Treatment With Xeomin Versus Botox in Children With Spastic Equine and Equinovarus Foot Deformation in Pediatric Cerebral Palsy

Cerebral Palsy Clinical Trial

— XEBEC  

Official title:

Multi-center Open Comparative Randomized Trial of Clinical and Neurophysiological Efficacy and Safety of Xeomin (Botulinum Toxin Type A) vs. Botox (Complex of Botulinum Toxin Type A and Hemagglutinin) in Children With Spastic Equine and Equinovarus Foot Deformation in Pediatric Cerebral Palsy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02188277
• Other study ID #: MRZ-R-201212_01001_N_2
• Status: Completed
• Phase: Phase 2
• First received: July 10, 2014
• Last updated: January 25, 2017
• Start date: July 2014
• Est. completion date: December 2016

Study information

• Verified date: January 2017
• Source: Merz Pharmaceuticals GmbH
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

1. To assess the clinical and neurophysiological efficacy of Xeomin® vs. Botox® in children with spastic equine and equinovarus foot deformation in pediatric cerebral palsy

2. To assess the safety of Xeomin® use as compared to Botox® in this patient population

Recruitment information / eligibility

• Status: Completed
• Enrollment: 64
• Est. completion date: December 2016
• Est. primary completion date: December 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 2 Years to 12 Years

Eligibility

Inclusion Criteria:

• Children from 2 through 12 years of age, of both sexes, suffering from spastic paraplegia or hemiparesis in pediatric cerebral palsy.

• Equine and equinovarus foot posture.

• Gastrocnemius spasticity of 2 points and greater, by modified Ashworth scale.

• Patient can walk unassisted or with a support.

• Mental development of patients is normal or mildly retarded.

• Previous course of spasticity treatment with BTA products was completed earlier than at 6 months before this trial or never administered before.

• Patient's parents have signed an informed consent, are able and wishing to adhere to procedures described in the trial protocol and to the schedule of visits throughout the entire period of treatment.

Exclusion Criteria:

• Fixed ankle joint contracture.

• Previous denervation of spastic muscles by surgery, phenol or alcohol;

• Athetosis and dystonia in the area of injected muscles.

• Inflammation at the planned injection site.

• Elevated body temperature and acute (infectious and non-infectious) diseases at the time of injection.

• Neuromuscular transmission disorders (myasthenia gravis, Lambert-Eaton syndrome, etc.).

• Decompensated physical diseases potentially affecting the trial findings.

• Acute fever, infection or surgery within 1 month before the trial.

• Use of aminoglycosides or spectinomycin within 1 month before starting the trial.

• Hypersensitivity to any of product ingredients.

• Positive history for allergies (especially with regard to protein-containing products).

• Patient's parents are unable or unwilling to adhere to the trial protocol requirements including signing the informed consent and conforming to the schedule of visits.

• Participation in other clinical trials in the last 4 weeks before inclusion.

Related Conditions & MeSH terms

• Cerebral Palsy
• Clubfoot
• Equine and Equinovarus Foot Deformation
• Equinus Deformity
• Muscle Spasticity
• Paralysis
• Paraplegia
• Paresis
• Spastic Paraplegia and Hemiparesis

Intervention

Drug:
• Xeomin
Active ingredient: Clostridium Botulinum neurotoxin Type A free from complexing proteins. Solution for injection prepared by reconstitution of powder with 0.9% Sodium Chloride (NaCl). Administration route is intramuscular injection into medial (two points) and lateral heads (two points) of gastrocnemius.
• Botox®
Administration route is intramuscular injection into medial (two points) and lateral heads (two points) of gastrocnemius.

Locations

Country	Name	City	State
Russian Federation	Federal State Autonomous Institution "Scientific Center of Children's Health" of the Ministry of Health of the Russian Federation	Moscow
Russian Federation	State Budget Institution of Health in Moscow "Scientific and Practical Center of Pediatric psychoneurology Moscow Health Department"	Moscow
Russian Federation	Federal State Budget Educational Institution of Higher Professional Learning "Stavropol State Medical University" of the Ministry of Health of the Russian Federation	Stavropol

Sponsors (2)

Lead Sponsor	Collaborator
Merz Pharmaceuticals GmbH	LLC Merz Pharma, Russia

Country where clinical trial is conducted

Russian Federation, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Changes from baseline in the degree of spasticity in gastrocnemius according to modified Ashworth scale (AS)	The AS is a well known and commonly used scale in clinical trials with spasticity. In spastic muscles the resistance to passive movement is assessed. It is a 5-point scale that ranges from 0 (=no increase in tone) to 4 (=limb rigid in flexion or extension).	From baseline to day 30
Secondary	Changes from baseline in patient percentage in groups by the degree of gastrocnemius spasticity according to modified Ashworth scale		From baseline up to day 90
Secondary	Percentage of decrease in M-response magnitude and area recorded from the lateral and medial gastrocnemius heads, from baseline values	Electromyography: The amplitude of a compound muscle action potential (M-wave) is recorded. An electrical stimulation is considered supramaximal when the M-wave amplitude no longer increases while increasing the stimulus. The measurements include the M-wave amplitude and the negative peak area of the M-wave.	From baseline up to day 90
Secondary	Changes from baseline in the ratio of M-response recorded from the lateral and medial gastrocnemius heads and from tibialis anterior		From baseline up to day 90
Secondary	Changes from baseline in angles and angle ratio of ankle joints at passive and voluntary extension		From baseline up to day 90
Secondary	Changes from baseline in motor activity according to Gross Motor Function Classification Systems (GMFCS) criteria	GMFCS is a 5-level classification system that is a standardized observational instrument for children with CP developed to measure change in gross motor function over time.	From baseline up to day 90
Secondary	Changes from baseline in the degree of spasticity in gastrocnemius according to modified Ashworth scale		Baseline up to day 90