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NCT06798896PHASE2Recruiting

RENAISSANCE 2: SPN-817 Phase 2, Double-Blind, Placebo-Controlled Study in Adults With Focal Onset Seizures

Supernus Pharmaceuticals, Inc.

Start Date

12/30/2024

Completion Date

8/1/2027

Summary

This is a Phase 2 double-blind, randomized, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy, safety, and tolerability of SPN-817 in adults with focal onset seizures.

Detailed Description

This is a Phase 2 double-blind, randomized, placebo-controlled, multicenter, parallel-group study to evaluate the efficacy, safety, and tolerability of SPN-817 administered as an adjunctive treatment in adults with focal onset seizures that have previously failed at least 2 anti-seizure medication (ASM) regimens. Participants will be taking 1 to 4 ASMs, with at least 4 seizures during the 6-week Screening Period. Following the Screening Period, eligible participants will be randomized 2:1 to SPN-817 (3.0-4.0 mg BID) or placebo and begin the Titration Period (8-10 weeks). In both treatment groups, open-label ondansetron (or another concomitant medication to assess pharmacological approaches to managing cholinergic adverse events \[AEs\]) will be taken (8 mg oral \[PO\]) prophylactically approximately 30 minutes before each study medication (SM) dose (ie, BID) during the Titration Period as an antiemetic. After the target dose of 3.0-4.0 mg BID is reached, participants will enter the Maintenance Period (14 weeks). Ondansetron (or another concomitant medication to assess pharmacological approaches to managing cholinergic AEs) may be taken as needed as either a preventative or therapeutic antiemetic during the Maintenance Period. Participants who complete the Maintenance Period will have the opportunity to enroll in a separate open-label study for continued treatment with SPN-817. Participants who do not enroll in the open-label study will undergo a Tapering Period (up to 4 weeks) and a follow-up safety phone call.

Eligibility Criteria

Age Range: 18 years to 70 years

Inclusion Criteria: 1. Diagnosis of treatment-resistant focal epilepsy as adjudicated by the Epilepsy Study Consortium, Inc (ESCI); 2. Failed to achieve sustained seizure freedom after ≥2 tolerated, appropriately chosen, and adequately dosed ASM drug schedules; 3. Able to keep accurate Seizure electronic diaries \[eDiaries\] (with the aid of a caregiver as needed); 4. Has a body mass index (BMI) between 18.0 and 40.0 kg/m2; 5. Treatment with a stable dose of 1 to 4 current ASMs for ≥28 days prior to screening. If following a diet plan along with the ASM, the participant should have been on a stable diet plan for at least 1 month prior to Visit 1. The diet plan should be maintained throughout the duration of the study; 6. At least 4 clinically observable focal onset seizures accepted by the ESCI prior to the first dose of SM (during the days of baseline Seizure electronic diary \[eDiary\] data collection) and no more than a consecutive 21-day period that was free of these seizures. To be eligible for the study, participants must comply with the eDiary on at least 80% of the days of baseline data collection; Exclusion Criteria: 1. Has taken huperzine A within the past 6 months; 2. Prior diagnosis of combined focal and generalized epilepsy syndrome as evidenced by severe developmental delay and multiple seizure types and confirmed by electroencephalography (EEG) (eg, Lennox-Gastaut syndrome). Participants should also be excluded in case of nondiagnostic information; 3. History of or current nonepileptic events that could be confused by the participant and/or study staff as epileptic seizures; 4. Only has seizures that are difficult to count; for example, seizures that are not clinically observable; 5. History of uncountable seizures, such as seizures that happen in a cluster that are too rapid to be counted individually; 6. History of status epilepticus within 6 months prior to screening; 7. Vagus nerve stimulation, deep brain stimulation, responsive neurostimulator system, or other neurostimulation for epilepsy device implanted or activated within 1 year prior to screening; or epilepsy surgery within 1 year prior to screening. Stimulation parameters for devices must have been stable for at least 3 months prior to Screening. Battery change for any epilepsy devices will be allowed; however, stimulation parameters must remain stable during the duration of the study; 8. Any suicidal behavior or suicidal ideation related to item 4 (active suicidal ideation with some intent to act, without specific plan) or item 5 (active suicidal ideation with specific plan and intent) based on the C-SSRS assessment in the 1 year before screening; a suicide attempt in the last 2 years before screening; or more than 1 lifetime suicide attempt; 9. Chronic concomitant therapy with non-ASMs that have potent cholinergic (central or peripheral) or potent central (only) anticholinergic pharmacology. 10. History of \>2 allergic reactions to an ASM or 1 serious hypersensitivity reaction to an ASM; 11. Any other reason which, in the opinion of the Investigator, would prevent the participant from taking part in the study.

