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CompletedNCT02721069Updated Jan 31, 2022Results posted

Repeat Dose Safety Study of NRL-1 in Epilepsy Subjects

A Phase 3 interventional study of NRL-1 in Acute Repetitive Seizures and Breakthrough Seizures, sponsored by Neurelis, Inc.. Completed at 5 sites in United States. Open to participants aged 6 Years to 65 Years. Per ClinicalTrials.gov, last updated 2022-01-31.

Sponsored by Neurelis, Inc. · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
175
Allocation
Not applicable
Ages
6 Years to 65 Years
Sex
All
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Study summary

This is a 12 month safety study to evaluate the safety of repeated doses of NRL-1

Read the detailed description

This is a Phase 3, repeat dose, open-label, safety study in Epilepsy subjects who have frequent breakthrough seizures or Acute Repetitive Seizures (ARS). NRL-1 will be administered as needed to treat bouts of those seizures over a 12-month period of time. Doses will be defined as 5 mg, 10 mg, 15 mg, or 20 mg based on the subject's body weight. A diary will be used to record the seizure and NRL-1 administration.

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Conditions studied

  • Acute Repetitive Seizures
  • Breakthrough Seizures

Keywords

  • Seizures
  • Epilepsy
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In context

Epilepsy

1,805 studies on the registry are indexed under Epilepsy; 417 are open to participants now.

This study's enrollment of 175 is above the median of 50 across 1,205 interventional studies indexed under Epilepsy.

Browse Epilepsy studies →

Lead sponsor

Neurelis, Inc. is the lead sponsor of 3 studies on the registry; none are open to participants now.

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

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Who can participate

Ages eligible
6 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Male and female subjects between the ages of 6 and 65 years, inclusive.
  2. Written informed consent to participate in the study.
  3. Subject has a clinical diagnosis of Epilepsy and while on a stable regimen of anti-epileptic medication, still experiences bouts of seizures (e.g. frequent break through seizures or Acute Repetitive Seizures [ARS]), and who, in the opinion of the Investigator, may need benzodiazepine intervention for seizure control at least 1 time a month on average.
  4. Subject has a qualified caregiver or medical professional available that can administer study medication in the event of a seizure.
  5. Subjects having either partial or generalized Epilepsy with motor seizures or seizures with clear alteration of awareness.
  6. Female subjects of childbearing potential, defined as having a menstrual cycle and who are not surgically sterile or less than two (2) years postmenopausal, must complete a pregnancy screen and agree to utilize one of the following forms of contraception during the trial and for 21 days after the last dose of study drug: abstinence, hormonal (oral, transdermal, implant, or injection), barrier (condom, diaphragm with spermicide), intrauterine device (IUD), or vasectomized partner (six months minimum). Subjects must have used the same method for at least one (1) month prior to starting the study.
  7. No clinically significant abnormal findings in the medical history, on the physical examination or electrocardiogram (QTcF\<450 msec for males and QTcF\<470 msec for females).
  8. Subjects and caregivers must agree to return to the study site for all study visits and must be willing to comply with all required study procedures.

Exclusion criteria

Exclusion Criteria:

  1. A history of clinically significant gastrointestinal, renal, hepatic, hematologic, endocrine, oncologic, pulmonary, immunologic, psychiatric, or cardiovascular disease, or any other condition which, in the opinion of the Investigator, would jeopardize the safety of the subject.
  2. Subject has had significant traumatic injury, major surgery or open biopsy within 30 days prior to study screening.
  3. Subjects with active major depression or a past suicide attempt, or any Suicidal Ideation of 3, 4, or 5 or any Suicidal Behavior in Lifetime using Columbia-Suicide Severity Rating Scale (C-SSRS). The pediatric C-SSRS should be used for subjects age 6 to 11. The adult C SSRS should be used for subjects 12 and greater years of age.
  4. A history of allergic or adverse responses to diazepam or any comparable or similar product.
  5. Participation in a clinical trial other than protocol DIAZ.001.04 within 30 days prior to Day 0. Participation in an observational (non-interventional) study is not excluded as long as there are no scheduling conflicts with this study.
  6. Positive serum pregnancy test (ß-hCG) at screening for subjects age 12 or greater.
  7. Positive blood screen for Human immunodeficiency virus (HIV), Hepatitis B surface antigen (HbSAg), or Hepatitis C, or a positive urine screen for alcohol or drugs of abuse, except marijuana use for medical reasons. When marijuana was used for medical reasons in the opinion of the investigator, it is not considered as drug abuse and the patient can be enrolled even if the marijuana metabolites in the urine revealed as positive.
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
175 participants (actual)

Study arms

  • Experimental
    NRL-1

    Intranasal dose of NRL-1 will be administered at either 5 mg, 10 mg, 15 mg, or 20 mg based on the subject's body weight.

    Drug: NRL-1

Interventions

  • DrugNRL-1

    Also known as: Intranasal diazepam

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What researchers measure

Primary outcomes

  1. Number of Participants Who Received NRL-1 (Valtoco)

    Assess the number of participants who received at least one dose of NRL-1 (Valtoco) during the study and comprised the safety population.

    Time frame: 12 months

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Results

Posted Jan 31, 2022

Participant flow

Participant flow — Overall Study
MilestoneNRL-1
Started175
Completed117
Not completed58

Outcome measures

PrimaryNumber of Participants Who Received NRL-1 (Valtoco)

Assess the number of participants who received at least one dose of NRL-1 (Valtoco) during the study and comprised the safety population.

