Randomized, double-blind, placebo-controlled trial of ezogabine (retigabine) in partial epilepsy
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Abstract
Objective: To evaluate the efficacy and safety of ezogabine (United States adopted name)/retigabine (international nonproprietary name) (EZG[RTG]) 1,200 mg/day as adjunctive treatment in adults with drug-resistant epilepsy with partial-onset seizures with or without secondary generalization.
Methods: RESTORE 1 was a multicenter, randomized, double-blind, parallel-group trial. Following a prospective 8-week baseline phase, patients entered an 18-week double-blind treatment period (6-week forced dose titration to EZG[RTG] 1,200 mg/day in 3 equally divided doses or placebo, followed by a 12-week maintenance phase). Results were analyzed on an intent-to-treat basis for the entire 18-week period and for patients reaching the maintenance phase.
Results: In 306 patients randomized, 305 received EZG(RTG) 1,200 mg/day (n = 153) or placebo (n = 152). Median percent reduction in total partial-seizure frequency was 44.3% vs 17.5% (p < 0.001) for EZG(RTG) and placebo, respectively, during the 18-week double-blind period; responder rates (≥50% reduction in total partial-seizure frequency from baseline) were 44.4% vs 17.8% (p < 0.001). In 256 patients (EZG[RTG], 119; placebo, 137) entering the 12-week maintenance phase, median percent reduction in seizure frequency for EZG(RTG) vs placebo was 54.5% and 18.9% (p < 0.001), respectively; responder rates were 55.5% vs 22.6% (p < 0.001). The proportion of patients discontinuing due to treatment-emergent adverse events (TEAEs) was 26.8% (EZG[RTG]) vs 8.6% (placebo). Dizziness, somnolence, fatigue, confusion, dysarthria, urinary tract infection, ataxia, and blurred vision were the most common TEAEs reported by more patients treated with EZG(RTG) than placebo.
Conclusions: This study demonstrates that EZG(RTG) is effective as add-on therapy for reducing seizure frequency in patients with drug-resistant partial-onset seizures.
Classification of evidence: This study provides Class II evidence that EZG(RTG) 1,200 mg/day is effective as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization.
Footnotes
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Study funding: Supported by Valeant Pharmaceuticals International, Aliso Viejo, CA, USA. Research funding for design and conduct of this study, collection, management, analysis, and interpretation of the data were sponsored by Valeant Pharmaceuticals. Preparation of the manuscript was sponsored by GlaxoSmithKline and Valeant Pharmaceuticals International.
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Supplemental data at www.neurology.org
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- AE=
- adverse event;
- AED=
- antiepileptic drug;
- CGI–I=
- Clinical Global Impression of Improvement;
- EMA=
- European Medicines Agency;
- EZG=
- ezogabine;
- FDA=
- Food and Drug Administration;
- ILAE=
- International League Against Epilepsy;
- ITT=
- intent-to-treat;
- NNT=
- number needed to treat;
- PGI–I=
- Patient Global Impression of Improvement;
- PVR=
- postvoid residual;
- RTG=
- retigabine;
- TEAE=
- treatment-emergent adverse event
- Received September 23, 2010.
- Accepted January 19, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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