ClinicalTrials.gg
CompletedNCT00319501Updated Sep 23, 2016Results posted

Efficacy and Safety of Diazepam in the Management of Refractory Epilepsy in Selected Patients Who Require Intermittent Medical Intervention for Acute Repetitive Seizures.

A Phase 3 interventional study of Placebo and Vanquix Auto-Injector (Diazepam Injection) in Seizures, Epilepsies, Partial and Epilepsy, Complex Partial, sponsored by Pfizer. Completed at 86 sites in United States. Open to participants aged 2 Years and older. Per ClinicalTrials.gov, last updated 2016-09-23.

Sponsored by Pfizer · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
234
Allocation
Randomized
Ages
2 Years and older
Sex
All
01

Study summary

To evaluate the efficacy and safety of diazepam in the management of refractory epilepsy in selected patients who require intermittent medical intervention for the control of episodes of acute repetitive seizures. In addition, to assess the support provided by caregivers who are not themselves or not under the direct supervision of health care professionals at the time of administration.

02

Conditions studied

  • Seizures
  • Epilepsies, Partial
  • Epilepsy, Complex Partial
  • Epilepsy, Generalized
  • Epilepsy

Keywords

  • Acute Repetitive Seizures
  • ARS
  • Diazepam
  • Cluster Seizures
03

In context

Seizures

766 studies on the registry are indexed under Seizures; 136 are open to participants now.

This study's enrollment of 234 is above the median of 64 across 519 interventional studies indexed under Seizures.

Browse Seizures studies →

Lead sponsor

Pfizer is the lead sponsor of 3,334 studies on the registry; 149 are open to participants now.

Of its 601 completed or terminated interventional studies of FDA-regulated products, 391 (65%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Key Inclusion Criteria

For Patient:

  • Older than 2 years of age and between 6 and 136 kg body weight
  • Recipient of clinical diagnosis of epilepsy, taking a stable antiepileptic drug regimen for at least 2 weeks, and requiring intermittent medical intervention to control episodes of acute repetitive seizures (ARS)
  • Experienced at least 2 episodes of ARS in previous year, one of which occurred in previous 6 months
  • Has episodes of ARS that include complex partial or generalized seizures
  • Has a responsible caregiver available to participate
  • Is not pregnant or lactating and is practicing an acceptable method of .

For Caregiver:

  • Age of 18 years or older and has demonstrated responsibility as a caregiver through training to:

    • Recognize an episode of repetitive seizures for which the injection was intended,
    • Administer study drug
    • Count and record seizures and respiratory rate in the patient diary,
    • Monitor the patient and record observations in the patient diary for 12 hours following study drug treatment
    • Recognize the need for immediate medical attention.

Key Exclusion Criteria

For Patient:

  • Petit mal status or petit mal variant status
  • History of ARS consistently progressing to status epilepticus
  • History of failure to respond to benzodiazepine treatment
  • to diazepam
  • Acute narrow angle glaucoma
  • Alcohol and/or other substance abuse
  • Has taken another drug in previous 30 days
  • Acute or progressive neurologic or severe psychiatric disease or severe mental abnormality.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
234 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    During the Double-blind Period, participants received a single, age- and weight-appropriate dose of placebo solution as a deep intramuscular injection in the mid to outer thigh. Drug was administered by a caregiver using a spring-driven, pressure-activated, prefilled autoinjector at the onset of an episode of acute repetitive seizures (ARS).

    Drug: Placebo

  • Experimental
    Diazepam

    During the Double-blind Period, participants received a single, age- and weight-appropriate dose of diazepam solution, ranging from 0.2 to 0.5 mg/kg, as a deep intramuscular injection in the mid to outer thigh. Additional doses were permissible during the Open-label Period. Drug was administered by a caregiver using a spring-driven, pressure-activated, prefilled autoinjector at the onset of an episode of ARS.

