Page last updated: 2024-10-27

fenfluramine and Seizures

fenfluramine has been researched along with Seizures in 45 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 It was withdrawn worldwide after reports of heart valve disease and pulmonary hypertension.

Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as EPILEPSY or seizure disorder.

Research Excerpts

ExcerptRelevanceReference
"This study reports on the long-term results for an initial cohort of patients with Sunflower syndrome who enrolled in an open-label study of low-dose fenfluramine as well as the short-term results of a second cohort."9.69Follow-up to low-dose fenfluramine for Sunflower syndrome: A non-randomized controlled trial. ( Bruno, PL; Dowless, D; Geenen, KR; Patel, S; Thiele, EA, 2023)
"This study was undertaken to evaluate the long-term safety and effectiveness of fenfluramine in patients with Lennox-Gastaut syndrome (LGS)."9.69Fenfluramine provides clinically meaningful reduction in frequency of drop seizures in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. ( Agarwal, A; Ceulemans, B; Dai, D; Davis, R; Farfel, GM; Galer, BS; Gammaitoni, AR; Gil-Nagel, A; Guerrini, R; Knupp, KG; Lagae, L; Lock, M; Nabbout, R; Nickels, KC; Polega, S; Riney, K; Scheffer, IE; Sullivan, J; Zuberi, SM, 2023)
"Results of this trial showed that, in patients with LGS, fenfluramine compared with placebo provided a significantly greater reduction in drop seizures and may be a particularly advantageous choice in patients who experience generalized tonic-clonic seizures."9.51Efficacy and Safety of Fenfluramine for the Treatment of Seizures Associated With Lennox-Gastaut Syndrome: A Randomized Clinical Trial. ( Agarwal, A; Ceulemans, B; Davis, R; Farfel, GM; Galer, BS; Gammaitoni, AR; Gil-Nagel, A; Guerrini, R; Knupp, KG; Lagae, L; Lock, M; Nabbout, R; Nickels, KC; Riney, K; Scheffer, IE; Shore, S; Sullivan, JE; Zuberi, SM, 2022)
" After a 6-week observation period to establish baseline monthly convulsive seizure frequency (MCSF; convulsive seizures were defined as hemiclonic, tonic, clonic, tonic-atonic, generalised tonic-clonic, and focal with clearly observable motor signs), patients were randomly assigned through an interactive web response system in a 1:1:1 ratio to placebo, fenfluramine 0·2 mg/kg per day, or fenfluramine 0·7 mg/kg per day, added to existing antiepileptic agents for 14 weeks."9.30Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial. ( Agarwal, A; Ceulemans, B; Cross, JH; Devinsky, O; Farfel, G; Galer, BS; Gammaitoni, A; Guerrini, R; Knupp, K; Lagae, L; Lai, WW; Laux, L; Lock, M; Miller, I; Mistry, A; Morrison, G; Nikanorova, M; Polster, T; Sullivan, J; Talwar, D, 2019)
" Before the approval of fenfluramine (FFA) for the treatment of seizures in DS, patients in Germany could receive treatment under a compassionate use program (CUP)."8.02Efficacy, tolerability, and retention of fenfluramine for the treatment of seizures in patients with Dravet syndrome: Compassionate use program in Germany. ( Alber, M; Klotz, KA; Kluger, G; Kurlemann, G; Mayer, T; Muhle, H; Polster, T; Pringsheim, M; Schubert-Bast, S; Spors, H; Strzelczyk, A; Trollmann, R, 2021)
"5 mg/kg clonidine significantly increased the latency to the first convulsion and reduced tonic seizures and mortality caused by pentylenetetrazol (PTZ), 90 mg/kg, administered subcutaneously to rats."7.66Serotonin mediation of the protective effect of clonidine against pentylenetetrazol-induced seizures in rats. ( Lazarova, M; Samanin, R, 1983)
"Median time-to-nth seizure was longer after fenfluramine than after placebo (Study 1: fenfluramine ."7.11Fenfluramine significantly reduces day-to-day seizure burden by increasing number of seizure-free days and time between seizures in patients with Dravet syndrome: A time-to-event analysis. ( Auvin, S; Dai, D; Devinsky, O; Galer, BS; Gammaitoni, AR; Gil-Nagel, A; Perry, MS; Specchio, N; Strzelczyk, A; Sullivan, J, 2022)
" In recently published randomized controlled trials, fenfluramine (FFA) proved to be safe and effective in DS."6.94Efficacy and safety of Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: A real-world study. ( Battaglia, D; Cossu, A; Dalla Bernardina, B; Darra, F; Doccini, V; Granata, T; Guerrini, R; Luigia Gambardella, M; Mei, D; Pietrafusa, N; Quintiliani, M; Ragona, F; Rosati, A; Specchio, N; Spolverato, S; Trivisano, M; Vigevano, F, 2020)
"Fenfluramine hydrochloride has classically been described as acting pharmacologically through a serotonergic mechanism."6.72Fenfluramine as antiseizure medication for epilepsy. ( Cross, JH; Gogou, M, 2021)
"Dravet syndrome is a rare and severe encephalopathy that first presents in infancy with seizures refractory to conventional antiepileptic drugs."6.61Individualized treatment approaches: Fenfluramine, a novel antiepileptic medication for the treatment of seizures in Dravet syndrome. ( Polster, T, 2019)
"This study was undertaken to evaluate the long-term safety and effectiveness of fenfluramine in patients with Lennox-Gastaut syndrome (LGS)."5.69Fenfluramine provides clinically meaningful reduction in frequency of drop seizures in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. ( Agarwal, A; Ceulemans, B; Dai, D; Davis, R; Farfel, GM; Galer, BS; Gammaitoni, AR; Gil-Nagel, A; Guerrini, R; Knupp, KG; Lagae, L; Lock, M; Nabbout, R; Nickels, KC; Polega, S; Riney, K; Scheffer, IE; Sullivan, J; Zuberi, SM, 2023)
"This study reports on the long-term results for an initial cohort of patients with Sunflower syndrome who enrolled in an open-label study of low-dose fenfluramine as well as the short-term results of a second cohort."5.69Follow-up to low-dose fenfluramine for Sunflower syndrome: A non-randomized controlled trial. ( Bruno, PL; Dowless, D; Geenen, KR; Patel, S; Thiele, EA, 2023)
"Fenfluramine (FFA), an antiseizure medication (ASM) indicated for treating convulsive seizures in Dravet syndrome, was assessed in six patients (five female; 83%) with CDD whose seizures had failed 5-12 ASMs or therapies."5.62Effect of fenfluramine on convulsive seizures in CDKL5 deficiency disorder. ( Conway, E; Devinsky, O; King, L; Price, D; Schwartz, D, 2021)
"Results of this trial showed that, in patients with LGS, fenfluramine compared with placebo provided a significantly greater reduction in drop seizures and may be a particularly advantageous choice in patients who experience generalized tonic-clonic seizures."5.51Efficacy and Safety of Fenfluramine for the Treatment of Seizures Associated With Lennox-Gastaut Syndrome: A Randomized Clinical Trial. ( Agarwal, A; Ceulemans, B; Davis, R; Farfel, GM; Galer, BS; Gammaitoni, AR; Gil-Nagel, A; Guerrini, R; Knupp, KG; Lagae, L; Lock, M; Nabbout, R; Nickels, KC; Riney, K; Scheffer, IE; Shore, S; Sullivan, JE; Zuberi, SM, 2022)
"The repertoire of available and developmental therapies for epilepsy is rapidly expanding, and now includes disease-modifying vigabatrin in TSC and agents with extraordinary efficacy, fenfluramine and cenobamate."5.41Recent advances in pharmacotherapy for epilepsy. ( Klein, P; Pong, AW; Xu, KJ, 2023)
"There exists first-class evidence that documents the efficacy and tolerability of stiripentol, pharmaceutical-grade cannabidiol, fenfluramine hydrochloride, and soticlestat for the treatment of seizures associated with DS, and allows discussion about the expected outcomes regarding seizure frequency reduction and tolerability profiles."5.41Pharmacotherapy for Dravet Syndrome: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. ( Brigo, F; Damavandi, PT; Del Giovane, C; Lattanzi, S; Matricardi, S; Meletti, S; Russo, E; Silvestrini, M; Striano, P; Trinka, E, 2023)
", soticlestat, fenfluramine, or ganaxolone) have been introduced to the treatment of drug-resistant seizures in Dravet, Lennox-Gastaut, maternally inherited chromosome 15q11."5.41Genetic Background of Epilepsy and Antiepileptic Treatments. ( Borowicz-Reutt, K; Czernia, J; Krawczyk, M, 2023)
" After a 6-week observation period to establish baseline monthly convulsive seizure frequency (MCSF; convulsive seizures were defined as hemiclonic, tonic, clonic, tonic-atonic, generalised tonic-clonic, and focal with clearly observable motor signs), patients were randomly assigned through an interactive web response system in a 1:1:1 ratio to placebo, fenfluramine 0·2 mg/kg per day, or fenfluramine 0·7 mg/kg per day, added to existing antiepileptic agents for 14 weeks."5.30Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial. ( Agarwal, A; Ceulemans, B; Cross, JH; Devinsky, O; Farfel, G; Galer, BS; Gammaitoni, A; Guerrini, R; Knupp, K; Lagae, L; Lai, WW; Laux, L; Lock, M; Miller, I; Mistry, A; Morrison, G; Nikanorova, M; Polster, T; Sullivan, J; Talwar, D, 2019)
"Fenfluramine is a substituted phenylethylamine structurally related to amphetamine."5.25Fenfluramine poisoning. ( Temple, AR; Veltri, JC, 1975)
