A Study to Test the Safety and Tolerability of Staccato Alprazolam in Study Participants 12 Years of Age and Older With Stereotypical Prolonged Seizures

• Status: Not yet recruiting
• Trial end date: 2025-08-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of the study is to evaluate the long-term safety and tolerability of Staccato alprazolam.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: UCB Biopharma SRL
• Treatments: Alprazolam

Criteria

Inclusion Criteria:

• Participant must be ≥12 years of age at the time of signing informed consent (or giving assent, where required)

• Participant must have a caregiver ≥18 years of age at the time of signing the informed consent; the caregiver(s) must be a relative, partner, friend, or legally authorized representative (LAR) of the participant, or a person who provides daily care to the participant and has a significant personal relationship with the participant; the caregiver(s) must be able to recognize and observe the participant's seizures

• Participants with an established diagnosis of focal or generalized epilepsy or combined focal and generalized epilepsy with a documented history of stereotypical episodes of prolonged seizures that includes at least 1 of the following:

1. Generalized seizure episodes starting with a flurry of absence seizures or myoclonic seizures with a minimum total duration of 5 minutes

2. Episodes of a focal seizure with a minimum duration of 3 minutes

3. Episodes of a focal seizure or myoclonic seizure for at least 90 seconds followed by a generalized/bilateral tonic-clonic seizure with a minimum total duration of 3 minutes

• Prior to the Screening Visit, participant completed a study using Staccato alprazolam

• Participant has had a documented brain computerized tomography or magnetic resonance imaging review, performed after diagnosis of epilepsy and within the 5 years prior to the Screening Visit, that confirms the absence of a progressive neurological disorder

• Male and female participants:

A male participant must agree to use contraception of the protocol during the Treatment Period and for at least 7 days after the final IMP administration and refrain from donating sperm during this period

A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:

i) Not a woman of childbearing potential (WOCBP) OR ii) A WOCBP who agrees to follow the contraceptive guidance during the Treatment Period and for at least 30 days after the final IMP administration

• Participant is capable of giving signed informed consent (or giving assent, where required), which includes compliance with the requirements and restrictions listed in the ICF, the protocol, and the participant management plan (iPMP). The informed consent form (ICF) or a specific assent form, where required, will be signed and dated by minors

• The participant's caregiver(s) must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the ICF, the protocol, and the iPMP

Exclusion Criteria:

• Participant has a current history of alcohol or drug use disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders 5, within the previous 1 year

• Participant has a known hypersensitivity to any components of the investigational medicinal product (IMP) or comparable drugs (and/or an investigational device) as stated in this protocol or to albuterol (or similar bronchospasm rescue medication if needed to meet country-specific requirements)

• Participant has a diagnosis of atrial fibrillation or mitral stenosis

• Participant has a history of convulsive status epilepticus in the 8 weeks prior to the Screening Visit

• Participant has a history or presence of known nonepileptic seizures which cannot be distinguished from qualifying epileptic seizures

• Participant has a clinically significant known airway hypersensitivity (eg, bronchospasm to known allergens, such as pollen, animals, or food) and/or acute respiratory signs/symptoms (eg, shortness of breath, wheezing on lung auscultation)

• Participant has a clinically significant chronic pulmonary disorder (eg, asthma, chronic obstructive pulmonary disease, restrictive lung diseases [including idiopathic pulmonary fibrosis]) and/or recent history or presence of hemoptysis or pneumothorax

• Participant has ever been diagnosed with asthma (irrespective of current treatment)

• Participant has experienced an upper respiratory tract infection within 4 weeks or bronchitis/pneumonia within 3 months before the Screening Visit

• Participant has a history or presence of acute narrow-angle glaucoma

• Participant has a condition for which oral alprazolam is contraindicated (eg, myasthenia gravis, severe respiratory insufficiency, and sleep apnea syndrome)

• Participant has a history or presence of long QT syndrome, a family history of sudden death due to long QT syndrome, or unexplained syncope

• Participant is taking any drug that is a strong CYP3A4 inhibitor, including azole antifungal agents (ketoconazole and itraconazole) and nefazodone

• Participant is taking any opioids (eg, fentanyl, oxycodone, morphine) or sedative hypnotics on a chronic basis

• Participant is taking nonselective beta blockers (eg, propranolol, nadolol, and timolol) on a chronic basis

• Participant is taking pharmacotherapy/treatment for an active major psychiatric disorder where changes to medications have occurred within the last 4 weeks before the Screening Visit

• Participant has the presence of any sign (clinical or imaging techniques) suggesting rapidly progressing (ie, not expected to stay stable during study participation) brain disorder or brain tumor, as per the Investigator. Stable arteriovenous malformations, meningiomas, or other benign tumors may be acceptable

• Participant has a clinically significant laboratory abnormality that may increase the risk associated with study participation or may interfere with the interpretation of study results, according to the judgment of the Investigator

• Participant has an FEV1 <80 % of predicted forced expiratory volume in 1 second (FEV1) as measured via spirometry at the Screening Visit

• Participant has an oxygen saturation <95 % (or less than normal, in regions of altitude >2500 meters) for greater than 30 seconds during the Screening Visit. In case of an out-of-range result, 1 repeat will be allowed. If the readings are out of range again, the study participant will be excluded

• Participant has >2.0x upper limit of normal (ULN) of any of the following: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), or >1.0xULN total bilirubin (≥1.5xULN total bilirubin if known Gilbert's syndrome or >2.0xULN total bilirubin for liver impairment)

• Participant has current unstable liver or biliary disease per Investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis

• Participant has a QT interval corrected for heart rate (QTc) >450 msec (males), QTc interval >470 msec (females), or QTc interval >480 msec (participants with bundle branch block), PR interval ≥220 msec, or any other clinically significant electrocardiogram (ECG) abnormality according to the Investigator i) The QTc is the QT interval corrected for heart rate according to Fridericia's formula (QTcF). It is either machine-read or manually over-read.

• Participant has a blood pressure (BP) or heart rate (HR) outside the normal range after 5 minutes rest (systolic BP: 90mmHg to 150 mmHg; diastolic BP: 40 mmHg to 95 mmHg; HR: 40 bpm to 100 bpm). In case of an out-of-range result, 1 repeat will be allowed. If the readings are out of range again, the study participant will be excluded