    Drug: Vanquix Auto-Injector (Diazepam Injection)

Interventions

  • DrugPlacebo

    Intramuscular autoinjector; administered at onset of an episode

  • Intramuscular autoinjector: 5, 10, 15, or 20 mg (based on participant's age and weight); administered at the onset of an episode

06

What researchers measure

Primary outcomes

  1. Time to Next Seizure or Rescue Medication During the Double-blind Period (Kaplan-Meier 50th Percentile)

    An event was defined as an episode of or required rescue medication for an episode of acute repetitive seizures (ARS) within 15 minutes to 12 hours following study drug administration. Patients without an ARS event were censored at 12 hours. Diaries were provided; if no diary was returned, or the diary did not provide answers to questions about seizures and rescue during the 12-hour follow-up period, the patient was considered censored as of 15 minutes past the treatment time, unless another contact was documented. If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the ARS episode. Patients and their caregivers were trained to recognize the onset of an episode of ARS and when and how to administer study drug.

    Time frame: From 15 minutes to 12 hours after study drug administration for an episode of ARS during the Double-blind Period

  2. Percentage of Participants With an Event (Next Seizure or Rescue Medication) During the Open-label Period

    An event was defined as an episode of or required rescue medication for an episode of acute repetitive seizures (ARS) within 15 minutes to 12 hours following study drug administration. Patients without an ARS event were censored at 12 hours. Diaries were provided; if no diary was returned, or the diary did not provide answers to questions about seizures and rescue during the 12-hour follow-up period, the patient was considered censored as of 15 minutes past the treatment time, unless another contact was documented. If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the ARS episode. Patients and their caregivers were trained to recognize the onset of an episode of ARS and when and how to administer study drug.

    Time frame: From 15 minutes to 12 hours after study drug administration for an episode of ARS during the Double-blind Period

Secondary outcomes

  1. Number of Participants Requiring Rescue Medication During the Double-blind Period

    If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the acute repetitive seizure (ARS) episode. Each patient's specific criteria for seizure and an episode of ARS were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug. An episode of ARS was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: From 15 minutes to 12 hours following study drug administration for an episode of ARS during the Double-blind Period

  2. Number of Participants Requiring Emergency Department Visits During the Double-blind Period

    Any use of emergency treatment (such as an emergency room visit) was recorded in the patient's diary, along with the date, time, and reason for the emergency treatment. Emergency department visits required some type of rescue action taken, other than the visit itself. An episode of acute repetitive seizures (ARS) was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: From 15 minutes to 12 hours following study drug administration for onset of an episode of ARS during the Double-blind Period

  3. Number of Participants Requiring Rescue Medical Care Other Than Rescue Medication or Emergency Department Visits During the Double-blind Period

    Other rescue medical care consisted of care other than rescue medication or emergency department visits. Each patient's specific criteria for seizure and an episode of acute repetitive seizure (ARS) were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug. An episode of ARS was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: From 15 minutes to 12 hours following study drug administration for an episode of ARS during the Double-blind Period

  4. Mean Score on Caregiver Global Treatment Assessment During the Double-blind Period

    Caregiver global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes and is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) is defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: Assessments completed at the end of each treated episode of ARS in the Double-blind Period

  5. Mean Score on Physician Global Treatment Assessment During the Double-blind Period

    Physician global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes. The physician global evaluation is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: At Visit 2 and subsequent visits in the Double-blind Period

  6. Number of Participants Requiring Rescue Medication During the Open-label Period

    Each patient's specific criteria for seizure and an episode of acute repetitive seizure (ARS) were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug. If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the ARS episode.

    Time frame: From 15 minutes to 12 hours after study drug administration during the Open-label Period

  7. Number of Participants Requiring Emergency Department Visits During the Open-label Period

    Any use of emergency treatment (such as an emergency room visit) was recorded in the patient's diary, along with the date, time, and reason for the emergency treatment. Emergency department visits required some type of rescue action taken, other than the visit itself.

    Time frame: From 15 minutes to 12 hours after study drug administration for onset of an episode of ARS during the Open-label Period

  8. Number of Participants Requiring Rescue Medical Care Other Than Medication or Emergency Department Visits During the Open-label Period

    Other rescue medical care consisted of care other than rescue medication or emergency department visits. Each patient's specific criteria for seizure and an episode of acute repetitive seizure (ARS) were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug.