Interventions

DRUG

SPN-817

DRUG

Placebo

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Conditions

Focal Onset Seizures

Locations

Xenoscience

Phoenix, Arizona 85004

United States

Banner University Medical Center-Phoenix

Phoenix, Arizona 85006

United States

Center for Neurosciences

Tucson, Arizona 85718

United States

University of Arizona College of Medicine - Tucson

Tucson, Arizona 85724

United States

Clinical Trials, Inc

Little Rock, Arkansas 72205

United States

Clinical Research Institute

Los Angeles, California 90048

United States

Access Community Clinical Trials

Mission Hills, California 91345

United States

University of California, Irvine

Orange, California 92868

United States

Focus Clinical Research

West Hills, California 91307

United States

Yale University

New Haven, Connecticut 06510

United States

Northwest Florida Clinical Research Group, LLC

Gulf Breeze, Florida 32561

United States

Ilumina Medical Research

Kissimmee, Florida 34744

United States

Visionary Investigators Network

Miami, Florida 33133

United States

University of Miami

Miami, Florida 33136

United States

Research Institute of Orlando, LLC

Orlando, Florida 32806

United States

Medsol Clinical Research Center

Port Charlotte, Florida 33952

United States

Cleveland Clinic Florida Martin Health

Port Saint Lucie, Florida 34990

United States

Southern Illinois University School of Medicine

Springfield, Illinois 62702

United States

University of Louisville Physicians

Louisville, Kentucky 40223

United States

Neurocare of Louisiana

Covington, Louisiana 70433

United States

Ochsner Clinic Foundation

New Orleans, Louisiana 70121

United States

Johns Hopkins University

Baltimore, Maryland 21287

United States

Mid Atlantic Epilepsy and Sleep Center

Bethesda, Maryland 20817

United States

Wayne State University - Detroit Medical Center

Detroit, Michigan 48201

United States

Northeast Regional Epilepsy Group - Hackensack

Hackensack, New Jersey 07601

United States

Hackensack Meridian Health Jersey Shore University Medical Center

Neptune City, New Jersey 07753

United States

Albany Medical Center

Albany, New York 12208

United States

Dent Neurologic Institute

Amherst, New York 14226

United States

Northwell Health - Lenox Hill

New York, New York 10021

United States

University of Rochester Medical Center

Rochester, New York 14618

United States

Asheville Neurology Specialists

Asheville, North Carolina 28806

United States

OnSite Clinical Solutions, LLC

Charlotte, North Carolina 28211

United States

Neurology Institute Epilepsy Center of Cleveland Clinic

Cleveland, Ohio 44195

United States

Thomas Jefferson University

Philadelphia, Pennsylvania 19107

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37232

United States

Advanced Neurology Epilepsy and Sleep Center/ANESC Research

El Paso, Texas 79912

United States

Stryde Research

Frisco, Texas 75034

United States

UT Health Houston

Houston, Texas 77030

United States

Medstar Health Research Institute

McLean, Virginia 22101

United States

Royal Brisbane and Women's Hospital

Herston, Queensland 4029

Australia

Royal Adelaide Hospital

Adelaide, South Australia 5000

Australia

Monash Medical Centre

Clayton, Victoria 3168

Australia

St. Vincent's Hospital Melbourne

Fitzroy, Victoria 3065

Australia

The Alfred Hospital

Melbourne, Victoria 3004

Australia

Royal Melbourne Hospital

Parkville, Victoria 3052

Australia

The Perron Institute for Neurological and Translational Science

Nedlands, Western Australia 6009

Australia

University Multiprofile Hospital for Active Treatment Aleksandrovska, Clinic for Neurology Diseases

Sofia, Sofia-Grad 1431

Bulgaria

Multiprofile Hospital for Active Treatment PULS

Blagoevgrad, 2700

Bulgaria

Medical Center (MC) Academica

Pleven, 5809

Bulgaria

Medical Center - Teodora EOOD

Rousse, 7012

Bulgaria

Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum" EAD

Sofia, 1113

Bulgaria

Flash Clinic

Budapest, 1125

Hungary

SE, Idegsebeszeti es Neurointervencios Klinika, Epilepszia Centrum

Budapest, 1145

Hungary

Pratia MCM Kraków

Krakow, Lesser Poland Voivodeship 30-727

Poland

Centrum Medyczne Plejady

Krakow, Maloplski 30-363

Poland

Centrum Medyczne NeuroProtect

Warsaw, Masovian Voivodeship 01-684

Poland

TZ Clinical Research powered by Pratia

Warsaw, Masovian Voivodeship 02-172

Poland

Neurosphera

Warsaw, Masovian Voivodeship 02-952

Poland

Synexus Polska Sp. z o. o. Oddział w Gdyni

Gdynia, Pomeranian Voivodeship 81-537

Poland

Terra Centrum Leczenia

Sopot, Pomeranian Voivodeship 81-735

Poland

NZOZ Wielospacjalistyczna Poradnia Lekarska Synapsis

Katowice, Silesian Voivodeship 40-123

Poland

Novo-Med Zieliński i Wsp. Sp.J.

Katowice, Silesian Voivodeship 40-650

Poland

NZOZ NEUROMED M. and M. Nastaj Spółka Partnerska

Lublin, 20-064

Poland