" Fenfluramine is a new ASM for the treatment of seizures associated with DS as add-on therapy to other ASMs for patients aged 2 years and older."5.22The contribution of fenfluramine to the treatment of Dravet syndrome in Spain through Multi-Criteria Decision Analysis. ( Abad-Sazatornil, MR; Aibar, JÁ; Aras, LM; Cardenal-Muñoz, E; Falip, M; Gil, A; Gil-Nagel, A; Poveda, JL; Sánchez, R; Sánchez-Carpintero, R; Sancho-López, A; Torrejón, M; Trillo-Mata, JL, 2022)
"Although cannabidiol and fenfluramine have been recently approved by the US Food and Drug Administration (FDA) for seizures in children with Dravet syndrome (DS), the comparative efficacy and safety of these and stiripentol as an add-on therapy for DS has not been evaluated in head-to-head trials."5.12Comparative short-term efficacy and safety of add-on anti-seizure medications in Dravet syndrome: An indirect treatment comparison. ( Asrar, MM; Bansal, D; Devi, N; Madaan, P; Sahu, JK, 2021)
"Although there are differences in antiseizure activity and pharmacokinetics among the enantiomers of fenfluramine and norfenfluramine, all compounds tested are effective in protecting against MES-induced seizures in rodents."4.31Comparative activity of the enantiomers of fenfluramine and norfenfluramine in rodent seizure models, and relationship with their concentrations in plasma and brain. ( Bialer, M; Erenburg, N; Hamed, R; Perucca, E; Shaul, C, 2023)
" Before the approval of fenfluramine (FFA) for the treatment of seizures in DS, patients in Germany could receive treatment under a compassionate use program (CUP)."4.02Efficacy, tolerability, and retention of fenfluramine for the treatment of seizures in patients with Dravet syndrome: Compassionate use program in Germany. ( Alber, M; Klotz, KA; Kluger, G; Kurlemann, G; Mayer, T; Muhle, H; Polster, T; Pringsheim, M; Schubert-Bast, S; Spors, H; Strzelczyk, A; Trollmann, R, 2021)
"Radioligand binding assays tested the affinity of fenfluramine for 47 receptors associated with seizures in the literature, including σ receptors."3.96Fenfluramine acts as a positive modulator of sigma-1 receptors. ( de Witte, PAM; Farfel, G; Galer, B; Gammaitoni, A; Martin, P; Maurice, T, 2020)
"5 mg/kg clonidine significantly increased the latency to the first convulsion and reduced tonic seizures and mortality caused by pentylenetetrazol (PTZ), 90 mg/kg, administered subcutaneously to rats."3.66Serotonin mediation of the protective effect of clonidine against pentylenetetrazol-induced seizures in rats. ( Lazarova, M; Samanin, R, 1983)
"Improved seizure control can reduce morbidity and mortality."3.30Failure to use new breakthrough treatments for epilepsy. ( Devinsky, O; Klein, P; Krauss, GL; Sperling, MR; Steinhoff, BJ, 2023)
"Median time-to-nth seizure was longer after fenfluramine than after placebo (Study 1: fenfluramine ."3.11Fenfluramine significantly reduces day-to-day seizure burden by increasing number of seizure-free days and time between seizures in patients with Dravet syndrome: A time-to-event analysis. ( Auvin, S; Dai, D; Devinsky, O; Galer, BS; Gammaitoni, AR; Gil-Nagel, A; Perry, MS; Specchio, N; Strzelczyk, A; Sullivan, J, 2022)
"Individuals with Dravet syndrome (DS) experience frequent pharmacoresistant seizures beginning in infancy."3.01Improved everyday executive functioning following profound reduction in seizure frequency with fenfluramine: Analysis from a phase 3 long-term extension study in children/young adults with Dravet syndrome. ( Bishop, KI; Farfel, G; Galer, BS; Gammaitoni, AR; Gioia, GA; Isquith, PK; Nabbout, R; Polster, T; Sullivan, J; Wirrell, EC, 2021)
" In recently published randomized controlled trials, fenfluramine (FFA) proved to be safe and effective in DS."2.94Efficacy and safety of Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: A real-world study. ( Battaglia, D; Cossu, A; Dalla Bernardina, B; Darra, F; Doccini, V; Granata, T; Guerrini, R; Luigia Gambardella, M; Mei, D; Pietrafusa, N; Quintiliani, M; Ragona, F; Rosati, A; Specchio, N; Spolverato, S; Trivisano, M; Vigevano, F, 2020)
"Fenfluramine has been shown to provide clinically meaningful and statistically significant reductions in convulsive seizure frequency in children and adolescents (aged 2-18 years) with Dravet syndrome in two randomized, placebo-controlled clinical trials."2.94Fenfluramine HCl (Fintepla ( Agarwal, A; Farfel, G; Galer, B; Gammaitoni, A; Lagae, L; Lock, M; Morrison, G; Nabbout, R; Polster, T; Pringsheim, M; Scheffer, IE; Sullivan, J; Talwar, D, 2020)
"The potential antiseizure effects of fenfluramine were first identified in patients with photosensitive epilepsy in the 1980s but it was not rigorously explored as a treatment option until 30 years later."2.72Fenfluramine for treatment-resistant epilepsy in Dravet syndrome and other genetically mediated epilepsies. ( Simmons, R; Sullivan, J, 2021)
"Fenfluramine was found to be more efficacious than placebo, in terms of mean convulsive and total seizure frequency reduction (mean difference: -45."2.72Efficacy and tolerability of fenfluramine in patients with Dravet syndrome: A systematic review and meta-analysis. ( Dawman, L; Joshi, K; Kasinathan, A; Panda, P; Panda, PK; Sharawat, IK, 2021)
"Fenfluramine is an effective antiepileptic drug for pediatric patients with Dravet syndrome, demonstrating clinically meaningful reduction in convulsive frequency, and generally could be well tolerated."2.72Efficacy and safety of fenfluramine in patients with Dravet syndrome: A meta-analysis. ( Li, W; Wang, C; Zhang, L, 2021)
"Fenfluramine hydrochloride has classically been described as acting pharmacologically through a serotonergic mechanism."2.72Fenfluramine as antiseizure medication for epilepsy. ( Cross, JH; Gogou, M, 2021)
"Dravet syndrome is a rare and severe encephalopathy that first presents in infancy with seizures refractory to conventional antiepileptic drugs."2.61Individualized treatment approaches: Fenfluramine, a novel antiepileptic medication for the treatment of seizures in Dravet syndrome. ( Polster, T, 2019)
" Seizure incidence was recorded in a written diary, and adverse events (AEs) were reported at each patient visit."1.72An examination of the efficacy and safety of fenfluramine in adults, children, and adolescents with Dravet syndrome in a real-world practice setting: A report from the Fenfluramine European Early Access Program. ( Aledo-Serrano, Á; Darra, F; Gammaitoni, A; Gil-Nagel, A; Guerrini, R; Lothe, A; Mayer, T; Polster, T; Pringsheim, M; Specchio, N; Strzelczyk, A; Zuberi, SM, 2022)
"The most commonly reported seizure-related benefits (> 50 % of participants) of FFA treatment included a reduction in seizure activity, fewer seizure triggers, and shorter post-ictal recovery."1.72Fenfluramine treatment for dravet syndrome: Real-world benefits on quality of life from the caregiver perspective. ( Amtmann, D; Galer, BS; Gammaitoni, AR; Jensen, MP; Salem, R; Wilkie, D, 2022)
"Fenfluramine has been recently approved by the FDA and EMA and is marketed as Fintepla®."1.72A critical evaluation of fenfluramine hydrochloride for the treatment of Dravet syndrome. ( Ceulemans, B; Schoonjans, AS, 2022)
"Fenfluramine (FFA), an antiseizure medication (ASM) indicated for treating convulsive seizures in Dravet syndrome, was assessed in six patients (five female; 83%) with CDD whose seizures had failed 5-12 ASMs or therapies."1.62Effect of fenfluramine on convulsive seizures in CDKL5 deficiency disorder. ( Conway, E; Devinsky, O; King, L; Price, D; Schwartz, D, 2021)
"Fenfluramine (Fintepla) has demonstrated profound reduction in convulsive seizure frequency in DS and was recently approved for use in DS in the US and EU."1.62Treatment with fenfluramine in patients with Dravet syndrome has no long-term effects on weight and growth. ( Agarwal, A; Ceulemans, B; Cortes, RM; Davis, R; Devinsky, O; Farfel, G; Galer, BS; Gammaiton, AR; Gil-Nagel, A; Knupp, KG; Lock, M; Nabbout, R; Polster, T; Scott Perry, M; Sullivan, J; Wirrell, E, 2021)
"Prevention of sudden unexpected death in epilepsy (SUDEP) is a critical goal for epilepsy therapy."1.51Fenfluramine, a serotonin-releasing drug, prevents seizure-induced respiratory arrest and is anticonvulsant in the DBA/1 mouse model of SUDEP. ( Faingold, CL; Tupal, S, 2019)
"Median frequency of major motor seizures was 15."1.46Low-dose fenfluramine significantly reduces seizure frequency in Dravet syndrome: a prospective study of a new cohort of patients. ( Ceulemans, B; Galer, BS; Gammaitoni, A; Gunning, B; Lagae, L; Marchau, F; Paelinck, BP; Schoonjans, A, 2017)
"Excitation, coma, convulsions, tachycardia, mydriasis, nystagmus, and rubeosis of the face were the most important signs."1.26[Fenfluramin (ponderax) intoxications in children (author's transl)]. ( Krienke, EG; Mühlendahl, KE, 1978)
"Fenfluramine is a substituted phenylethylamine structurally related to amphetamine."1.25Fenfluramine poisoning. ( Temple, AR; Veltri, JC, 1975)

