Abstract
Objective: To assess the long term safety of diazepam after repeat intranasal doses of Valtoco™ (NRL-1, diazepam nasal spray), formulated with Intravail® A3, administered to patients with epilepsy who experience frequent breakthrough seizures or Acute Repetitive Seizures (ARS), over 12-months.
Background: Valtoco is designed as an easy-to-use, non-invasive treatment by care-partners outside the medical setting for bouts of seizures.
Design/Methods: In this repeat dose, open-label trial, Valtoco was administered as needed to treat bouts of diagnosed seizures over a 12-month period of time. Doses were defined as 5 mg, 10 mg, 15 mg, or 20 mg based on the subject’s age and body weight, and were modified by the investigators as needed. Patients diaries documented time and duration of seizures and outcome.
Results: Of the 121 patients enrolled to date in this interim analysis, 109 patients (14 < 12 years of age) received at least one dose of Valtoco and were included in the safety population. There was a total of 1585 seizure episodes treated with Valtoco in 109 patients in the safety population (1 to >40 doses).
A single dose was adequate for seizure control in 92% (1457) of seizure episodes.
Overall, 67 out of 109 patients (61.5%) had at least one adverse event (AE). Nineteen patients (17.4%) had AEs that were considered treatment-related by the Investigator. The most frequent treatment-related events were nasal discomfort (7 patients, 6.4%), and epistaxis, headache (4 patients, 8.2%). Of the 67 patients experiencing AEs, 18 patients had 30 AEs that were considered serious, none of which was considered treatment-related by the Investigators.
Conclusions: Overall, this study demonstrates that Valtoco is safe and well tolerated in subjects with epilepsy who have frequent breakthrough seizures. Relatively few of the reported AEs were treatment related, and these were generally mild or moderate in severity. No SAEs were attributable to Valtoco.
Disclosure: Dr. Sperling has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Medtronic. Dr. Sperling has received research support from Eisai, Medtronic, Neurelis, Pfizer, SK Life Science, Takeda, Sunovion, UCB Pharma and Upsher-Smith. Dr. Hogan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with SK Chemical. Dr. Hogan has received research support from UCB Pharmaceuticals, Neurelis Pharnaceuticals, Biogen Inc. Dr. Biton has nothing to disclose. Dr. Tarquinio has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Marinus and Avexis. Dr. Carrazana has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Neurelis, Marinus, Zogenix, Praxis, Adamas, Ovid, Epalex, Aeromics, Alexza. Dr. Carrazana has received compensation for serving on the Board of Directors of Marinus Pharmaceuticals, Epalex. Dr. Novack has nothing to disclose.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