    Time frame: From 15 minutes to 12 hours after study drug administration for onset of an episode of ARS during the Open-label Period

  9. Mean Score on Caregiver Global Treatment Assessment During the Open-label Period

    Caregiver global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes and is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) is defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: Assessments completed at the end of each treated episode of ARS in the Open-label Period

  10. Mean Score on Physician Global Treatment Assessment During the Open-label Period

    Physician global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes and is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) is defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

    Time frame: From Visit 2 and subsequent visits in the Open-label Period to discharge or study termination

07

Results

Posted Aug 16, 2016

Participant flow

Double-blind Period
Participant flow — Double-blind Period
MilestoneDiazepamPlacebo
Started124110
Received treatment8281
Completed8178
Not completed4332
Withdrew: Withdrawal by subject03
Withdrew: Sponsor request10
Withdrew: Did not receive treatment4229
Open-label Period
Participant flow — Open-label Period
MilestoneDiazepamPlacebo
Started1610
Received treatment1280
Completed450
Not completed1160
Withdrew: Adverse event50
Withdrew: Protocol violation60
Withdrew: Withdrawal by subject380
Withdrew: Principal investigator decision60
Withdrew: Sponsor request120
Withdrew: Lost to follow-up50
Withdrew: Did not receive treatment330
Withdrew: Other110
Open-label Extension Period
Participant flow — Open-label Extension Period
MilestoneDiazepamPlacebo
Started510
Received treatment330
Completed00
Not completed510
Withdrew: Adverse event20
Withdrew: Did not receive treatment180
Withdrew: Other10
Withdrew: Principal investigator decision20
Withdrew: Sponsor request260
Withdrew: Withdrawal by subject20

Outcome measures

PrimaryTime to Next Seizure or Rescue Medication During the Double-blind Period (Kaplan-Meier 50th Percentile)

An event was defined as an episode of or required rescue medication for an episode of acute repetitive seizures (ARS) within 15 minutes to 12 hours following study drug administration. Patients without an ARS event were censored at 12 hours. Diaries were provided; if no diary was returned, or the diary did not provide answers to questions about seizures and rescue during the 12-hour follow-up period, the patient was considered censored as of 15 minutes past the treatment time, unless another contact was documented. If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the ARS episode. Patients and their caregivers were trained to recognize the onset of an episode of ARS and when and how to administer study drug.

Time frame:
From 15 minutes to 12 hours after study drug administration for an episode of ARS during the Double-blind Period
Reported as:
Median · Hours
Time to Next Seizure or Rescue Medication During the Double-blind Period (Kaplan-Meier 50th Percentile)
HoursDiazepamPlacebo
Time to Next Seizure or Rescue Medication During the Double-blind Period (Kaplan-Meier 50th Percentile)5.92 (2.28 to NA)NA (NA to NA)
Statistical analysis
  • Diazepam · Cox Proportional Hazard · p = 0.012 (p-value is adjusted. All statistical tests were 2-sided and employed a level of significance of alpha=0.05.) · Hazard ratio (hr): 0.55 · 95% CI 0.34 to 0.88Age adjusted
PrimaryPercentage of Participants With an Event (Next Seizure or Rescue Medication) During the Open-label Period

An event was defined as an episode of or required rescue medication for an episode of acute repetitive seizures (ARS) within 15 minutes to 12 hours following study drug administration. Patients without an ARS event were censored at 12 hours. Diaries were provided; if no diary was returned, or the diary did not provide answers to questions about seizures and rescue during the 12-hour follow-up period, the patient was considered censored as of 15 minutes past the treatment time, unless another contact was documented. If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the ARS episode. Patients and their caregivers were trained to recognize the onset of an episode of ARS and when and how to administer study drug.