Research

Studies (45)

TimeframeStudies, this research(%)All Research%
pre-19907 (15.56)18.7374
1990's1 (2.22)18.2507
2000's0 (0.00)29.6817
2010's6 (13.33)24.3611
2020's31 (68.89)2.80

Authors

AuthorsStudies
Sullivan, J10
Specchio, N6
Devinsky, O5
Auvin, S4
Perry, MS1
Strzelczyk, A3
Gil-Nagel, A7
Dai, D2
Galer, BS12
Gammaitoni, AR9
Sourbron, J3
Lagae, L6
Knupp, KG6
Scheffer, IE6
Ceulemans, B6
Sullivan, JE1
Nickels, KC2
Guerrini, R8
Zuberi, SM3
Nabbout, R8
Riney, K2
Shore, S1
Agarwal, A5
Lock, M5
Farfel, GM2
Davis, R3
Falip, M1
Sánchez-Carpintero, R1
Abad-Sazatornil, MR1
Poveda, JL1
Aibar, JÁ1
Cardenal-Muñoz, E1
Aras, LM1
Sánchez, R1
Sancho-López, A1
Trillo-Mata, JL1
Torrejón, M1
Gil, A1
Aledo-Serrano, Á2
Pringsheim, M3
Darra, F2
Mayer, T2
Polster, T7
Lothe, A1
Gammaitoni, A5
Cabal-Paz, B1
Gardella, E1
Gómez-Porro, P1
Martínez-Múgica, O1
Beltrán-Corbellini, A1
Toledano, R1
García-Morales, I1
Jensen, MP1
Salem, R1
Wilkie, D1
Amtmann, D1
Polega, S1
Bishop, KI4
Isquith, PK4
Gioia, GA4
Helen Cross, J3
Farfel, G8
Patel, S2
Geenen, KR2
Dowless, D1
Bruno, PL2
Thiele, EA2
Pong, AW1
Xu, KJ1
Klein, P2
Krauss, GL1
Steinhoff, BJ1
Sperling, MR1
Erenburg, N1
Hamed, R1
Shaul, C1
Perucca, E1
Bialer, M1
Frampton, JE1
Lattanzi, S1
Trinka, E1
Russo, E1
Del Giovane, C1
Matricardi, S1
Meletti, S1
Striano, P1
Damavandi, PT1
Silvestrini, M1
Brigo, F1
Borowicz-Reutt, K1
Czernia, J1
Krawczyk, M1
Berkovic, SF1
Knupp, K1
Laux, L1
Nikanorova, M1
Cross, JH2
Talwar, D2
Miller, I1
Mistry, A1
Morrison, G2
Lai, WW1
Martin, P2
de Witte, PAM2
Maurice, T1
Galer, B2
Pietrafusa, N1
Doccini, V1
Trivisano, M1
Ragona, F1
Cossu, A1
Spolverato, S1
Battaglia, D1
Quintiliani, M1
Luigia Gambardella, M1
Rosati, A1
Mei, D1
Granata, T1
Dalla Bernardina, B1
Vigevano, F1
Zhang, L1
Li, W1
Wang, C1
Schoonjans, AS1
Sharawat, IK1
Panda, PK1
Kasinathan, A1
Panda, P1
Dawman, L1
Joshi, K1
Gogou, M1
King, L1
Schwartz, D1
Conway, E1
Price, D1
Wirrell, EC1
Doshi, SP1
Falk, A1
Morgan, A1
Vu, U1
Simmons, R1
Devi, N1
Madaan, P1
Asrar, MM1
Sahu, JK1
Bansal, D1
Wirrell, E1
Scott Perry, M1
Cortes, RM1
Gammaiton, AR1
Klotz, KA1
Muhle, H1
Alber, M1
Trollmann, R1
Spors, H1
Kluger, G1
Kurlemann, G1
Schubert-Bast, S1
Reeder, T1
Tupal, S1
Faingold, CL1
Silenieks, LB1
Carroll, NK1
Van Niekerk, A1
Van Niekerk, E1
Taylor, C1
Upton, N1
Higgins, GA1
Schoonjans, A1
Paelinck, BP1
Marchau, F1
Gunning, B1
Lazarova, M1
Samanin, R1
LoVecchio, F1
Curry, SC1
Mühlendahl, KE1
Krienke, EG1
Nieminen, L1
Möttönen, M1
Arvela, P1
Veltri, JC1
Temple, AR1
Opitz, K1
Srimal, RC1
Singh, HK1
Dhawan, BN1
Wolfsdorf, J1
Kanarek, KS1

Clinical Trials (3)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A Multicenter, Randomized, Double-blind, Parallel Group, Placebo-controlled Trial of Two Fixed Doses of ZX008 (Fenfluramine Hydrochloride) Oral Solution as an Adjunctive Therapy in Children and Young Adults With Dravet Syndrome[NCT02682927]Phase 3262 participants (Actual)Interventional2016-01-15Completed
A Two-Part Study of ZX008 in Children and Adults With Lennox-Gastaut Syndrome (LGS); Part 1: A Randomized, Double-blind, Placebo-controlled Trial of Two Fixed Doses of ZX008 (Fenfluramine Hydrochloride) Oral Solution as Adjunctive Therapy for Seizures in [NCT03355209]Phase 3296 participants (Actual)Interventional2017-11-27Active, not recruiting
Fenfluramine in CKDL5 Deficiency Disorder (CDD)[NCT03861871]Phase 27 participants (Actual)Interventional2019-10-29Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Area Under the Concentration Time Curve of ZX008 From Time Zero to Time 24 Hours [AUC0-24hours] at Steady State

AUC0-24 is the area under the concentration time curve from time zero to 24 hours. (NCT02682927)
Timeframe: At Visit 8 (Day 43): pre-dose, 1, 2, and 4-6 hours postdose

Interventionnanogram*hour per milliliter (ng*h/mL) (Geometric Mean)
Study 1: ZX008 0.2 mg/kg/Day356
Study 1: ZX008 0.8 mg/kg/Day1390
Study 3: ZX008 0.2 mg/kg/Day348
Study 3: ZX008 0.8 mg/kg/Day1290

Change From Baseline in Convulsive + Non-convulsive Seizure Frequency to the Combined Titration and Maintenance Period in Each ZX008 Treatment Arm Compared to Placebo

Total seizure frequency were defined as the combination of convulsive and non-convulsive seizures. Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). Non-convulsive seizures included focal without clear observable motor signs, absence or atypical absence, myoclonic and atonic. The seizure frequency was based on electronic diary data obtained for each participant. The number of all seizures reported during the entire time interval was divided by the number of nonmissing diary days and the result was then multiplied by 28 to get a 28-day convulsive or non-convulsive seizure frequency. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionseizure frequency per 28 days (Median)
Study 1: Placebo-4.45
Study 1: ZX008 0.2 mg/kg/Day-7.40
Study 1: ZX008 0.8 mg/kg/Day-22.95
Study 3: Placebo-1.09
Study 3: ZX008 0.2 mg/kg/Day-6.54
Study 3: ZX008 0.8 mg/kg/Day-11.39

