Open-label Study of Cenobamate Monotherapy in Adult Subjects With Newly Diagnosed or Recurrent Partial-Onset Epilepsy

Last updated: March 25, 2025
Sponsor: SK Life Science, Inc.
Overall Status: Active - Recruiting

Phase

4

Condition

Epilepsy

Treatment

Cenobamate

Clinical Study ID

NCT06453213
YKP3089C049
  • Ages 18-74
  • All Genders

Study Summary

Cenobamate (YKP3089) is a small molecule approved in the United States (US), Europe and several other countries around the world for the treatment of Partial-Onset (focal) seizures in adult subjects (≥18 years of age). In the US it is approved for use as monotherapy, however, there is little clinical data assessing its use as monotherapy in adults with POS. This study is designed to explore the effectiveness of doses of 100 mg/day and 200 mg/day as monotherapy in adult subjects with newly diagnosed or recurrent POS/focal onset epilepsy.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Be considered reliable and willing to be available for the study period and are ableto record seizures and report adverse events (AEs) himself/herself or have acaregiver who can record seizures and report AEs for them.

  2. Male or female subjects 18-74 years of age with a diagnosis of partial-onsetseizures (POS) according to the 2017 ILAE Classification of Epileptic Seizures.Diagnosis will be established by clinical history and an electroencephalogram (EEG)consistent with POS. Subjects with a normal EEG could be included provided they metthe other diagnostic criteria according to clinical history.

  3. Subjects who are newly diagnosed or have recurrent epilepsy and have experienced:

  4. At least 2 unprovoked seizures (at least >24 hours apart) within the 1 yearprior to Day 1 of the Treatment Period, of which, at least 1 unprovoked seizure (but below 20 seizures) occurred in the 12 weeks prior to Day 1 of theTreatment Period.OR

  5. 1 unprovoked seizure within the 12 weeks prior to Day 1 of the Treatment Periodwith concomitant information to support an increased risk (>60%) of a secondseizure. In the absence of clear information about recurrence risk, or evenknowledge of such information, the default definition of epilepsy originates atthe second unprovoked seizure. Subjects who are newly diagnosed and have been prescribed a low dose of 1 ASM for ≤12 weeks can be included if the other ASM can be safely down-titrated/discontinuedper Investigator discretion within 6 weeks after the 1st dose of cenobamate. Forsubjects with recurrent epilepsy, they must have relapsed at least 6 months afterthe end of the last ASM treatment but can have been prescribed a low dose of 1 ASMfor ≤12 weeks if the other ASM can be safely down-titrated/discontinued perInvestigator discretion within 6 weeks after the 1st dose of cenobamate.

  6. Female subjects are either not of childbearing potential, defined as premenarchal,postmenopausal for at least 1 year or surgically sterile (bilateral tubal ligation,bilateral oophorectomy, or hysterectomy), if of childbearing potential, must complywith an acceptable method of birth control during the study, for at least 4 weeksprior to study entry and for 2 weeks after last dose of study drug.

  7. Subject and/or caregiver(s)/legal representative must be willing and able to giveinformed assent/consent for participation in the study.

  8. Subject and their caregiver must be willing and able (in the investigator's opinion)to comply with all study requirements.

Exclusion

Exclusion Criteria:

  1. Subjects who have only simple partial-onset seizures (focal aware seizures) withoutmotor signs.

  2. Subjects who have seizure clusters where individual seizures cannot be counted.

  3. Subjects who present with or have a history of Lennox-Gastaut syndrome.

  4. Subjects who have a history of status epilepticus that required hospitalizationwithin 1 year prior to Day 1 of the Treatment Period.

  5. Subjects who have a history of psychogenic non-epileptic seizures within 2 yearsprior to Day 1 of the Treatment Period.

  6. Subjects who have a history of active suicidal ideation within the last 6 months orsuicide attempt within 2 years prior to Day 1 of Treatment Period.

  7. Evidence of clinically significant disease (eg, cardiac, respiratory,gastrointestinal, psychiatric, other neurological) that in the opinion of theinvestigator(s) could affect the subject's safety or interfere with the studyassessments.

  8. History of Familial Short QT syndrome or prior subject diagnosis of Short QTsyndrome.

  9. Evidence of clinically significant active renal or hepatic disease.

  10. Subjects taking a strong CYP3A inducer such as phenytoin, phenobarbital,carbamazepine, or rifampin within 12 weeks prior to the Pretreatment Period unlessemergency care was needed due to the subject experiencing status epilepticus,uncontrolled seizures, or clusters of seizures.