Time frame:
From 15 minutes to 12 hours after study drug administration for an episode of ARS during the Double-blind Period
Reported as:
Number · Percentage of participants
Percentage of Participants With an Event (Next Seizure or Rescue Medication) During the Open-label Period
Percentage of participantsDiazepam
Percentage of Participants With an Event (Next Seizure or Rescue Medication) During the Open-label Period22.4 (NA to NA)
SecondaryNumber of Participants Requiring Rescue Medication During the Double-blind Period

If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the acute repetitive seizure (ARS) episode. Each patient's specific criteria for seizure and an episode of ARS were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug. An episode of ARS was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
From 15 minutes to 12 hours following study drug administration for an episode of ARS during the Double-blind Period
Reported as:
Number · Participants
Number of Participants Requiring Rescue Medication During the Double-blind Period
ParticipantsDiazepamPlacebo
Number of Participants Requiring Rescue Medication During the Double-blind Period1424
Statistical analysis
  • Diazepam · Fisher Exact · p = 0.066 (p-value is unadjusted. All statistical tests were 2-sided and employed a level of significance of alpha=0.05.)
SecondaryNumber of Participants Requiring Emergency Department Visits During the Double-blind Period

Any use of emergency treatment (such as an emergency room visit) was recorded in the patient's diary, along with the date, time, and reason for the emergency treatment. Emergency department visits required some type of rescue action taken, other than the visit itself. An episode of acute repetitive seizures (ARS) was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
From 15 minutes to 12 hours following study drug administration for onset of an episode of ARS during the Double-blind Period
Reported as:
Number · Participants
Number of Participants Requiring Emergency Department Visits During the Double-blind Period
ParticipantsDiazepamPlacebo
Number of Participants Requiring Emergency Department Visits During the Double-blind Period24
Statistical analysis
  • Diazepam · Fisher Exact · p = 0.443
SecondaryNumber of Participants Requiring Rescue Medical Care Other Than Rescue Medication or Emergency Department Visits During the Double-blind Period

Other rescue medical care consisted of care other than rescue medication or emergency department visits. Each patient's specific criteria for seizure and an episode of acute repetitive seizure (ARS) were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug. An episode of ARS was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
From 15 minutes to 12 hours following study drug administration for an episode of ARS during the Double-blind Period
Reported as:
Number · Participants
Number of Participants Requiring Rescue Medical Care Other Than Rescue Medication or Emergency Department Visits During the Double-blind Period
ParticipantsDiazepamPlacebo
Number of Participants Requiring Rescue Medical Care Other Than Rescue Medication or Emergency Department Visits During the Double-blind Period02
Statistical analysis
  • Diazepam · Fisher Exact · p = 0.245 (p-value is unadjusted. All statistical tests were 2-sided and employed a level of significance of alpha=0.05.)
SecondaryMean Score on Caregiver Global Treatment Assessment During the Double-blind Period

Caregiver global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes and is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) is defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
Assessments completed at the end of each treated episode of ARS in the Double-blind Period
Reported as:
Mean · Units on a scale
Mean Score on Caregiver Global Treatment Assessment During the Double-blind Period
Units on a scaleDiazepamPlacebo
Mean Score on Caregiver Global Treatment Assessment During the Double-blind Period6.2 ± 2.795.5 ± 2.86
Statistical analysis
  • Diazepam · ANOVA · p = 0.086 (p-Value is unadjusted. All statistical tests were 2-sided and employed a level of significance of alpha = 0.05.) · Difference in least square means: 0.75 · 95% CI -0.11 to 1.61Model included treatment and age category.
SecondaryMean Score on Physician Global Treatment Assessment During the Double-blind Period

Physician global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes. The physician global evaluation is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) was defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
At Visit 2 and subsequent visits in the Double-blind Period
Reported as:
Mean · Units on a scale
Mean Score on Physician Global Treatment Assessment During the Double-blind Period
Units on a scaleDiazepamPlacebo
Mean Score on Physician Global Treatment Assessment During the Double-blind Period6.3 ± 2.455.5 ± 2.69
Statistical analysis
  • Diazepam · ANOVA · p = 0.045 (p-value is unadjusted. All statistical tests were 2-sided and employed a level of significance of alpha=0.05.) · Difference in least square means: 0.79 · 95% CI 0.02 to 1.56Model included treatment and age category.
SecondaryNumber of Participants Requiring Rescue Medication During the Open-label Period

Each patient's specific criteria for seizure and an episode of acute repetitive seizure (ARS) were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug. If seizure control following study drug administration was inadequate, diazepam rectal gel was provided as a rescue medication, given only in the first 4 hours after study drug administration and only if the caregiver was directed to do so by the Investigator or designee at the time of the ARS episode.