Change From Baseline in Non-convulsive Seizure Frequency to the Combined Titration and Maintenance Period in Each ZX008 Treatment Arm Compared to Placebo

Non-convulsive seizures included focal without clear observable motor signs, absence or atypical absence, myoclonic and atonic. The number of non-convulsive seizures reported during the entire time interval was divided by the number of nonmissing diary days and the result was then multiplied by 28 to get a 28-day non-convulsive seizure frequency. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionseizure frequency per 28 days (Median)
Study 1: Placebo-9.38
Study 1: ZX008 0.2 mg/kg/Day-4.85
Study 1: ZX008 0.8 mg/kg/Day-20.06
Study 3: Placebo-0.68
Study 3: ZX008 0.2 mg/kg/Day-0.67
Study 3: ZX008 0.8 mg/kg/Day-4.35

Change From Baseline in the Mean Convulsive Seizures Frequency (MCSF) to the Combined Titration and Maintenance Periods (T+M) in Participants Receiving ZX008 0.8 mg/kg/Day Compared to Placebo

Monthly (28 day) convulsive seizure frequency (CSF) was based on electronic diary data obtained for each participant. Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). The number of convulsive seizures reported during the entire time interval was divided by the number of nonmissing diary days and the result was then multiplied by 28 to get a 28-day CSF. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionseizure frequency per 28 days (Mean)
Study 1: Placebo-6.71
Study 1: ZX008 0.8 mg/kg/Day-13.11
Study 3: Placebo1.54
Study 3: ZX008 0.8 mg/kg/Day-3.54

Change From Baseline in the Mean Convulsive Seizures Frequency to the Combined Titration and Maintenance Period (T+M) in Participants Receiving ZX008 0.2 mg/kg/Day Compared to Placebo

Monthly (28 day) convulsive seizure frequency (CSF) was based on electronic diary data obtained for each participant. Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). The number of convulsive seizures reported during the entire time interval was divided by the number of nonmissing diary days and the result was then multiplied by 28 to get a 28-day CSF. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionseizure frequency per 28 days (Mean)
Study 1: Placebo-6.71
Study 1: ZX008 0.2 mg/kg/Day-18.81
Study 3: Placebo1.54
Study 3: ZX008 0.2 mg/kg/Day-5.89

Change From Baseline to Day 99 in the Overall Quality of Life Score From the Pediatric Quality of Life Inventory™ (PedsQL) Score in Each ZX008 Treatment Arm Compared to Placebo

The Pediatric Quality of Life Inventory (PedsQL) is a pediatric modular measure of health related quality of life (QoL) completed by the parent/caregiver on behalf of the participant. It consisted of 23 items across 4 core scales that measure physical (8 items), emotional, social, and school functioning (5 items each). Each of the responses to the 23 items is initially scored on a 5-point Likert scale from 0 (Never) to 4 (Almost always). Scores are linearly transformed to a scale of 0 to 100, where 0=100, 1=75, 2=50, 3=25 and 4=0, and higher scores correspond to better health-related QoL. The Overall Quality of Life is the average of all the items over the number of items answered on all the Scales. (NCT02682927)
Timeframe: From Baseline to Day 99

Interventionscore on a scale (Mean)
Study 1: Placebo-1.6
Study 1: ZX008 0.2 mg/kg/Day6.8
Study 1: ZX008 0.8 mg/kg/Day5.9
Study 3: Placebo1.9
Study 3: ZX008 0.2 mg/kg/Day4.2
Study 3: ZX008 0.8 mg/kg/Day2.1

Change From Baseline to Day 99 in the Quality of Life in Childhood Epilepsy (QOLCE) Score to Measure Quality of Life in Each ZX008 Treatment Arm Compared to Placebo

QOLCE is a low-burden parent/caregiver completed assessment that evaluates how epilepsy affects day-to day functioning of the participant in various life areas, including physical activities, well being, cognition, social activities, behavior, and general health. QOLCE scores items on 16 subscales with possible 5-point response for each, where scores of 5 was best possible response and 1 was worst possible response. Item scores were then transformed to a 0-100 scale as follows: 1-0, 2-25, 3-50, 4-75, 5-100. A score for each participant for each subscale was calculated by averaging that participant's responses to each item in the subscale. Subscale scores per participant were averaged to obtain an overall QoL score for each participant. Higher the subscale and overall QoL scores, better the response. (NCT02682927)
Timeframe: From Baseline to Day 99

Interventionscore on a scale (Mean)
Study 1: Placebo1.5
Study 1: ZX008 0.2 mg/kg/Day0.8
Study 1: ZX008 0.8 mg/kg/Day5.8
Study 3: Placebo1.2
Study 3: ZX008 0.2 mg/kg/Day6.1
Study 3: ZX008 0.8 mg/kg/Day5.5

Change From Baseline to Day 99 in the Total Score From PedsQL Family Impact Module Score in Each ZX008 Treatment Arm Compared to Placebo

The PedsQL Family Impact measured the impact of pediatric chronic health conditions on parents and the family by measuring parent self-reported physical, emotional, social, and cognitive functioning, communication, worry, and family daily activities and relationships. There are a total of 36 items in the PedsQL: 6 items for Physical Functioning, 5 items each for Emotional Functioning, Cognitive Functioning and Worry, 4 for Social Functioning, 3 for Communication, 3 questions for Daily Activities, and 5 for Family Relationships. Each of the responses are initially scored on a 5-point Likert scale from 0 (Never) to 4 (Almost always) and then linearly transformed to a scale of 0 to 100, where 0=100, 1=75, 2=50, 3=25 and 4=0, and higher scores mean better health-related QoL. (NCT02682927)
Timeframe: From Baseline to Day 99

Interventionscore on a scale (Mean)
Study 1: Placebo-4.4
Study 1: ZX008 0.2 mg/kg/Day3.9
Study 1: ZX008 0.8 mg/kg/Day5.4
Study 3: Placebo1.3
Study 3: ZX008 0.2 mg/kg/Day0.7
Study 3: ZX008 0.8 mg/kg/Day6.3

Elimination Half-life [t1/2 Beta] of ZX008 at Steady State

t1/2 beta is the elimination half-life. (NCT02682927)
Timeframe: At Visit 8 (Day 43): pre-dose, 1, 2, and 4-6 hours postdose

Interventionhours (h) (Geometric Mean)
Study 1: ZX008 0.2 mg/kg/Day18.4
Study 1: ZX008 0.8 mg/kg/Day21.1
Study 3: ZX008 0.2 mg/kg/Day18.1
Study 3: ZX008 0.8 mg/kg/Day18.6

Longest Convulsive Seizure-free Interval in Each ZX008 Treatment Arm Compared to Placebo During the Titration and Maintenance Period

The longest interval between convulsive seizures was calculated over the entire Titration and Maintenance Period and was derived as the maximum of the number of days between consecutive convulsive seizures. (NCT02682927)
Timeframe: During 14 weeks Titration (2 weeks) and Maintenance Period (12 weeks) (average of 99 days)

Interventiondays (Median)
Study 1: Placebo9.50
Study 1: ZX008 0.2 mg/kg/Day15.00
Study 1: ZX008 0.8 mg/kg/Day25.00
Study 3: Placebo10
Study 3: ZX008 0.2 mg/kg/Day18.5
Study 3: ZX008 0.8 mg/kg/Day30

Maximum Observed Concentration of ZX008 Determined Directly From the Concentration Time Profile [Cmax] at Steady State

Cmax is the maximum observed concentration determined directly from the concentration-time profile. (NCT02682927)
Timeframe: At Visit 8 (Day 43): pre-dose, 1, 2, and 4-6 hours postdose

Interventionnanograms per milliliter (ng/mL) (Geometric Mean)
Study 1: ZX008 0.2 mg/kg/Day17.7
Study 1: ZX008 0.8 mg/kg/Day67.9
Study 3: ZX008 0.2 mg/kg/Day17.4
Study 3: ZX008 0.8 mg/kg/Day64.5

Number of Convulsive Seizure-free Days in Each ZX008 Treatment Arm Compared to Placebo During the Titration and Maintenance Period

A convulsive seizure free day was defined as a day for which diary data are available and no convulsive seizures were reported. Convulsive seizure free days were taken from the electronic diary data. (NCT02682927)
Timeframe: During 14 weeks Titration (2 weeks) and Maintenance Period (12 weeks) (average of 99 days)

Interventionseizure free days (Median)
Study 1: Placebo15.14
Study 1: ZX008 0.2 mg/kg/Day20.86
Study 1: ZX008 0.8 mg/kg/Day24.43
Study 3: Placebo20.20
Study 3: ZX008 0.2 mg/kg/Day23.36
Study 3: ZX008 0.8 mg/kg/Day25.33

