fenfluramine and Epilepsy, Absence

fenfluramine has been researched along with Epilepsy, Absence in 2 studies

Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release.
fenfluramine : A secondary amino compound that is 1-phenyl-propan-2-amine in which one of the meta-hydrogens is substituted by trifluoromethyl, and one of the hydrogens attached to the nitrogen is substituted by an ethyl group. It binds to the serotonin reuptake pump, causing inhbition of serotonin uptake and release of serotonin. The resulting increased levels of serotonin lead to greater serotonin receptor activation which in turn lead to enhancement of serotoninergic transmission in the centres of feeding behavior located in the hypothalamus. This suppresses the appetite for carbohydrates. Fenfluramine was used as the hydrochloride for treatment of diabetes and obesity. It was withdrawn worldwide after reports of heart valve disease and pulmonary hypertension.

Epilepsy, Absence: A seizure disorder usually occurring in childhood characterized by rhythmic electrical brain discharges of generalized onset. Clinical features include a sudden cessation of ongoing activity usually without loss of postural tone. Rhythmic blinking of the eyelids or lip smacking frequently accompanies the SEIZURES. The usual duration is 5-10 seconds, and multiple episodes may occur daily. Juvenile absence epilepsy is characterized by the juvenile onset of absence seizures and an increased incidence of myoclonus and tonic-clonic seizures. (Menkes, Textbook of Child Neurology, 5th ed, p736)

Research

Studies (2)

Authors

Clinical Trials (1)

Trial Overview

Trial Outcomes

% Change in Frequency of Handwaving Episodes

"The number of handwaving episodes (seizures) per day were recorded on a seizure diary by either the subject or the parent of the subject. One handwaving episode was defined as the period starting from when the hand first came up toward the face, until there was a brief pause in waving. Subjects and their caregivers were instructed to record the total number of handwaving episodes each day during a one month baseline, and during the 3 month treatment period.~The baseline seizure frequency was calculated as an average of the reported handwaving episodes per day during the baseline period. This number was compared to the average episodes per day for the final month of the study (month 3 of treatment with fenfluramine) for each patient. The median percent change in frequency of handwaving episodes across all patients is reported below." (NCT03790137)
Timeframe: Month 3

Change in Frequency of Generalized Tonic-clonic Seizures

Daily seizure logs will be maintained by either the subject or the parent of the subject and used to calculate seizure frequency. Frequency of Generalized Tonic-clonic seizures was recorded as an average number of seizures/day. The average number of tonic-clonic seizures per day during the baseline period was compared to the average number of tonic-clonic seizures per day during the final month (month 3) for each patient that had experienced at least one tonic-clonic seizure in their lifetime. (NCT03790137)
Timeframe: Month 3

Change in Spike Frequency on EEG

The investigators will read and interpret pre-drug (baseline) and post-drug EEGs (month 3 of core study) for the first 9 patients. The average number of spikes/hour across these patients will be reported for both pre- and post-treatment EEGs. (NCT03790137)
Timeframe: Month 3

Changes in Anger Determined by the Beck Self Report Inventory

"The Beck Self Report Inventory will be administered at baseline, and 84 days after the first dose (Month 3; Visit 5). This questionnaire assesses self-concept, depression, anxiety, anger and disruptive behavior through a 100-item self-report.~The raw scores for subscales are calculated in the following manner:~Add scores from Items 1-20 for the total Beck Self Concept Inventory for Youth (BSCI-Y) score.~Add scores from Items 21-40 for the total Beck Anxiety Inventory for Youth (BAI-Y) score.~Add scores from Items 41-60 for the total Beck Depression Inventory for Youth (BDI-Y) score.~Add scores from Items 61-80 for the total Beck Anger Inventory for Youth (BANI-Y) score.~Add scores from Items 81-100 for the total Beck Disruptive Inventory for Youth (BDBI-Y) score.~Raw scores will be translated into T-scores.~T-scores for BYI are as follows:~55 or less = average~55-59 = mildly elevated~60-69 = moderately elevated~70+ = extremely elevated" (NCT03790137)
Timeframe: Month 3