Time frame:
From 15 minutes to 12 hours after study drug administration during the Open-label Period
Reported as:
Number · Participants
Number of Participants Requiring Rescue Medication During the Open-label Period
ParticipantsDiazepam
Number of Participants Requiring Rescue Medication During the Open-label Period39
SecondaryNumber of Participants Requiring Emergency Department Visits During the Open-label Period

Any use of emergency treatment (such as an emergency room visit) was recorded in the patient's diary, along with the date, time, and reason for the emergency treatment. Emergency department visits required some type of rescue action taken, other than the visit itself.

Time frame:
From 15 minutes to 12 hours after study drug administration for onset of an episode of ARS during the Open-label Period
Reported as:
Number · Participants
Number of Participants Requiring Emergency Department Visits During the Open-label Period
ParticipantsDiazepam
Number of Participants Requiring Emergency Department Visits During the Open-label Period13
SecondaryNumber of Participants Requiring Rescue Medical Care Other Than Medication or Emergency Department Visits During the Open-label Period

Other rescue medical care consisted of care other than rescue medication or emergency department visits. Each patient's specific criteria for seizure and an episode of acute repetitive seizure (ARS) were determined by the Investigator. Patients and their caregivers were trained to use these criteria to recognize the onset of an episode of ARS and when and how to administer study drug.

Time frame:
From 15 minutes to 12 hours after study drug administration for onset of an episode of ARS during the Open-label Period
Reported as:
Number · Participants
Number of Participants Requiring Rescue Medical Care Other Than Medication or Emergency Department Visits During the Open-label Period
ParticipantsDiazepam
Number of Participants Requiring Rescue Medical Care Other Than Medication or Emergency Department Visits During the Open-label Period5
SecondaryMean Score on Caregiver Global Treatment Assessment During the Open-label Period

Caregiver global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes and is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) is defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
Assessments completed at the end of each treated episode of ARS in the Open-label Period
Reported as:
Mean · Units on a scale
Mean Score on Caregiver Global Treatment Assessment During the Open-label Period
Units on a scaleDiazepam
Mean Score on Caregiver Global Treatment Assessment During the Open-label Period6.78 ± 1.896
SecondaryMean Score on Physician Global Treatment Assessment During the Open-label Period

Physician global evaluation is based on seizure frequency, severity, and overall outcome compared with previous episodes and is rated on a 10-cm visual analogue scale, where 0=much worse and 10=much better. A higher score indicates greater improvement. An episode of acute repetitive seizures (ARS) is defined as an episode of multiple complex, partial, or generalized seizures occurring over a brief period (minutes to 12 hours) with the patient regaining consciousness between seizures, which were readily recognizable by the patient or a trained caregiver. ARS includes seizures sometimes referred to as serial, cluster, crescendo, or stuttering prolonged.

Time frame:
From Visit 2 and subsequent visits in the Open-label Period to discharge or study termination
Reported as:
Mean · Units on a scale
Mean Score on Physician Global Treatment Assessment During the Open-label Period
Units on a scaleDiazepam
Mean Score on Physician Global Treatment Assessment During the Open-label Period6.87 ± 1.645