Percentage of Participants Who Achieved a ≥50% Reduction in Convulsive Seizure Frequency in Each ZX008 Treatment Arm Compared to Placebo From Baseline During the Titration and Maintenance Period

Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). A responder was a participant who experienced a 50% or greater reduction in convulsive seizure frequency per 28 days during Titration and Maintenance Period. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionpercentage of participants (Number)
Study 1: Placebo12.5
Study 1: ZX008 0.2 mg/kg/Day38.5
Study 1: ZX008 0.8 mg/kg/Day67.5
Study 3: Placebo6.3
Study 3: ZX008 0.2 mg/kg/Day45.7
Study 3: ZX008 0.8 mg/kg/Day72.9

Percentage of Participants Who Achieved a ≥75% Reduction in Convulsive Seizure Frequency in Each ZX008 Treatment Arm Compared to Placebo From Baseline During the Titration and Maintenance Period

Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). A responder was a participant who experienced a 75% or greater reduction in convulsive seizure frequency per 28 days during Titration and Maintenance Period. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionpercentage of participants (Number)
Study 1: Placebo2.5
Study 1: ZX008 0.2 mg/kg/Day23.1
Study 1: ZX008 0.8 mg/kg/Day50.0
Study 3: Placebo4.2
Study 3: ZX008 0.2 mg/kg/Day28.3
Study 3: ZX008 0.8 mg/kg/Day47.9

Percentage of Participants Who Achieved a 100% Reduction in Convulsive Seizure Frequency in Each ZX008 Treatment Arm Compared to Placebo From Baseline During the Titration and Maintenance Period

Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). A responder was a participant who experienced a 100% reduction in convulsive seizure frequency per 28 days during Titration and Maintenance Period. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionpercentage of participants (Number)
Study 1: Placebo0
Study 1: ZX008 0.2 mg/kg/Day7.7
Study 1: ZX008 0.8 mg/kg/Day7.5
Study 3: Placebo0
Study 3: ZX008 0.2 mg/kg/Day0
Study 3: ZX008 0.8 mg/kg/Day12.5

Percentage of Participants Who Achieved Greater Than or Equal to 25% (≥25%) Reduction in Convulsive Seizure Frequency in Each ZX008 Treatment Arm Compared to Placebo From Baseline During the Titration and Maintenance Period

Convulsive seizures included hemiclonic, focal with clear observable motor signs, generalized tonic clonic, secondarily generalized tonic clonic, tonic, clonic, and drop seizures (tonic/atonic). A responder was a participant who experienced a 25% or greater reduction in convulsive seizure frequency per 28 days during Titration and Maintenance Period. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionpercentage of participants (Number)
Study 1: Placebo35.0
Study 1: ZX008 0.2 mg/kg/Day66.7
Study 1: ZX008 0.8 mg/kg/Day90.0
Study 3: Placebo27.1
Study 3: ZX008 0.2 mg/kg/Day71.7
Study 3: ZX008 0.8 mg/kg/Day83.3

Percentage of Participants With Hospitalization and Healthcare Resource Utilization to Treat Seizures in Each ZX008 Treatment Arm Compared to Placebo During Study

Participants who utilized medical center care to treat a seizure during the study were reported. (NCT02682927)
Timeframe: During 14 weeks Titration (2 weeks) and Maintenance Period (12 weeks) (average of 99 days)

Interventionpercentage of participants (Number)
Study 1: Placebo22.5
Study 1: ZX008 0.2 mg/kg/Day17.9
Study 1: ZX008 0.8 mg/kg/Day15.0
Study 3: Placebo12.5
Study 3: ZX008 0.2 mg/kg/Day19.6
Study 3: ZX008 0.8 mg/kg/Day14.6

Percentage of Participants With Rescue Medication Usage in Each ZX008 Treatment Arm Compared to Placebo During the Titration and Maintenance Period

Rescue medication was administered according to each participant's usual or prescribed regimen consisting of 1 or more medications. The usage of rescue medication (number of days and number of medications used per seizure episode) was based on electronic diary data obtained for each participant. The number of days rescue medication was taken (normalized to 28 days) was calculated for each participant. Multiple medications taken on the same day were counted once for that day. (NCT02682927)
Timeframe: From Baseline up to 14 weeks [Titration Period (2 weeks) plus Maintenance Period (12 weeks)]

Interventionpercentage of participants (Number)
Study 1: Placebo77.5
Study 1: ZX008 0.2 mg/kg/Day59.0
Study 1: ZX008 0.8 mg/kg/Day45.0
Study 3: Placebo60.4
Study 3: ZX008 0.2 mg/kg/Day65.2
Study 3: ZX008 0.8 mg/kg/Day47.9

Percentage of Participants With Status Epilepticus (SE) in Each ZX008 Treatment Arm Compared to Placebo During the Titration and Maintenance Period

The participants who either had SE episode recorded as an adverse event (AE) during treatment or a seizure greater than 10 minutes were reported for each treatment group. Additionally, a single participant who may had more than one episode of SE, and an episode of SE recorded as both an AE and as a seizure longer than 10 minutes was counted as a single event. (NCT02682927)
Timeframe: During 14 weeks Titration (2 weeks) and Maintenance Period (12 weeks) (average of 99 days)

Interventionpercentage of participants (Number)
Study 1: Placebo27.5
Study 1: ZX008 0.2 mg/kg/Day28.2
Study 1: ZX008 0.8 mg/kg/Day35.0
Study 3: Placebo16.7
Study 3: ZX008 0.2 mg/kg/Day19.6
Study 3: ZX008 0.8 mg/kg/Day25.0

Time to Maximum Concentration [Tmax] of ZX008 at Steady State

Tmax is the time to maximum concentration at steady state. (NCT02682927)
Timeframe: At Visit 8 (Day 43): pre-dose, 1, 2, and 4-6 hours postdose

Interventionhours (h) (Median)
Study 1: ZX008 0.2 mg/kg/Day2.90
Study 1: ZX008 0.8 mg/kg/Day3.00
Study 3: ZX008 0.2 mg/kg/Day2.90
Study 3: ZX008 0.8 mg/kg/Day2.90

Change From Baseline to Day 99 in Affective Symptoms of the Parent/Caregiver Using the Hospital Anxiety and Depression Scale (HADS) in Each ZX008 Treatment Arm Compared to Placebo

The HADS is a tool that was validated to assess presence of anxiety or depression in an outpatient non-psychiatric population. The HADS a 14-item scale that generates ordinal data for 2 dimensions: 1) Anxiety (7 items), and 2) Depression (7 items). Each item has 4 possible answers rated 0 to 3, of which 0 = No distress and 3 = worst distress. All answers to the items for a dimension with their respective rating are added resulting in a range for each dimension from 0-21, out of which of 0-7 = normal; 8-10=borderline abnormal; 11-21=abnormal. Scores for the entire scale (emotional distress) range from 0 to 42, with higher scores indicating more distress. (NCT02682927)
Timeframe: From Baseline to Day 99

,,,,,
Interventionscore on a scale (Mean)
AnxietyDepressionTotal emotional distress
Study 1: Placebo-0.40.80.4
Study 1: ZX008 0.2 mg/kg/Day-0.80.2-0.6
Study 1: ZX008 0.8 mg/kg/Day-0.80.1-0.7
Study 3: Placebo-0.6-0.7-1.2
Study 3: ZX008 0.2 mg/kg/Day0.22.02.2
Study 3: ZX008 0.8 mg/kg/Day-0.7-0.8-1.5

Distribution of Duration of Convulsive Seizures (in Percentage) in Each ZX008 Treatment Arm Compared to Placebo at Baseline and During the Titration and Maintenance Period

Duration of single convulsive seizures during the Baseline and the duration over the Titration and Maintenance Period were reported by treatment group using categories as <2 minutes, 2 to 10 minutes and > 10 minutes as collected in the seizure diary. (NCT02682927)
Timeframe: At Baseline and 14 weeks of Titration (2 weeks) and Maintenance Period (12 weeks)

,,,,,
Interventionpercentage of seizures (Number)
<2 min (Baseline)2-10 min (Baseline)>10 min (Baseline)<2 min (Titration + Maintenance Period)2-10 min (Titration + Maintenance Period)>10 min (Titration + Maintenance Period)
Study 1: Placebo69.2826.863.8671.3126.312.38
Study 1: ZX008 0.2 mg/kg/Day64.1334.950.9371.5925.612.79
Study 1: ZX008 0.8 mg/kg/Day71.6124.224.1772.2722.914.82
Study 3: Placebo64.2134.830.9665.8433.740.43
Study 3: ZX008 0.2 mg/kg/Day63.9033.662.4563.4531.345.22
Study 3: ZX008 0.8 mg/kg/Day74.1122.783.1084.6713.711.62

