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A Dose Escalation Study of Levetiracetam in the Treatment of Neonatal Seizures
Sponsor: University of California, San Diego
Summary
The main purpose of this study is to determine the maximum safe tolerated dose of LEV in the treatment of neonatal seizures. Our hypothesis is that optimal dosing of Levetiracetam (LEV) to treat neonatal seizures is significantly greater than 60mg/kg. This study will be an open label dose-escalation, preliminary safety and efficacy study. There will be a randomized control treatment component. Infants recognized as having neonatal seizures or as being at risk of developing seizures will be recruited and started on continuous video EEG monitoring (CEEG). Eligibility will be confirmed and consent will be obtained. In the first 2 phases of the study, neurologists will identify neonates with mild-moderate seizure burden (less than 8 minutes cumulative seizure activity per hour), appropriate for study with LEV, and exclude patients with higher seizure burden where treatment with PHB is more appropriate. Phase 3 of the dose escalation will only proceed if additional efficacy of LEV has been demonstrated in phases 1 and 2. In Phase 3 we will recruit neonates with seizures of greater severity up to 30 minute seizure burden/hour. This will make the final results of study more generalizable. If seizures are confirmed, enrolled subjects will receive 60mg/kg of LEV. Subjects whose seizures persist or recur 15 minutes after the first infusion is complete, subjects will then be randomized in the dose escalation study. Patients in the dose escalation study will be randomly assigned to receive either higher dose LEV or treatment with the control drug PHB in a 3:1 allocation ratio, stratified by site. Funding Source- FDA OOPD
Official title: A Phase IIb Dose Escalation Study of Levetiracetam for the Treatment of Neonatal Seizures
Key Details
Gender
All
Age Range
Any - 1 Month
Study Type
INTERVENTIONAL
Enrollment
133
Start Date
2023-03-24
Completion Date
2027-12-31
Last Updated
2025-10-31
Healthy Volunteers
No
Interventions
Levetiracetam Injection
Neonates will be treated with intravenous levetiracetam 60mg/kg for first line management of seizures, and if seizures persist will be randomized to receive higher dose Levetiracetam or standard of care phenobarbital
Phenobarbital Sodium Injection
Standard of care for neonatal seizures
Locations (5)
University of California, San Diego
San Diego, California, United States
University of Minnesota
Minneapolis, Minnesota, United States
Auckland City Hospital
Auckland, Auckland, New Zealand
Middlemore Hospital
Auckland, Auckland, New Zealand
Capital and Coast District Health Board, Te Whatu Ora, Health New Zealand
Wellington, Wellington Region, New Zealand