  11. Subjects who are taking more than one of the following centrally acting drugs:antipsychotic, antidepressant, or anxiolytic. The dose should be stable for the 12weeks prior to the Pretreatment Period.

  12. Subjects who have a history of any type of surgery for brain or central nervoussystem within 1 year prior to the Pretreatment Period.

  13. Subjects who have a history of receiving any ASM (including ASM used as rescuetreatment and ASMs used for indications other than epilepsy) for more than 12 weeksin total within 6 months prior to Day 1 of the Treatment Period.

  14. Subjects who have used intermittent rescue medicine on 2 or more occasions within 12weeks before the Pretreatment Period (1 to 2 doses over a 24-hour period consideredone-time rescue).

  15. Subjects who have a history of receiving any ASM polytherapy (> 2 ASMs takenconcurrently) during a previous episode of epilepsy.

  16. Previous exposure to cenobamate or sensitivity/allergy to components of the oraltablets.

  17. Subjects who have a history of drug or alcohol dependency or abuse within the last 2years before the Pretreatment Period.

  18. Subjects who have had multiple drug allergies or a severe drug reaction, includingdermatological (eg, DRESS syndrome, Stevens-Johnson syndrome), hematological, ororgan toxicity reactions.

  19. Females who are breastfeeding or pregnant or planning to get pregnant in thePretreatment Period or during the conduct of the study.

  20. Subjects who have participated in a study involving administration of aninvestigational drug or device within 4 weeks before Visit 1, or withinapproximately 5 half-lives of the previous investigational compound, whichever islonger.

  21. Subjects with dementia.

  22. Subjects who have seizures due to a progressive CNS condition.

Study Design

Total Participants: 90
Treatment Group(s): 1
Primary Treatment: Cenobamate
Phase: 4
Study Start date:
October 14, 2024
Estimated Completion Date:
July 09, 2027

Study Description

This is an uncontrolled, single-arm, open-label, Phase IV study conducted at approximately 40 sites in the US. It will consist of the following Periods:

  1. Pretreatment Period (up to 21 days)

  2. 100 mg/day Treatment Period (6-week Titration Phase, 26-week Maintenance Phase)

  3. 200 mg/day Treatment Period (2-week Titration Phase, 26-week Maintenance Phase)

  4. 26-week Optional Extension Period

  5. Follow Up Period (4 weeks)

Pretreatment Period At the screening visit (Visit 1) the investigator will obtain informed consent and assess the subject for their eligibility to participate in the study. The investigator will review any available hematology, chemistry blood tests, and ECGs. Vital signs and routine physical and neurological exam will be performed.

100 mg/day Treatment Period Subjects who complete screening and meet the inclusion/exclusion criteria begin the 32-week Treatment Period which includes a 6-week Titration Phase and a 26-week Maintenance Phase. During the Titration Phase subjects will be treated with cenobamate 12.5 mg/day for two weeks, 25 mg/day for two weeks and 50 mg/day for two weeks. Subjects tolerating cenobamate at the end of the Titration Phase will continue treatment with 100 mg/day in the Maintenance Phase for 26 weeks. At the end of the Maintenance Phase, the subject will have the option of continuing on in a 26-week Extension Period or discontinuing cenobamate. Subjects who experience a certain type of seizure during the 100 mg/day Maintenance Phase (with or without rescue medication use) will transition to the 200 mg/day Treatment Period.

200 mg/day Treatment Period: The 200 mg/day Treatment Period consists of a 2-week Titration Phase and a 26-week Maintenance Phase. During the 2-week Titration Phase, subjects will receive cenobamate 150 mg/day before entering the 26-week 200 mg/day Maintenance Phase. At the end of the Maintenance Phase, the subject will have the option of continuing on in a 26-week Extension Period or discontinuing cenobamate. If the subject experiences a certain type of seizure at 200 mg/day during the Maintenance Phase, then they will be discontinued from the study.

Optional Extension Period:

An Optional Extension Period will last 26 weeks. During the Optional Extension Period, Visits will occur at 13th week (Day 315/287a, Visit 8/8a) and 26th week (Day 406/378a, Visit 9/9a) to record vital signs and identify adverse events and occurrence of a seizure using a seizure diary. If a certain type of seizure occurs during the Optional Extension Period, the subject will be discontinued from the study.

Follow-up Period:

If a subject prematurely discontinues from the study, is not continuing into the Optional Extension Period or completes the last visit in the Optional Extension Period, cenobamate should either be discontinued or will be titrated down by 50% for two weeks and then discontinued depending on the current dose. A follow-up visit should occur two weeks after the date of cenobamate discontinuation except in specific circumstances.