Percentage of Participants With Clinical Global Impression - Improvement (CGI-I) Rating Score, as Assessed by the Principal Investigator in Each ZX008 Treatment Arm Compared to Placebo

CGI-I scale measures improvement in the participant's clinical status from Baseline. The severity of a participant's condition was rated on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse), as follows: 1-very much improved,2-much improved, 3-minimally improved, 4- no change, 5-minimally worse, 6-much worse and 7-very much worse. The Principal Investigator rated their global impression of the participant's condition during the study. (NCT02682927)
Timeframe: At Visit 6 (Day 15), 8 (Day 43), 10 (Day 71) and 12 (Day 99)

,,,,,
Interventionpercentage of participants (Number)
1 = Very much improved (Visit 6)2 = Much improved (Visit 6)3 = Minimally improved (Visit 6)4 = No change (Visit 6)5 = Minimally worse (Visit 6)6 = Much worse (Visit 6)7 = Very much worse (Visit 6)1 = Very much improved (Visit 8)2 = Much improved (Visit 8)3 = Minimally improved (Visit 8)4 = No change (Visit 8)5 = Minimally worse (Visit 8)6 = Much worse (Visit 8)7 = Very much worse (Visit 8)1 = Very much improved (Visit 10)2 = Much improved (Visit 10)3 = Minimally improved (Visit 10)4 = No change (Visit 10)5 = Minimally worse (Visit 10)6 = Much worse (Visit 10)7 = Very much worse (Visit 10)1 = Very much improved (Visit 12)2 = Much improved (Visit 12)3 = Minimally improved (Visit 12)4 = No change (Visit 12)5 = Minimally worse (Visit 12)6 = Much worse (Visit 12)7 = Very much worse (Visit 12)
Study 1: Placebo5.012.520.040.05.000012.530.030.05.02.502.57.530.035.010.0002.57.530.047.52.52.50
Study 1: ZX008 0.2 mg/kg/Day23.112.820.525.67.7005.130.820.517.95.15.1017.917.925.628.27.72.6012.828.217.928.210.32.60
Study 1: ZX008 0.8 mg/kg/Day17.525.020.017.55.02.5017.537.510.010.002.52.520.047.55.07.500027.535.015.012.5002.5
Study 3: Placebo4.22.127.154.24.2004.26.316.750.04.22.104.210.412.560.40004.24.216.758.36.300
Study 3: ZX008 0.2 mg/kg/Day21.721.717.426.12.20017.410.926.134.800015.219.626.128.30008.728.321.728.310.900
Study 3: ZX008 0.8 mg/kg/Day16.727.127.112.52.14.2029.231.314.68.34.20035.418.816.74.202.1033.331.310.416.76.300

Percentage of Participants With Clinical Global Impression - Improvement Rating Score, as Assessed by the Parent/Caregiver in Each ZX008 Treatment Arm Compared to Placebo

CGI-I scale measures improvement in the participant's clinical status from Baseline. The severity of a participant's condition was rated on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse), as follows: 1-very much improved,2-much improved, 3-minimally improved, 4- no change, 5-minimally worse, 6-much worse and 7-very much worse. The Parent/Caregiver rated their global impression of the participant's condition during the study. (NCT02682927)
Timeframe: At Visit 6 (Day 15), 8 (Day 43), 10 (Day 71) and 12 (Day 99)

,,,,,
Interventionpercentage of participants (Number)
1 = Very much improved (Visit 6)2 = Much improved (Visit 6)3 = Minimally improved (Visit 6)4 = No change (Visit 6)5 = Minimally worse (Visit 6)6 = Much worse (Visit 6)7 = Very much worse (Visit 6)1 = Very much improved (Visit 8)2 = Much improved (Visit 8)3 = Minimally improved (Visit 8)4 = No change (Visit 8)5 = Minimally worse (Visit 8)6 = Much worse (Visit 8)7 = Very much worse (Visit 8)1 = Very much improved (Visit 10)2 = Much improved (Visit 10)3 = Minimally improved (Visit 10)4 = No change (Visit 10)5 = Minimally worse (Visit 10)6 = Much worse (Visit 10)7 = Very much worse (Visit 10)1 = Very much improved (Visit 12)2 = Much improved (Visit 12)3 = Minimally improved (Visit 12)4 = No change (Visit 12)5 = Minimally worse (Visit 12)6 = Much worse (Visit 12)7 = Very much worse (Visit 12)
Study 1: Placebo2.522.512.545.02.55.00015.025.020.015.02.502.512.522.532.512.52.52.52.57.520.035.017.57.50
Study 1: ZX008 0.2 mg/kg/Day17.920.528.212.87.72.6015.425.625.612.810.35.1020.517.920.525.67.77.7020.520.515.420.515.47.70
Study 1: ZX008 0.8 mg/kg/Day15.027.522.520.02.57.52.520.037.515.05.02.55.02.535.030.07.510.0002.527.527.510.015.05.05.02.5
Study 3: Placebo6.32.125.045.810.42.104.28.320.847.96.34.24.22.16.325.045.86.3002.16.318.850.010.42.10
Study 3: ZX008 0.2 mg/kg/Day13.023.926.119.62.22.206.530.428.317.46.52.208.728.326.126.104.306.528.330.413.08.74.32.2
Study 3: ZX008 0.8 mg/kg/Day16.731.331.32.16.32.12.139.629.214.66.302.1041.722.98.36.34.20033.329.220.84.24.22.12.1

Quality of Life (QoL) of the Parent/Caregiver Using the EQ- 5D-5L Scale in Each ZX008 Treatment Arm Compared to Placebo at Baseline and Day 99

"The EuroQOL-5 Dimensions-5 Levels scale produced by European QOL Group (EQ-5D-5L) health questionnaire is a health-related QOL instrument with 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The 5 dimensions of EQ-5D-5L health questionnaire were assessed on a Likert scale with 5 possible levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The categories slight problems, moderate problems, severe problems and extreme problems are collapsed into one response category problems. The QOL of the parent/caregiver was assessed and percentage of participants was reported for each item." (NCT02682927)
Timeframe: At Baseline and Day 99

,,,,,
Interventionpercentage of participants (Number)
Mobility- No problems (Baseline)Mobility- Problems (Baseline)Mobility- No problems (Day 99)Mobility- Problems (Day 99)Self-care - No problems (Baseline)Self-care - Problems (Baseline)Self-care - No problems (Day 99)Self-care - Problems (Day 99)Usual activities- No problems (Baseline)Usual activities- Problems (Baseline)Usual activities- No problems (Day 99)Usual activities- Problems (Day 99)Pain/discomfort- No problems (Baseline)Pain/discomfort- Problems (Baseline)Pain/discomfort- No problems (Day 99)Pain/discomfort- Problems (Day 99)Anxiety/depression- No problems (Baseline)Anxiety/depression- Problems (Baseline)Anxiety/depression- No problems (Day 99)Anxiety/depression- Problems (Day 99)
Study 1: Placebo33.3366.6740.0060.0025.6474.3628.5771.4323.0876.9225.7174.2948.7251.2848.5751.4374.3625.6465.7134.29
Study 1: ZX008 0.2 mg/kg/Day52.9447.0645.9554.0541.1858.8243.2456.7641.1858.8232.4367.5741.1858.8251.3548.6561.7638.2467.5732.43
Study 1: ZX008 0.8 mg/kg/Day46.1553.8551.3548.6538.4661.5448.6551.3535.9064.1048.6551.3546.1553.8564.8635.1456.4143.5967.5732.43
Study 3: Placebo40.0060.0052.3847.6222.5077.5030.9569.0525.0075.0030.9569.0545.0055.0076.1945.2460.0040.0069.0530.95
Study 3: ZX008 0.2 mg/kg/Day54.5545.4551.1648.8436.3663.6434.8865.1239.3960.6125.5874.4251.5248.4846.5153.4963.6436.3667.4432.56
Study 3: ZX008 0.8 mg/kg/Day28.5771.4346.6753.3322.8677.1435.5664.4420.0080.0035.5664.4451.4348.5764.4435.5674.2925.7173.3326.67

Change From Baseline in Median Monthly Convulsive Seizure Frequency

Change between baseline and Week 14 in the median number of monthly convulsive seizures. (NCT03861871)
Timeframe: Baseline, Week 14

InterventionNumber of monthly seizures (Median)
Fenfluramine Hydrochloride88.429

Change in Caregiver Global Impression of Change (CGIC) Score

The CGIC is a 1-item, parent/caregiver-completed assessment used determine how much their child/care-recipient has improved with treatment. The instrument asks parents/caregivers to rate their child's/care-recipient's improvement as: 1) very much improved; 2) much improved; 3) minimally improved; 4) unchanged; 5) a little worse; 6) much worse; 7) very much worse; the total score correspondingly ranges from 1-7. (NCT03861871)
Timeframe: Baseline, Week 14

