Epilepsy Clinical Trial
Official title:
Characterization of Epilepsy Patients At-risk for Adverse Outcomes Related to Switching Antiepileptic Drug Products: BEEP 2b Study
Some epilepsy patients are described as GB when they have worsened seizures or side effects related to switching between brand name and generic, or between generic antiepileptic drug (AED) products. In concert with Aim 1 (protocol BEEP2a), this study will uncover possible reasons for patient problems with the drug switching. Factors that will be studied in GB epilepsy patients include physiologic, psychological, and genetic factors, including in this protocol whether brand and generic AEDs are pharmacokinetically similar in GB individuals.
This pilot study is exploratory research to characterize the "generic brittle" (GB) patient
and to identify major causes for generic brittleness in epilepsy patients who are sensitive
to antiepileptic drug (AED) formulation changes.
The primary aim of this BEEP2b study is to perform individual pharmacokinetic (PK) similarity
testing of brand and generic AEDs in "probably GB" patients (N=12),who were selected on the
basis of having GB-defining factors from the BEEP2a study, in order to confirm whether these
factors are predictive of a generic brittle response to product switching. The study design
involves a randomized, double-blind, multiple-dose, complete four-way replicate crossover
design in which one brand and one generic will be compared in each patient from the patient's
own AED regimen. Associated adverse events (i.e. seizures and side effects) will also be
assessed. Bioequivalence (BE) will not be assessed. Rather, about nine AEDs are expected to
be collectively evaluated. Generic brittleness anticipates that, for individual subjects,
brand and generic may be the same or different, depending upon the underlying basis for
generic brittleness. This exploratory research is focused on understanding individual patient
attributes that contribute to GB, and is not focused on either product development or
comparison of specific products.
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