Time frame:
12 months
Reported as:
Count of participants · Participants
Number of Participants Who Received NRL-1 (Valtoco)
ParticipantsNRL-1 5mgNRL-1 10mgNRL-1 15 mgNRL-1 20mg
Number of Participants Who Received NRL-1 (Valtoco)9544654

Adverse events

Collected over 12 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
NRL-1 5mg0/9 (0%)2/9 (22.2%)6/9 (66.7%)
NRL-1 10mg0/54 (0%)20/54 (37%)34/54 (63%)
NRL-1 15mg0/46 (0%)15/46 (32.6%)24/46 (52.2%)
NRL-1 20mg1/54 (1.9%)13/54 (24.1%)21/54 (38.9%)
Most frequent serious events
Showing 10 of 53
Most frequent serious events
EventNRL-1 5mgNRL-1 10mgNRL-1 15mgNRL-1 20mg
SeizureNervous system disorders1/911/548/464/54
LethargyNervous system disorders1/90/540/460/54
Status EpilepticusNervous system disorders0/95/541/461/54
PneumoniaInfections and infestations0/94/541/462/54
EpilepsyNervous system disorders0/92/541/462/54
Seizure ClusterNervous system disorders0/90/540/462/54
VomitingGastrointestinal disorders0/92/540/460/54
ScoliosisMusculoskeletal and connective tissue disorders0/92/540/460/54
AmnesiaNervous system disorders0/90/541/460/54
Partial SeizuresNervous system disorders0/90/541/460/54
Most frequent other events
Most frequent other events
EventNRL-1 5mgNRL-1 10mgNRL-1 15mgNRL-1 20mg
InfluenzaInfections and infestations3/95/543/461/54
NasopharyngitisInfections and infestations1/912/543/464/54
DiarrhoeaGastrointestinal disorders2/94/541/462/54
PyrexiaGeneral disorders1/910/543/461/54
Upper Respiratory Tract InfectionInfections and infestations0/99/547/464/54
SeizureNervous system disorders0/94/547/462/54
Urinary Tract InfectionInfections and infestations1/94/543/463/54
Nasal DiscomfortRespiratory, thoracic and mediastinal disorders0/90/544/466/54
VomitingGastrointestinal disorders1/94/542/462/54
SomnolenceNervous system disorders0/95/544/462/54

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)NRL-1
<=18 years92
Between 18 and 65 years82
>=65 years1
Age, Continuous
Age, Continuous(years)NRL-1
Mean22.3 ± 14.87
Sex: Female, Male
Sex: Female, Male(Participants)NRL-1
Female93
Male82
Race (NIH/OMB)
Race (NIH/OMB)(Participants)NRL-1
American Indian or Alaska Native0
Asian4
Native Hawaiian or Other Pacific Islander5
Black or African American19
White143
More than one race4
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(Participants)NRL-1
United States175
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Study locations

5 sites
  • Clinical Trials, Inc.
    Little Rock, Arkansas 72205, United States
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Washington University School of Medicine
    Saint Louis, Missouri 63110, United States
  • New York University Comprehensive Epilepsy Center
    New York, New York 10016, United States
  • Thomas Jefferson University Hospital Laboratory
    Philadelphia, Pennsylvania 19107, United States
09

References and documents

Publications

  • Cramer JA, Faught E, Davis C, Misra SN, Carrazana E, Rabinowicz AL. Quality-of-life results in adults with epilepsy using diazepam nasal spray for seizure clusters from a long-term, open-label safety study. Epilepsy Behav. 2022 Sep;134:108811. doi: 10.1016/j.yebeh.2022.108811. Epub 2022 Jul 8. PubMed 35816831 ↗
  • Wheless JW, Miller I, Hogan RE, Dlugos D, Biton V, Cascino GD, Sperling MR, Liow K, Vazquez B, Segal EB, Tarquinio D, Mauney W, Desai J, Rabinowicz AL, Carrazana E; DIAZ.001.05 Study Group. Final results from a Phase 3, long-term, open-label, repeat-dose safety study of diazepam nasal spray for seizure clusters in patients with epilepsy. Epilepsia. 2021 Oct;62(10):2485-2495. doi: 10.1111/epi.17041. Epub 2021 Aug 21. PubMed 34418086 ↗
  • Miller I, Wheless JW, Hogan RE, Dlugos D, Biton V, Cascino GD, Sperling MR, Liow K, Vazquez B, Segal EB, Tarquinio D, Mauney W, Desai J, Rabinowicz AL, Carrazana E; DIAZ.001.05 Study Group. Consistent safety and tolerability of Valtoco(R) (diazepam nasal spray) in relationship to usage frequency in patients with seizure clusters: Interim results from a phase 3, long-term, open-label, repeat-dose safety study. Epilepsia Open. 2021 Sep;6(3):504-512. doi: 10.1002/epi4.12494. Epub 2021 May 13. PubMed 34033266 ↗
  • Penovich P, Wheless JW, Hogan RE, Guerra C, Cook DF, Carrazana E, Rabinowicz AL. Examining the patient and caregiver experience with diazepam nasal spray for seizure clusters: Results from an exit survey of a phase 3, open-label, repeat-dose safety study. Epilepsy Behav. 2021 Aug;121(Pt A):108013. doi: 10.1016/j.yebeh.2021.108013. Epub 2021 May 19. PubMed 34022621 ↗

Study documents

  • Study protocol · Sep 28, 2017
  • Statistical analysis plan · Jul 8, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 31, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02721069
Lead sponsor
Neurelis, Inc.
Responsible party
Sponsor
First posted
Mar 28, 2016
Start date
Apr 11, 2016
Primary completion
Jun 17, 2020
Completion
Jul 23, 2020
Results posted
Jan 31, 2022
Last update
Jan 31, 2022

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2022. You cannot join it, but the record below documents what was studied.

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