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Diazepam (Double-blind Period)—2/81 (2.5%)33/81 (40.7%)
Diazepam (Open-label Period)—20/128 (15.6%)43/128 (33.6%)
Diazepam (Open-label Extension)—11/33 (33.3%)20/33 (60.6%)
Placebo (Double-blind Period)—3/79 (3.8%)32/79 (40.5%)
Most frequent serious events
Showing 10 of 46
Most frequent serious events
EventDiazepam (Double-blind Period)Diazepam (Open-label Period)Diazepam (Open-label Extension)Placebo (Double-blind Period)
EPILEPSYNervous system disorders0/8110/1285/331/79
GAIT DISTURBANCESGeneral disorders1/810/1281/330/79
PneumoniaInfections and infestations0/810/1281/331/79
STATUS EPILEPTICUSNervous system disorders0/811/1281/330/79
POSTICTAL STATENervous system disorders0/810/1281/330/79
CORNEAL ABRASIONInjury, poisoning and procedural complications0/810/1281/330/79
TOXICITY TO VARIOUS AGENTSInjury, poisoning and procedural complications0/810/1281/330/79
DEPRESSIONPsychiatric disorders0/811/1281/330/79
SUICIDAL IDEATIONPsychiatric disorders0/811/1281/330/79
RESPIRATORY DISTRESSRespiratory, thoracic and mediastinal disorders0/811/1281/330/79
Most frequent other events
Showing 10 of 135
Most frequent other events
EventDiazepam (Double-blind Period)Diazepam (Open-label Period)Diazepam (Open-label Extension)Placebo (Double-blind Period)
INJECTION SITE PAINGeneral disorders14/8115/1282/3311/79
HEADACHENervous system disorders2/8122/1281/332/79
URINARY TRACT INFECTIONInfections and infestations0/815/1284/330/79
INJECTION SITE HEMORRHAGEGeneral disorders4/8112/1280/335/79
EXCORIATIONInjury, poisoning and procedural complications1/810/1283/330/79
FALLInjury, poisoning and procedural complications0/810/1283/330/79
INSOMNIAPsychiatric disorders0/813/1283/330/79
UPPER RESPIRATORY TRACT INFECTIONInfections and infestations0/819/1283/330/79
VOMITINGGastrointestinal disorders1/8110/1281/331/79
PYREXIAGeneral disorders2/819/1281/332/79

Baseline characteristics

Participants who were randomized to receive treatment

Age, Continuous
Age, Continuous(years)DiazepamPlaceboTotal
Mean22.8 ± 15.9821.3 ± 12.9222.1 ± 14.61
Age, Customized
Age, Customized(participants)DiazepamPlaceboTotal
2 to 5 years12618
6 to 11 years181432
12 years and older9490184
Sex: Female, Male
Sex: Female, Male(Participants)DiazepamPlaceboTotal
Female6254116
Male6256118
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)DiazepamPlaceboTotal
Hispanic or Latino15924
Not Hispanic or Latino109101210
Unknown or Not Reported000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)DiazepamPlaceboTotal
White/Caucasian10489193
Black/African American131730
Asian224
Native Hawaiian or other Pacific Islander000
American Indian or Alaska Native000
Other527
Missing000
Place of Residence
Place of Residence(Participants)DiazepamPlaceboTotal
Home123107230
Foster home011
Group home112
Residential facility011
Other000
Height
Height(Centimeters)DiazepamPlaceboTotal
Mean154.2 ± 25.08154.5 ± 22.61154.4 ± 23.91
Weight
Weight(Kilograms)DiazepamPlaceboTotal
Mean61.0 ± 29.1558.9 ± 28.4760.0 ± 28.79
08

