit 8; vital signs and weight conducted at Visits 1,2,5 and 8; clinical laboratory tests Visit 1 and 8. ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria:

  1. Subjects with a clinical diagnosis of non-symptomatic (i.e., idiopathic or cryptogenic) localisation-related epilepsy with partial onset seizures with or without secondary generalisation according to International League Against Epilepsy (ILAE) classification27. Diagnosis should be clinically established by history, by previous electroencephalogram (EEG) and by previous magnetic resonance imaging or computer tomography of the brain, consistent with localisation related epilepsy. No lower or upper limit of baseline seizures is defined.
  2. Able and willing to sign informed consent form (ICF) in accordance with the International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) guidelines.
  3. Male or female subjects aged ≥18 years.
  4. Subjects taking carbamazepine as monotherapy at baseline or who can be transferred to carbamazepine monotherapy in the two months before the Screening Visit. Dose of carbamazepine is within that recommended by the SPC. Carbamazepine dose has not been altered during the previous 2 weeks prior to the start of the Baseline Period, or 6 weeks if the Baseline Period is to be shortened due to the availability of a retrospective seizure history. The carbamazepine dose is to remain stable throughout the study.
  5. Subjects requiring addition of another AED, either because they continue to have seizures (are refractory), or because they wish eventually to switch to another AED for other reasons after the study completion (e.g. tolerability reasons).
  6. Female subjects of childbearing potential must not be pregnant (as confirmed by negative serum beta-human chorionic gonadotropin (βHCG) at screening and negative urine pregnancy test at baseline and during the study), must not be lactating and must use a medically acceptable form of contraception during the study and for at least 1 month after discontinuation of study drug. Medically acceptable contraception is defined here as:

    • High dose combined oral contraceptive (OC) pill (50µg of oestrogen preparation)
    • Documented surgical sterilisation or documented vasectomised sexual partner
    • Intrauterine device in place for at least 3 months and not exceeding the documented replacement date. (If the replacement date is not available, the device must not have been in situ for more than 5 years).
    • Women more than 2 years post-menopause
    • Abstinence Examples of contraception NOT acceptable include, but are not limited to:· Conventional dose of combined OC (< 50µg oestrogen)
    • Progesterone-only OC
    • Contraceptive implant
    • Contraceptive patch
    • Progesterone injection
    • Barrier contraception:

      • Condom
      • Diaphragm
      • Sponge

Exclusion criteria:

  1. Previous treatment with valproate or zonisamide.
  2. Use of an AED other than carbamazepine less than 6 weeks prior to randomisation, and other than carbamazepine, zonisamide or sodium valproate during the study.
  3. Hypersensitivity to zonisamide or valproate or their respective excipients.
  4. Predisposing condition potentially altering the absorption, distribution or elimination of zonisamide or valproate.
  5. Sulphonamide allergy.
  6. Subjects with diagnosed idiopathic/primary generalised epilepsy or with results of clinical investigations or EEG that suggest idiopathic/primary generalised epilepsy.
  7. History of status epilepticus within 12 months of screening whilst complying with AED therapy.
  8. History of cluster seizures.
  9. History of non epileptic seizures.
  10. Use of benzodiazepines during the Baseline Period or during randomised treatment.
  11. Regular treatment with antihistamines.
  12. Use of ketogenic diet.
  13. Use of acetazolamide, triamterene, vitamin C (>2g/day), regular antacids or other medicines associated with nephrolithiasis less than one month prior to randomisation or during the study.
  14. Subjects with a vagal nerve stimulator implanted, or due to be implanted within the expected duration of the study.
  15. Subjects expected to undergo any surgery within the expected duration of the study.
  16. History of renal calculi or renal insufficiency (above the upper normal limits of creatinine).
  17. Active psychiatric disease.
  18. History of suicide attempt within last 2 years.
  19. History of drug or alcohol abuse within the last 2 years.
  20. History of cerebrovascular disease/stroke or transient ischemic attacks; progressive neurological disease; focal central nervous system pathology or behavioural disturbances that may impair the subject's ability to complete the neuropsychological tests; or previous or current brain neoplasm.
  21. Neoplastic disease within the last 5 years except non-metastatic and adequately treated cutaneous squamous cell carcinoma.
  22. Diagnosis of human immunodeficiency virus (HIV) or Hepatitis B or C.
  23. Other clinically significant organic disease.
  24. Female subjects who are lactating, pregnant or intending to become pregnant.
  25. Subjects with history of demonstrated non compliance with medication or an inability to maintain a seizure diary.
  26. Subjects considered by the Investigator not to be within normal cognitive limits.
  27. Participation in clinical study within 30 days of screening.
  28. Clinically significant laboratory value abnormalities at baseline.
  29. Weight <40kg

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00713622

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Universitae Klinik fur Neurologiet
Innsbruck, Austria, 6020
Kuopio University Hospital
Kuopio, Finland, 70211
Sponsors and Collaborators
Eisai Limited
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Study Director: Andrew Yeates Eisai Limited
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Responsible Party: Eisai Limited Identifier: NCT00713622    
Other Study ID Numbers: E2090-E044-406
2007-005313-19 ( EudraCT Number )
First Posted: July 11, 2008    Key Record Dates
Last Update Posted: November 3, 2015
Last Verified: November 2015
Keywords provided by Eisai Inc. ( Eisai Limited ):
Additional relevant MeSH terms:
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Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Valproic Acid
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
GABA Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Antimanic Agents
Tranquilizing Agents
Central Nervous System Depressants
Psychotropic Drugs
Calcium Channel Blockers
Membrane Transport Modulators
Calcium-Regulating Hormones and Agents