Changes in Anxiety Determined by the Beck Self Report Inventory

"The Beck Self Report Inventory will be administered at baseline, and 84 days after the first dose (Month 3; Visit 5). This questionnaire assesses self-concept, depression, anxiety, anger and disruptive behavior through a 100-item self-report.~The raw scores for subscales are calculated in the following manner:~Add scores from Items 1-20 for the total Beck Self Concept Inventory for Youth (BSCI-Y) score.~Add scores from Items 21-40 for the total Beck Anxiety Inventory for Youth (BAI-Y) score.~Add scores from Items 41-60 for the total Beck Depression Inventory for Youth (BDI-Y) score.~Add scores from Items 61-80 for the total Beck Anger Inventory for Youth (BANI-Y) score.~Add scores from Items 81-100 for the total Beck Disruptive Inventory for Youth (BDBI-Y) score.~Raw scores will be translated into T-scores.~T-scores for BYI are as follows:~55 or less = average~55-59 = mildly elevated~60-69 = moderately elevated~70+ = extremely elevated" (NCT03790137)
Timeframe: Month 3

Changes in Cognitive Functioning Determined by the Weschler Abbreviated Scale of Intelligence (WASI-II Subtests)

"The Weschler Abbreviated Scale of Intelligence (WASI-II subtests) will be administered to the first 10 patients at baseline and 84 days after the start of the first dose of study drug. Results of these cognitive tests will be compared between baseline and 84 days post initial dose.~The WASI-II measures cognitive functioning through 2 subtests, vocabulary and matrix reasoning. The raw scores on these subtests are combined to give a composite full-scale IQ (FSIQ) that is scaled to an average of 100 and standard deviation of 15.~Maximum raw scores for the subtests are as follows (higher values are considered better and minimum score on each is 0).~Vocabulary:~ages 7-11: 47 ages 12-14: 53 ages 15-25: 59~Matrix Reasoning:~ages 6-8: 24 ages 9-25: 30" (NCT03790137)
Timeframe: Month 3 (~84 days after the first dose of fenfluramine.)

Changes in Cognitive Functioning Determined by the Weschler Intelligence Scale for Children (WISC-V) -Processing Speed Subtests.

"The Weschler Intelligence Scale for Children (WISC-V) -Processing Speed subtests will be administered at baseline and 84 days after the start of the first dose of study drug (Month 3; visit 5). Results of these cognitive tests will be compared between baseline and 84 days post initial dose.~Raw scores for the coding and symbol search subtests will be used to evaluate processing speed. The maximum raw scores are as follows (the minimum score is 0 and higher scores are considered better).~Coding:~ages 6-7: 65 ages 8-16: 119~Symbol search:~ages 6-7: 45 ages 8-16: 60" (NCT03790137)
Timeframe: Month 3 (approximately 84 days after the first dose of fenfluramine)

Changes in Depression Determined by the Beck Self Report Inventory

"The Beck Self Report Inventory will be administered at baseline, and 84 days after the first dose (Month 3; Visit 5). This questionnaire assesses self-concept, depression, anxiety, anger and disruptive behavior through a 100-item self-report.~The raw scores for subscales are calculated in the following manner:~Add scores from Items 1-20 for the total Beck Self Concept Inventory for Youth (BSCI-Y) score.~Add scores from Items 21-40 for the total Beck Anxiety Inventory for Youth (BAI-Y) score.~Add scores from Items 41-60 for the total Beck Depression Inventory for Youth (BDI-Y) score.~Add scores from Items 61-80 for the total Beck Anger Inventory for Youth (BANI-Y) score.~Add scores from Items 81-100 for the total Beck Disruptive Inventory for Youth (BDBI-Y) score.~Raw scores will be translated into T-scores.~T-scores for BYI are as follows:~55 or less = average~55-59 = mildly elevated~60-69 = moderately elevated~70+ = extremely elevated" (NCT03790137)
Timeframe: Month 3

