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Trial record 9 of 89 for:    CARBAMAZEPINE AND Psychotropic

Effect of Carbamazepine and Oxcarbazepine on Serum Neuron-specific Enolase and S100B in Focal Seizures

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ClinicalTrials.gov Identifier: NCT02705768
Recruitment Status : Completed
First Posted : March 11, 2016
Last Update Posted : September 19, 2017
Sponsor:
Information provided by (Responsible Party):
RITUPARNA MAITI, All India Institute of Medical Sciences, Bhubaneswar

Brief Summary:
The present study has been planned to assess the level of serum neuron-specific enolase (NSE) in focal seizures and its changes after antiepileptic therapy.

Condition or disease Intervention/treatment Phase
Seizures, Focal Drug: Carbamazepine Drug: Oxcarbazepine Phase 4

Detailed Description:

Epileptic seizures can cause neuronal cell death, enhanced neurogenesis, axonal sprouting, dendritic changes, and reactive gliosis. Histopathological analyses have suggested that the initial insult and recurrent seizures contribute to the neuronal damage. Activation of mesial temporal structures is more likely to cause damage than that of other areas of brain; therefore, one of the consequences of prolonged seizures is selective neuronal loss in the hippocampus. The excitotoxic damage is considered the most important mechanism of injury but there is also evidence that programmed cell death contributes to neuronal damage.

Various biomarkers of brain damage have been studied in the context of epilepsy and brain damage but most widely investigated biochemical biomarker is neuron-specific enolase (NSE). NSE is γγ-isoenzyme of enolase involved in glycolysis pathway. NSE originates predominantly from the cytoplasm of neurons and neuroendocrine cells. Neuronal damage and impairment of blood brain barrier integrity can be detected by the release of NSE into cerebrospinal fluid (CSF) and eventually into blood. NSE is therefore regarded as a marker of neuronal damage and prognosis in various disorders associated with cell damage in the central or peripheral nervous system.

CSF and serum NSE levels obtained within first 48 hours were found to be elevated and correlated well with the duration of epilepsy and outcome of patients. Some studies have shown elevated NSE levels in temporal lobe epilepsy, after single tonic-clonic seizures, and status epilepticus. Literature review reveals that there is lack of data on serum NSE in focal seizures and there is no study on the effect of antiepileptic drugs on the level of serum NSE. So the present study has been planned to assess the level of serum NSE in focal seizures and its changes after antiepileptic therapy.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 90 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Effect of Carbamazepine and Oxcarbazepine on Serum Neuron-specific Enolase and S100B in Focal Seizures
Actual Study Start Date : April 2016
Actual Primary Completion Date : February 2017
Actual Study Completion Date : March 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Seizures

Arm Intervention/treatment
No Intervention: Healthy control
Twenty five (25) healthy individuals of same age group will serve as the control group. Control subjects will be evaluated at baseline only.
Experimental: Carbamazepine group
Twenty five (25) patients recruited in this group will receive Tab. Carbamazepine. Carbamazepine will be started with a dose of 200 mg/day for one week and then increased to 400 mg/day for one week and then 600mg/day for next two weeks.
Drug: Carbamazepine
Carbamazepine will be started with a dose of 200 mg/day for one week and then increased to 400 mg/day for one week and then 600mg/day for next two weeks.
Other Name: Tegretol

Experimental: Oxcarbazepine group
Twenty five (25) patients recruited in this group will receive Tab. Oxcarbazepine. Oxcarbazepine will be started with 10mg/kg daily dose for one week followed by 15mg/kg daily for next one week and then will be increased to 20mg/kg for next two weeks.
Drug: Oxcarbazepine
Oxcarbazepine will be started with 10mg/kg daily dose for one week followed by 15mg/kg daily for next one week and then will be increased to 20mg/kg for next two weeks.
Other Name: Oxetol




Primary Outcome Measures :
  1. Serum neuron-specific enolase (NSE) and S100B [ Time Frame: Change from baseline over 4 weeks ]
    Method: ELISA


Secondary Outcome Measures :
  1. Severity of seizure episode as measured by Chalfont-National Hospital seizure severity scale (NHS3) [ Time Frame: Change from baseline over 4 weeks ]
    The scale was developed at the Chalfont Centre for Epilepsy based on the Chalfont Seizure Severity Scale. It can be used to measure the severity of the seizures and to evaluate anti-epileptic agents during clinical trials.

  2. Quality of life as assessed by Quality of Life in Epilepsy Inventory (QOLIE-31) [ Time Frame: Change from baseline over 4 weeks ]
    Quality of Life in Epilepsy Inventory (QOLIE-31) contains seven 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 QOLIE31 overall score is obtained using a weighted average of the multi-item scale scores.



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Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • All patients with the clinical diagnosis of localization related epilepsy/focal seizure (International League Against Epilepsy 2010) with a history of an episode of seizure within 48 hours of presentation
  • Treatment naïve patients or patients who had not taken any treatment for at least 3 weeks before inclusion.

Exclusion Criteria:

  • History of any recent traumatic brain injury, cerebral ischemia/transient ischemic attack/stroke
  • Patients with neuroendocrinal tumours
  • History of any invasive neurosurgical /non-invasive neuropsychiatric procedure.
  • Patients who are already under treatment for the presenting conditions.
  • Medication history of psychoactive or central nervous system depressant drugs
  • Pregnant and nursing women

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 ClinicalTrials.gov identifier (NCT number): NCT02705768


Locations
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India
AIIMS, Bhubaneswar
Bhubaneswar, Odisha, India, 751019
Sponsors and Collaborators
All India Institute of Medical Sciences, Bhubaneswar
Investigators
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Study Director: DEBASISH HOTA, DM AIIMS, Bhubaneswar

Publications of Results:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: RITUPARNA MAITI, Associate Professor, All India Institute of Medical Sciences, Bhubaneswar
ClinicalTrials.gov Identifier: NCT02705768     History of Changes
Other Study ID Numbers: T/IM -NF/Pharm/15/30
First Posted: March 11, 2016    Key Record Dates
Last Update Posted: September 19, 2017
Last Verified: September 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by RITUPARNA MAITI, All India Institute of Medical Sciences, Bhubaneswar:
Neuron-specific enolase (NSE)
Carbamazepine
Oxcarbazepine
Additional relevant MeSH terms:
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Carbamazepine
Psychotropic Drugs
Seizures
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Oxcarbazepine
Anticonvulsants
Antimanic Agents
Tranquilizing Agents
Central Nervous System Depressants
Physiological Effects of Drugs
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Sodium Channel Blockers
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Cytochrome P-450 CYP3A Inducers
Cytochrome P-450 Enzyme Inducers
Voltage-Gated Sodium Channel Blockers