Connect with a study center

  • Arizona Neuroscience Research

    Phoenix, Arizona 85032
    United States

    Active - Recruiting

  • Center For Neurosciences

    Tucson, Arizona 85718
    United States

    Active - Recruiting

  • Clinical Trials Inc

    Little Rock, Arkansas 72205
    United States

    Active - Recruiting

  • Rancho Los Amigos National Rehabilitation Center

    Downey, California 90242
    United States

    Active - Recruiting

  • Neuro Pain Medical Center

    Fresno, California 93710
    United States

    Active - Recruiting

  • Hoag Physician Partners

    Newport Beach, California 92663
    United States

    Active - Recruiting

  • Hartford Hospital

    Hartford, Connecticut 06102
    United States

    Active - Recruiting

  • Yale School of Medicine - Yale-New Haven Hospital

    New Haven, Connecticut 06519
    United States

    Active - Recruiting

  • The George Washington University Hospital

    Washington, District of Columbia 20037
    United States

    Active - Recruiting

  • Neurology Consultants of Central Florida

    Kissimmee, Florida 34741
    United States

    Active - Recruiting

  • Elite Clinical Research

    Miami, Florida 33144
    United States

    Active - Recruiting

  • Serenity Research Center

    Miami, Florida 33176
    United States

    Active - Recruiting

  • Knight Neurology

    Rockledge, Florida 32955
    United States

    Active - Recruiting

  • Augusta University

    Augusta, Georgia 30912
    United States

    Site Not Available

  • Consultants In Epilepsy and Neurology

    Boise, Idaho 83702
    United States

    Active - Recruiting

  • RUSH Neurology Epilepsy

    Chicago, Illinois 60612
    United States

    Site Not Available

  • Southern Illinois University School of Medicine

    Springfield, Illinois 62702
    United States

    Site Not Available

  • The University of Kansas Hospital

    Kansas City, Kansas 66160
    United States

    Site Not Available

  • Bluegrass Epilepsy Research LLC

    Lexington, Kentucky 40504
    United States

    Active - Recruiting

  • New England Institute for Clinical Research

    Chalmette, Louisiana 70043
    United States

    Active - Recruiting

  • Louisiana State University Health Sciences

    Shreveport, Louisiana 71103
    United States

    Active - Recruiting

  • John Hopkins Epilepsy Center

    Baltimore, Maryland 21287
    United States

    Active - Recruiting

  • Midatlantic Epilepsy and Sleep Center

    Bethesda, Maryland 20817
    United States

    Active - Recruiting

  • Neurology Center of New England P.C.

    Foxboro, Massachusetts 02035
    United States

    Active - Recruiting

  • Henry Ford Health System

    Detroit, Michigan 48202
    United States

    Active - Recruiting

  • Wayne Neurology PLC

    Plymouth, Michigan 48170
    United States

    Active - Recruiting

  • Minnesota Epilepsy Group

    Roseville, Minnesota 55113
    United States

    Active - Recruiting

  • University of Missouri Health Care

    Columbia, Missouri 65212
    United States

    Site Not Available

  • Northeast Regional Epilepsy Group

    Hackensack, New Jersey 07601
    United States

    Active - Recruiting

  • Overlook Medical Center

    Summit, New Jersey 07901
    United States

    Site Not Available

  • Mount Sinai Hospital

    New York, New York 10029
    United States

    Site Not Available

  • NY Neurology Associates

    New York, New York 10003
    United States

    Active - Recruiting

  • Ohio Health Research Institute

    Columbus, Ohio 43214
    United States

    Site Not Available

  • Thomas Jefferson University

    Philadelphia, Pennsylvania 19107
    United States

    Active - Recruiting

  • Allegheny Neurological Associates

    Pittsburgh, Pennsylvania 15212
    United States

    Site Not Available

  • ClinSearch, LLC

    Chattanooga, Tennessee 37421
    United States

    Site Not Available

  • Vanderbilt Epilepsy Clinic

    Nashville, Tennessee 37232
    United States

    Active - Recruiting

  • Northwest Houston Neurology

    Cypress, Texas 77429
    United States

    Active - Recruiting

  • DHR Health Institute for Research and Development

    Edinburg, Texas 78539
    United States

    Active - Recruiting

  • University of Utah

    Salt Lake City, Utah 84132
    United States

    Site Not Available

  • Virginia Epilepsy and Neurodevelopmental Clinic

    Winchester, Virginia 22601
    United States

    Active - Recruiting

  • Froedtert and The Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Site Not Available

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