Study locations

86 sites
  • Neurology Clinic, PC
    Northport, Alabama 35476, United States
  • Clinical Trials, Inc
    Little Rock, Arkansas 72205, United States
  • Stein Life Child Neurology Medical Specialists Inc.
    Irvine, California 92606, United States
  • Collaborative NeuroScience Network, LLC
    Long Beach, California 90806, United States
  • Hoag Memorial Hospital Presbyterian
    Newport Beach, California 92658, United States
  • Brain and Spine Surgeons of Orange County
    Newport Beach, California 92663, United States
  • Drug Shipment
    Sacramento, California 95816, United States
  • Sacramento Comprehensive Epilepsy Program
    Sacramento, California 95816, United States
  • Sutter Cancer Center Specialty Clinic
    Sacramento, California 95816, United States
  • Sutter Institute for Medical Research
    Sacramento, California 95816, United States
  • Northern California Cardiology
    Sacramento, California 95819, United States
  • Bradenton Research Center, Inc.
    Bradenton, Florida 34205, United States
  • Morton Plant Hospital Epilepsy Clinic
    Clearwater, Florida 33756, United States
  • Morton Plant Hospital Pharmacy
    Clearwater, Florida 33756, United States
  • Child Neurology Center of NorthWest Florida
    Gulf Breeze, Florida 32561, United States
  • NorthWest Florida Clinical Research Group, LLC
    Gulf Breeze, Florida 32561, United States
  • Emery Neuroscience Center
    Lighthouse Point, Florida 33064, United States
  • Pediatric Neurology and Epilepsy Center
    Loxahatchee, Florida 33470, United States
  • Miami Children's Hospital
    Miami, Florida 33155, United States
  • EKG only
    Orlando, Florida 32806, United States
  • Pediatric Neurology, PA
    Orlando, Florida 32819, United States
  • AMO Corp
    Tallahassee, Florida 32308, United States
  • Tallahassee Neurological Clinic
    Tallahassee, Florida 32308, United States
  • Pediatric Epilepsy & Neurology Specialists
    Tampa, Florida 33609, United States
  • Willsey Research Inc
    Tampa, Florida 33613, United States
  • Child Neurology Associates, PC
    Atlanta, Georgia 30342, United States
  • Savannah Neurology, PC
    Savannah, Georgia 31405, United States
  • Consultants in Epilepsy and Neurology, PLLC
    Boise, Idaho 83702, United States
  • Comer Children's Hospital
    Chicago, Illinois 60637, United States
  • University of Chicago Hospital Pharmacy
    Chicago, Illinois 60637, United States
  • University of Chicago Medical Center (UCMC) Center for Advanced Medicine (CAM)
    Chicago, Illinois 60637, United States
  • University of Chicago Medical Center (UCMC)
    Chicago, Illinois 60637, United States
  • University Neurologists PSC Pediatric Division
    Louisville, Kentucky 40202, United States
  • University of Louisville Ambulatory Care Building Clinic
    Louisville, Kentucky 40202, United States
  • University of Louisville Clinical Trials Unit
    Louisville, Kentucky 40202, United States
  • Lahey Clinic Medical Center
    Burlington, Massachusetts 01805, United States
  • Neurology Clinic of St Cloud
    St Cloud, Minnesota 56303, United States
  • The Comprehensive Epilepsy Care Center For Children and Adults
    Chesterfield, Missouri 63017, United States
  • MRI Location
    Kansas City, Missouri 64111, United States
  • St Luke's Hospital Neurological Consultants
    Kansas City, Missouri 64111, United States
  • St Luke's Hospital
    Kansas City, Missouri 64111, United States
  • Dartmouth-Hitchcock Medical Center
    Lebanon, New Hampshire 03756, United States
  • Clinical Research Center of New Jersey
    Gibbsboro, New Jersey 08026, United States
  • University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School
    New Brunswick,, New Jersey 08901, United States
  • University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical Group
    New Brunswick, New Jersey 08901, United States
  • Elmwood Clinic
    Buffalo, New York 14207, United States
  • Millard Fillmore Gates Hospital/Comprehensive Epilepsy Center
    Buffalo, New York 14209, United States
  • Women and Children's Hospital of Buffalo
    Buffalo, New York 14222, United States
  • NYU Medical Center, Comprehensive Epilepsy Center
    New York, New York 10016, United States
  • Strong Memorial Hospital
    Rochester, New York 14642, United States
