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NOT YET RECRUITING
NCT07281027
PHASE3

COMparison Between Anakinra and Tocilizumab in NORSE - "COMBAT-NORSE"

Sponsor: Yale University

View on ClinicalTrials.gov

Summary

The goal of this clinical trial is to find out whether two existing medications-anakinra and tocilizumab-can effectively treat a rare and life-threatening brain condition called NORSE (New-Onset Refractory Status Epilepticus). NORSE causes continuous seizures in previously healthy children and adults and does not respond to standard treatments. It often leads to long-term disability or death. Doctors currently use anakinra and tocilizumab as second-line treatments when first-line therapies fail, but there is no clear evidence showing which drug works better or when it should be given. This study aims to answer those questions. The study will enroll patients across 33 hospitals in the United States, Canada, Europe, and Asia. It includes two groups: 1. Randomized Cohort Patients will be randomly assigned to receive either anakinra or tocilizumab within the first 7 days of their illness. Only patients whose doctors were already planning to use one of these medications as part of standard care will be eligible for randomization. Researchers will monitor their recovery and compare outcomes between the two treatments. 2. Observational Cohort Patients who cannot be randomized-usually because they were diagnosed too late-will still be followed to study how the timing of treatment affects recovery. Participants will: * Receive one of the two medications (depending on their group assignment). * Take part in follow-up assessments over the course of one year, including medical evaluations and surveys. Some participants may be followed annually beyond one year. * Optionally participate in a 60-minute interview to share their or their caregiver's experience with NORSE.

Official title: Comparing the Effects of Anakinra and Tocilizumab on Outcomes in Patients With New-Onset Refractory Status Epilepticus

Key Details

Gender

All

Age Range

2 Years - Any

Study Type

INTERVENTIONAL

Enrollment

438

Start Date

2026-03-01

Completion Date

2030-09-30

Last Updated

2025-12-15

Healthy Volunteers

No

Interventions

DRUG

Anakinra

SOC will be followed , Suggested Dose: 10 mg/kg/day IV, divided into 4 daily doses (q6h) Maximum dose: 400 mg/day

DRUG

Tocilizumab

SOC will be followed, Suggested Dose: If \<30 kg: 12 mg/kg IV once every 2 weeks If ≥30 kg: 8 mg/kg IV once every 2 weeks Maximum dose: 800 mg per dose

OTHER

Standard medical treatment

For patients who could not be randomized by day 7, standard clinical care will be followed and patients will be followed prospectively and observationally.

Locations (33)

Barrow Institute

Phoenix, Arizona, United States

Children's Hospital Colorado

Aurora, Colorado, United States

Yale New Haven Hospital

New Haven, Connecticut, United States

Children's National (DC)

Washington D.C., District of Columbia, United States

University of Florida

Gainesville, Florida, United States

University of Chicago

Chicago, Illinois, United States

Northwestern University

Evanston, Illinois, United States

Mass General (MGH)

Boston, Massachusetts, United States

Beth Israel Deaconess

Boston, Massachusetts, United States

Boston Children's Hospital

Boston, Massachusetts, United States

Mayo Clinic

Rochester, Minnesota, United States

University of Nebraska

Lincoln, Nebraska, United States

New York University

New York, New York, United States

Columbia University

New York, New York, United States

Mount Sinai (NY)

New York, New York, United States

University of Cincinnati

Cincinnati, Ohio, United States

Cleveland Clinic

Cleveland, Ohio, United States

Oregon Health and Science University

Portland, Oregon, United States

Children's Hospital Philadelphia (CHOP)

Philadelphia, Pennsylvania, United States

University of Pennsylvania

Philadelphia, Pennsylvania, United States

UT Southwestern Medical Center

Dallas, Texas, United States

Baylor/Texas Children's

Houston, Texas, United States

Seattle Children's Hospital

Seattle, Washington, United States

University of Wisconsin

Madison, Wisconsin, United States

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Western University

London, Canada

Hospital for Sick Children

Toronto, Canada

Salpêtrière

Paris, France

University of Modena

Modena, Italy

Seoul National University Hospital

Seoul, South Korea

Karolinska Institute

Stockholm, Sweden

Great Ormond Street Hospital

London, United Kingdom

King's College

London, United Kingdom