Changes in Disruptive Behavior Determined by the Beck Self Report Inventory

"The Beck Self Report Inventory will be administered at baseline, and 84 days after the first dose (Month 3; Visit 5). This questionnaire assesses self-concept, depression, anxiety, anger and disruptive behavior through a 100-item self-report.~The raw scores for subscales are calculated in the following manner:~Add scores from Items 1-20 for the total Beck Self Concept Inventory for Youth (BSCI-Y) score.~Add scores from Items 21-40 for the total Beck Anxiety Inventory for Youth (BAI-Y) score.~Add scores from Items 41-60 for the total Beck Depression Inventory for Youth (BDI-Y) score.~Add scores from Items 61-80 for the total Beck Anger Inventory for Youth (BANI-Y) score.~Add scores from Items 81-100 for the total Beck Disruptive Inventory for Youth (BDBI-Y) score.~Raw scores will be translated into T-scores.~T-scores for BYI are as follows:~55 or less = average~55-59 = mildly elevated~60-69 = moderately elevated~70+ = extremely elevated" (NCT03790137)
Timeframe: Month 3

Changes in Executive Functioning Determined by The Behavioral Rating Inventory of Executive Function (BRIEF) Questionnaire.

"The Behavioral Rating Inventory of Executive Function (BRIEF) questionnaire will be administered at baseline, and 84 days after the first dose of fenfluramine (Month 3; Visit 5). This questionnaire assesses executive function across 8 clinical scales:~Inhibit~Shift~Emotional Control~Initiate~Working Memory~Plan/Organize~Organization of Materials~Monitor~Item level scores are rated on a 3 point Likert Scale from 1-3:~Never~Sometimes~Often~The Global Executive Composite (GEC) score is the total score of all 8 clinical subscales. The item scores are summed for each scale and raw scores are converted to Tscores. The mean of the GEC score will be reported.~T scores from 60 to 64 are considered mildly elevated. T scores from 65 to 69 are considered potentially clinically elevated. T scores at or above 70 are considered clinically elevated." (NCT03790137)
Timeframe: Month 3 (approximately 84 days after the first dose of fenfluramine)

Changes in Quality of Life Determined by the Quality of Life in Childhood Epilepsy Questionnaire(QOLCE-16)

"The Quality of Life in Childhood Epilepsy Questionnaire will be administered at baseline, and 84 days after the first dose (Month 3; visit 5). This questionnaire assesses mood, social relationships, and behaviors. Results will be compared.~The QOLCE assesses quality of life across 4 domains of functioning: cognitive, emotional, social and physical. Scores range from 0-100. Composite scores are calculated as a mean across all measures." (NCT03790137)
Timeframe: Month 3 (approximately 84 days after first dose of fenfluramine)

Changes in Self-Concept Determined by The Beck Self Report Inventory.

"The Beck Self Report Inventory will be administered at baseline, and 84 days after the first dose (Month 3; Visit 5). This questionnaire assesses self-concept, depression, anxiety, anger and disruptive behavior through a 100-item self-report.~The raw scores for subscales are calculated in the following manner:~Add scores from Items 1-20 for the total Beck Self Concept Inventory for Youth (BSCI-Y) score.~Add scores from Items 21-40 for the total Beck Anxiety Inventory for Youth (BAI-Y) score.~Add scores from Items 41-60 for the total Beck Depression Inventory for Youth (BDI-Y) score.~Add scores from Items 61-80 for the total Beck Anger Inventory for Youth (BANI-Y) score.~Add scores from Items 81-100 for the total Beck Disruptive Inventory for Youth (BDBI-Y) score.~Raw scores will be translated into T-scores.~T-scores for BYI are as follows:~55 or less = average~55-59 = mildly elevated~60-69 = moderately elevated~70+ = extremely elevated" (NCT03790137)
Timeframe: Month 3 (approximately 84 days after first dose of fenfluramine)

Number of Patients That Experienced a Photoparoxysmal Response on EEG

The investigators will read and interpret pre- (baseline) and post-treatment (month 3) EEGs. The number of patients that experienced a photoparoxysmal response during the EEGs will be reported. (NCT03790137)
Timeframe: Month 3

Other Studies

2 other studies available for fenfluramine and Epilepsy, Absence