  • University of Rochester, Strong Epilepsy Center
    Rochester, New York 14642, United States
  • Cone Health Child Neurology
    Greensboro, North Carolina 27401, United States
  • Guilford Neurologic Associates
    Greensboro, North Carolina 27405, United States
  • Raleigh Neurology Associates, PA
    Raleigh, North Carolina 27607, United States
  • The Cleveland Clinic Foundation
    Cleveland, Ohio 44195-5102, United States
  • The Cleveland Clinic Health Systems
    Cleveland, Ohio 44195-5102, United States
  • Ohio State University Neurology Clinic
    Columbus, Ohio 43210, United States
  • Ohio State University University Hospital
    Columbus, Ohio 43210, United States
  • Ohio State University
    Columbus, Ohio 43210, United States
  • North Pacific Epilepsy Research/The Northrup Center
    Portland, Oregon 97210, United States
  • The Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19104, United States
  • St. Christopher's Hospital for Children
    Philadelphia, Pennsylvania 19134-1095, United States
  • St. Christopher's Hospital for Children
    Philadelphia, Pennsylvania 19134, United States
  • Wellspan Neurosciences
    York, Pennsylvania 17402, United States
  • Apple Hill Medical Center (EKG & Lab Draw)
    York, Pennsylvania 17403, United States
  • Medical University of South Carolina Hospitals and Clinics
    Charleston, South Carolina 29425, United States
  • Medical University of South Carolina/Department of Pharmacy Service
    Charleston, South Carolina 29425, United States
  • Medical University of South Carolina
    Charleston, South Carolina 29425, United States
  • The Neurology and Pain Clinic
    Orangeburg, South Carolina 29118, United States
  • Mid-South Physicians Group, PLLC
    Germantown, Tennessee 38138, United States
  • University of Tennessee Lebonheur Pediatric Specialists Inc.
    Memphis, Tennessee 38103, United States
  • Access Clinical Trial, Inc.
    Nashville, Tennessee 37203, United States
  • CMC - Physician's Park
    Nashville, Tennessee 37203, United States
  • Vanderbilt University Medical Center
    Nashville, Tennessee 37232-2551, United States
  • Vanderbilt Epilepsy Clinic
    Nashville, Tennessee 37232, United States
  • Vanderbilt University Hospital Pharmacy
    Nashville, Tennessee 37232, United States
  • Neurological Clinic of Texas, PA
    Dallas, Texas 75230, United States
  • Cook Children's Medical Center
    Fort Worth, Texas 76104, United States
  • Cook Children's Physcian Network
    Fort Worth, Texas 76104, United States
  • Cook Children's Medical Center Office of Grants and Research
    Ft Worth, Texas 76104, United States
  • Alamo City Clinical Research, LLC
    San Antonio, Texas 78258, United States
  • Virginia Commonwealth University Health System
    Richmond, Virginia 23298-0042, United States
  • Virginia Commonwealth University Division of Child Neurology
    Richmond, Virginia 23298-0211, United States
  • Virginia Commonwealth University Ambulatory Care Center/Department of Neurology
    Richmond, Virginia 23298-0599, United States
  • Harborview Medical Center
    Seattle, Washington 98104, United States
  • University of Washington Regional Epilepsy Center, Harborview Medical Center
    Seattle, Washington 98104, United States
09

References and documents

Publications

  • Abou-Khalil B, Wheless J, Rogin J, Wolter KD, Pixton GC, Shukla RB, Sherman NA, Sommerville K, Goli V, Roland CL. A double-blind, randomized, placebo-controlled trial of a diazepam auto-injector administered by caregivers to patients with epilepsy who require intermittent intervention for acute repetitive seizures. Epilepsia. 2013 Nov;54(11):1968-76. doi: 10.1111/epi.12373. Epub 2013 Sep 20. Erratum In: Epilepsia. 2018 Dec;59(12):2344. doi: 10.1111/epi.14616. PubMed 24111974 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 23, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00319501
Lead sponsor
Pfizer
Responsible party
Sponsor
First posted
Apr 27, 2006
Start date
Jan 2006
Primary completion
Jul 2014
Completion
Jul 2014
Results posted
Aug 16, 2016
Last update
Sep 23, 2016

Study contacts

Pfizer CT.gov Call Center
study director · Pfizer

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jul 2016. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Diazepam

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