Interventionscore on a scale (Mean)
Fenfluramine Hydrochloride-2.429

Change in Investigator Global Impression of Change (IGIC) Score

The IGIC is a 1-item, investigator-completed assessment used determine how much a patient has improved with treatment. The instrument asks the investigator to rate patients' improvement as: 1) very much improved; 2) much improved; 3) minimally improved; 4) unchanged; 5) a little worse; 6) much worse; 7) very much worse; the total score correspondingly ranges from 1-7. (NCT03861871)
Timeframe: Baseline, Week 14

Interventionscore on a scale (Mean)
Fenfluramine Hydrochloride1.571

Change in Pediatric Quality Of Life (PEDS-QL) Epilepsy Module Raw Score

The PedsQL Epilepsy Module is a 29-item measure with five scales: Impact, Cognitive, Sleep, Executive Function, and Mood/Behavior. The Impact scale (nine items) assesses how epilepsy interferes with daily activities, interacting with peers, independence, and increased disease burden due to treatment. The Cognitive Scale (six items) assesses memory, ability to learn new materials, school-related difficulties, and reading difficulties. The Sleep Scale (three items) assesses fatigue and sleep difficulties. The Executive Function Scale (six items) assesses organization, task initiation, impulsivity, and inattention. The Mood/Behavior Scale (five items) assesses feelings of anger, sadness, worries, and frustration tolerance. Scores range from 0-100 for each subscale, with higher scores representing better quality of life. The raw score is the sum of each subscale score and ranges from 0-500. (NCT03861871)
Timeframe: Baseline, Week 14

Interventionscore on a scale (Mean)
Fenfluramine Hydrochloride-103.571

Change in Quality of Life in Childhood Epilepsy (QOLCE) Score

Parent/caregiver-completed assessment assessing how epilepsy affects day-to-day functioning of their child/care-recipient in various life areas. Each item is ranked on a 5-point Likert scale from 1 (response correlated with the lowest possible quality of life) to 5 (response correlated with the highest possible quality of life). Item scores are then transformed to a 0-100 scale as follows: 1 = 0, 2 = 25, 3 = 50, 4=75, and 5=100. The total score is the average of all item scores and ranges from 0-100. Higher scores indicate greater quality of life; an increase in scores indicates quality of life increased during the observational period. (NCT03861871)
Timeframe: Baseline, Week 14

Interventionscore on a scale (Mean)
Fenfluramine Hydrochloride-0.429

Reviews

13 reviews available for fenfluramine and Seizures

ArticleYear
Serotonin receptors in epilepsy: Novel treatment targets?
    Epilepsia open, 2022, Volume: 7, Issue:2

    Topics: Animals; Epilepsy; Fenfluramine; Receptors, Serotonin; Seizures; Serotonin

2022
The contribution of fenfluramine to the treatment of Dravet syndrome in Spain through Multi-Criteria Decision Analysis.
    Epilepsy & behavior : E&B, 2022, Volume: 132

    Topics: Anticonvulsants; Decision Support Techniques; Epilepsies, Myoclonic; Epileptic Syndromes; Fenflurami

2022
Recent advances in pharmacotherapy for epilepsy.
    Current opinion in neurology, 2023, 04-01, Volume: 36, Issue:2

    Topics: Adult; Anticonvulsants; Child; Epilepsies, Myoclonic; Epilepsies, Partial; Epilepsy; Fenfluramine; H

2023
Fenfluramine: A Review in Dravet and Lennox-Gastaut Syndromes.
    Drugs, 2023, Volume: 83, Issue:10

    Topics: Anticonvulsants; Epilepsies, Myoclonic; Fenfluramine; Humans; Lennox Gastaut Syndrome; Seizures; Tre

2023
Pharmacotherapy for Dravet Syndrome: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
    Drugs, 2023, Volume: 83, Issue:15

    Topics: Anticonvulsants; Cannabidiol; Epilepsies, Myoclonic; Fenfluramine; Humans; Network Meta-Analysis; Ph

2023
Genetic Background of Epilepsy and Antiepileptic Treatments.
    International journal of molecular sciences, 2023, Nov-14, Volume: 24, Issue:22

    Topics: Anticonvulsants; Epilepsy; Epileptic Syndromes; Fenfluramine; Genetic Background; Humans; Seizures

2023
Efficacy and safety of fenfluramine in patients with Dravet syndrome: A meta-analysis.
    Acta neurologica Scandinavica, 2021, Volume: 143, Issue:4

    Topics: Anticonvulsants; Child; Child, Preschool; Epilepsies, Myoclonic; Fatigue; Fenfluramine; Fever; Human

2021
Efficacy and tolerability of fenfluramine in patients with Dravet syndrome: A systematic review and meta-analysis.
    Seizure, 2021, Volume: 85

    Topics: Child; Epilepsies, Myoclonic; Female; Fenfluramine; Humans; Infant; Male; Seizures; Spasms, Infantil

2021
Fenfluramine as antiseizure medication for epilepsy.
    Developmental medicine and child neurology, 2021, Volume: 63, Issue:8

    Topics: Anticonvulsants; Epilepsy; Fenfluramine; Humans; Seizures

2021
Fenfluramine for treatment-resistant epilepsy in Dravet syndrome and other genetically mediated epilepsies.
    Drugs of today (Barcelona, Spain : 1998), 2021, Volume: 57, Issue:7

    Topics: Animals; Anticonvulsants; Epilepsies, Myoclonic; Fenfluramine; Humans; Randomized Controlled Trials

2021
Comparative short-term efficacy and safety of add-on anti-seizure medications in Dravet syndrome: An indirect treatment comparison.
    Seizure, 2021, Volume: 91

    Topics: Adolescent; Anticonvulsants; Child; Child, Preschool; Epilepsies, Myoclonic; Fenfluramine; Humans; I

2021
An Emerging Role for Sigma-1 Receptors in the Treatment of Developmental and Epileptic Encephalopathies.
    International journal of molecular sciences, 2021, Aug-05, Volume: 22, Issue:16

    Topics: Animals; Anticonvulsants; Brain Diseases; Epileptic Syndromes; Fenfluramine; Humans; Receptors, sigm

2021
Individualized treatment approaches: Fenfluramine, a novel antiepileptic medication for the treatment of seizures in Dravet syndrome.
    Epilepsy & behavior : E&B, 2019, Volume: 91

    Topics: Animals; Anticonvulsants; Clinical Trials, Phase III as Topic; Epilepsies, Myoclonic; Fenfluramine;

2019

Trials

10 trials available for fenfluramine and Seizures

ArticleYear
Fenfluramine significantly reduces day-to-day seizure burden by increasing number of seizure-free days and time between seizures in patients with Dravet syndrome: A time-to-event analysis.
    Epilepsia, 2022, Volume: 63, Issue:1

    Topics: Anticonvulsants; Epilepsies, Myoclonic; Epileptic Syndromes; Fenfluramine; Humans; Quality of Life;

2022
Efficacy and Safety of Fenfluramine for the Treatment of Seizures Associated With Lennox-Gastaut Syndrome: A Randomized Clinical Trial.
    JAMA neurology, 2022, 06-01, Volume: 79, Issue:6

    Topics: Adolescent; Anticonvulsants; Double-Blind Method; Fenfluramine; Humans; Lennox Gastaut Syndrome; Mal

2022
Fenfluramine provides clinically meaningful reduction in frequency of drop seizures in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study.
    Epilepsia, 2023, Volume: 64, Issue:1

    Topics: Adolescent; Adult; Anticonvulsants; Child; COVID-19; Fenfluramine; Humans; Lennox Gastaut Syndrome;

2023
Fenfluramine treatment is associated with improvement in everyday executive function in preschool-aged children (<5 years) with Dravet syndrome: A critical period for early neurodevelopment.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Child; Child, Preschool; Epilepsies, Myoclonic; Executive Function; Fenfluramine; Humans; Parents; S

2023
Fenfluramine treatment is associated with improvement in everyday executive function in preschool-aged children (<5 years) with Dravet syndrome: A critical period for early neurodevelopment.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Child; Child, Preschool; Epilepsies, Myoclonic; Executive Function; Fenfluramine; Humans; Parents; S

2023
Fenfluramine treatment is associated with improvement in everyday executive function in preschool-aged children (<5 years) with Dravet syndrome: A critical period for early neurodevelopment.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Child; Child, Preschool; Epilepsies, Myoclonic; Executive Function; Fenfluramine; Humans; Parents; S

2023
Fenfluramine treatment is associated with improvement in everyday executive function in preschool-aged children (<5 years) with Dravet syndrome: A critical period for early neurodevelopment.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Child; Child, Preschool; Epilepsies, Myoclonic; Executive Function; Fenfluramine; Humans; Parents; S

2023
Follow-up to low-dose fenfluramine for Sunflower syndrome: A non-randomized controlled trial.
    Developmental medicine and child neurology, 2023, Volume: 65, Issue:7

    Topics: Anticonvulsants; Epilepsy, Reflex; Fenfluramine; Follow-Up Studies; Helianthus; Humans; Seizures; Sy

2023
Failure to use new breakthrough treatments for epilepsy.
    Epilepsia, 2023, Volume: 64, Issue:6

    Topics: Adult; Anticonvulsants; Drug Resistant Epilepsy; Epilepsies, Myoclonic; Epilepsy; Fenfluramine; Huma

2023
Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial.
    Lancet (London, England), 2019, 12-21, Volume: 394, Issue:10216

    Topics: Administration, Oral; Adolescent; Anticonvulsants; Child; Child, Preschool; Double-Blind Method; Epi

2019
Efficacy and safety of Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: A real-world study.
    Epilepsia, 2020, Volume: 61, Issue:11

    Topics: Adolescent; Adult; Anorexia; Anticonvulsants; Child; Child, Preschool; Epilepsies, Myoclonic; Female

2020
Fenfluramine HCl (Fintepla
    Epilepsia, 2020, Volume: 61, Issue:11

    Topics: Adolescent; Child; Child, Preschool; Double-Blind Method; Epilepsies, Myoclonic; Female; Fenfluramin

2020
Improved everyday executive functioning following profound reduction in seizure frequency with fenfluramine: Analysis from a phase 3 long-term extension study in children/young adults with Dravet syndrome.
    Epilepsy & behavior : E&B, 2021, Volume: 121, Issue:Pt A

    Topics: Adolescent; Anticonvulsants; Child; Epilepsies, Myoclonic; Executive Function; Fenfluramine; Humans;

2021

Other Studies

22 other studies available for fenfluramine and Seizures

ArticleYear
An examination of the efficacy and safety of fenfluramine in adults, children, and adolescents with Dravet syndrome in a real-world practice setting: A report from the Fenfluramine European Early Access Program.
    Epilepsia open, 2022, Volume: 7, Issue:4

    Topics: Adolescent; Adult; Anticonvulsants; Child; Epilepsies, Myoclonic; Fenfluramine; Humans; Seizures; Tr

2022
Effect of fenfluramine on seizures and comorbidities in SCN8A-developmental and epileptic encephalopathy: A case series.
    Epilepsia open, 2022, Volume: 7, Issue:3

    Topics: Adolescent; Child; Child, Preschool; Comorbidity; Epilepsies, Myoclonic; Female; Fenfluramine; Human

2022
Fenfluramine treatment for dravet syndrome: Real-world benefits on quality of life from the caregiver perspective.
    Epilepsy research, 2022, Volume: 185

    Topics: Adolescent; Adult; Caregivers; Child; Child, Preschool; Epilepsies, Myoclonic; Epileptic Syndromes;

2022
Comparative activity of the enantiomers of fenfluramine and norfenfluramine in rodent seizure models, and relationship with their concentrations in plasma and brain.
    Epilepsia, 2023, Volume: 64, Issue:6

    Topics: Animals; Brain; Fenfluramine; Mice; Norfenfluramine; Rats; Rodentia; Seizures

2023
Epileptic encephalopathies of infancy: welcome advances.
    Lancet (London, England), 2019, 12-21, Volume: 394, Issue:10216

    Topics: Double-Blind Method; Epilepsies, Myoclonic; Fenfluramine; Humans; Infant; Seizures; Spasms, Infantil

2019
Fenfluramine acts as a positive modulator of sigma-1 receptors.
    Epilepsy & behavior : E&B, 2020, Volume: 105

    Topics: Animals; Benzazepines; CHO Cells; Cricetinae; Cricetulus; Fenfluramine; HEK293 Cells; Humans; Male;

2020
A critical evaluation of fenfluramine hydrochloride for the treatment of Dravet syndrome.
    Expert review of neurotherapeutics, 2022, Volume: 22, Issue:5

    Topics: Anticonvulsants; Epilepsies, Myoclonic; Epileptic Syndromes; Fenfluramine; Humans; Seizures; Spasms,

2022
Effect of fenfluramine on convulsive seizures in CDKL5 deficiency disorder.
    Epilepsia, 2021, Volume: 62, Issue:7

    Topics: Adolescent; Adult; Anticonvulsants; Child; Child, Preschool; Epilepsies, Myoclonic; Epilepsy, Tonic-

2021
Fenfluramine for seizures associated with Sunflower syndrome.
    Developmental medicine and child neurology, 2021, Volume: 63, Issue:12

    Topics: Adolescent; Anticonvulsants; Brain; Child; Electroencephalography; Female; Fenfluramine; Humans; Mal

2021
Treatment with fenfluramine in patients with Dravet syndrome has no long-term effects on weight and growth.
    Epilepsy & behavior : E&B, 2021, Volume: 122

    Topics: Adult; Child; Epilepsies, Myoclonic; Fenfluramine; Humans; Obesity; Seizures; Spasms, Infantile

2021
Efficacy, tolerability, and retention of fenfluramine for the treatment of seizures in patients with Dravet syndrome: Compassionate use program in Germany.
    Epilepsia, 2021, Volume: 62, Issue:10

    Topics: Adolescent; Adult; Anticonvulsants; Child; Child, Preschool; Compassionate Use Trials; Epilepsies, M

2021
Fenfluramine, a serotonin-releasing drug, prevents seizure-induced respiratory arrest and is anticonvulsant in the DBA/1 mouse model of SUDEP.
    Epilepsia, 2019, Volume: 60, Issue:3

    Topics: Animals; Anticonvulsants; Disease Models, Animal; Female; Fenfluramine; Male; Mice; Mice, Inbred DBA

2019
Evaluation of Selective 5-HT
    ACS chemical neuroscience, 2019, 07-17, Volume: 10, Issue:7

    Topics: Animals; Benzazepines; Disease Models, Animal; Ethylamines; Fenfluramine; Indoles; Mice; Piperazines

2019
Low-dose fenfluramine significantly reduces seizure frequency in Dravet syndrome: a prospective study of a new cohort of patients.
    European journal of neurology, 2017, Volume: 24, Issue:2

    Topics: Adolescent; Adult; Anticonvulsants; Child; Child, Preschool; Drug Therapy, Combination; Epilepsies,

2017
Serotonin mediation of the protective effect of clonidine against pentylenetetrazol-induced seizures in rats.
    Life sciences, 1983, May-16, Volume: 32, Issue:20

    Topics: Animals; Clonidine; Dose-Response Relationship, Drug; Fenfluramine; Male; Metergoline; Methysergide;

1983
Dexfenfluramine overdose.
    Annals of emergency medicine, 1998, Volume: 32, Issue:1

    Topics: Adult; Coma; Female; Fenfluramine; Humans; Respiratory Insufficiency; Seizures; Serotonin Agents; Su

1998
[Fenfluramin (ponderax) intoxications in children (author's transl)].
    Monatsschrift fur Kinderheilkunde, 1978, Volume: 126, Issue:10

    Topics: Adolescent; Adrenergic beta-Antagonists; Anticonvulsants; Child, Preschool; Chlorpromazine; Coma; El

1978
The effect of cold and diazepam on the toxicity of fenfluramine in mice.
    Experientia, 1975, Mar-15, Volume: 31, Issue:3

    Topics: Animals; Cold Temperature; Diazepam; Dose-Response Relationship, Drug; Fenfluramine; Male; Mice; Mod

1975
Fenfluramine poisoning.
    The Journal of pediatrics, 1975, Volume: 87, Issue:1

    Topics: Adolescent; Arrhythmias, Cardiac; Autopsy; Electrocardiography; Female; Fenfluramine; Heart Arrest;

1975
[Anorexigenic phenylalkylamines and serotonin metabolism].
    Naunyn-Schmiedebergs Archiv fur experimentelle Pathologie und Pharmakologie, 1967, Volume: 259, Issue:1

    Topics: 5-Hydroxytryptophan; Animals; Appetite Depressants; Chlorphentermine; Diarrhea; Eating; Feeding and

1967
Experimental evidence for imipramine like activity of fenfluramine.
    Archives internationales de pharmacodynamie et de therapie, 1970, Volume: 188, Issue:2

    Topics: Animals; Avoidance Learning; Blepharoptosis; Blood Pressure; Body Temperature; Cats; Columbidae; Dru

1970
Fenfluramine overdosage in childhood. Case report.
    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1972, May-20, Volume: 46, Issue:21

    Topics: Accidents, Home; Child, Preschool; Female; Fenfluramine; Fever; Gastric Lavage; Humans; Poisoning; S

1972