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. 2020 Jul 17;142(6):531–540. doi: 10.1111/ane.13305

TABLE 1.

Summary of Pivotal Phase 3 Trials in Patients with LGS or DS

GWEP1414 (LGS) GWEP1423 (LGS) GWEP1332B (DS) GWEP1424 (DS)
Description Adjunct to existing ASDs in patients with LGS who had inadequately controlled drop seizures Adjunct to existing ASDs in patients with DS who had inadequately controlled convulsive seizures
Patient population 2‐55 years with a clinical diagnosis of LGS, ≥ 2 drop seizures each week during the 28‐day baseline period despite taking ≥ 1 ASD at a stable dose for ≥ 4 weeks 2‐18 years with a clinical diagnosis of DS, ≥ 4 convulsive seizures during the 28‐day baseline period despite taking ≥ 1 ASD at a stable dose for ≥ 4 weeks
Regions US, UK, France, Spain US, The Netherlands, Poland US, UK, France, Poland US, Spain, Poland, Australia, Israel, The Netherlands
Patients planned/randomized 150/225 100/171 100/120 186/199
Treatment group: number of patients treated

Placebo: 76

CBD 10 mg/kg/day: 73

CBD 20 mg/kg/day: 76

Placebo: 85

CBD 20 mg/kg/day: 86

Placebo: 59

CBD 20 mg/kg/day: 61

Placebo: 65

CBD 10 mg/kg/day: 66

CBD 20 mg/kg/day: 67

Treatment plan Baseline Period (Days −28 to −1) Baseline Period (Days −28 to −1) Baseline Period (Days −28 to −1) Baseline Period (Days −28 to −1)

Double‐blind treatment period (Weeks 1‐14):

  • Titration Period (Weeks 1‐2):

  • CBD 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 7 days to 10 mg/kg/day, or 11 days to 20 mg/kg/day

  • Placebo volumes equivalent to 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 7 or 11 days

Double‐blind treatment period (Weeks 1‐14):

  • Titration Period (Weeks 1‐2):

  • CBD 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 11 days

  • Placebo volumes equivalent to 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 11 days

Double‐blind treatment period (Weeks 1‐14):

  • Titration Period (Weeks 1‐2):

  • CBD 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 11 days

  • Placebo volumes equivalent to 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 11 days

Double‐blind treatment period (Weeks 1‐14):

  • Titration Period (Weeks 1‐2):

  • CBD 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 7 days to 10 mg/kg/day, or 11 days to 20 mg/kg/day

  • Placebo volumes equivalent to 2.5 mg/kg/day increasing 2.5‐5.0 mg/kg QOD over 7 or 11 days

  • Maintenance Period (Weeks 3‐14):

  • CBD 10 or 20 mg/kg/day

  • Placebo volumes equivalent to 10 or 20 mg/kg/day

  • Maintenance Period (Weeks 3‐14):

  • CBD 20 mg/kg/day

  • Placebo volumes equivalent to 20 mg/kg/day

  • Maintenance Period (Weeks 3‐14):

  • CBD 20 mg/kg/day

  • Placebo volumes equivalent to 20 mg/kg/day

  • Maintenance Period (Weeks 3‐14):

  • CBD 10 or 20 mg/kg/day

  • Placebo volumes equivalent to 10 or 20 mg/kg/day

Optional OLE trial or taper (10% per day) and follow‐up Optional OLE trial or taper (10% per day) and follow‐up
Efficacy endpoints Primary: Percentage change from baseline in drop seizure frequency during the treatment period Primary: Percentage change from baseline in convulsive seizure frequency during the treatment period
Key secondary: Proportion of patients with a ≥ 50% reduction from baseline in drop seizure frequency during the treatment period Key secondary: Proportion of patients with a ≥ 50% reduction from baseline in convulsive seizure frequency during the treatment period
Efficacy: reduction in seizure frequency

Placebo: 17.2%

CBD 10 mg/kg/day: 37.2%, P = .0016

CBD 20 mg/kg/day: 41.9%, P = .0047

Placebo: 21.8%

CBD 20 mg/kg/day: 43.9%, P = .0135

Placebo: 13.3%

CBD 20 mg/kg/day: 38.9%, P = .0123

Placebo: 26.9%

CBD 10 mg/kg/day: 48.7%, P = .0095

CBD 20 mg/kg/day: 45.7%, P = .0299

Efficacy: 50% responder rates

Placebo: 14.5%

CBD 10 mg/kg/day: 35.6%, P = .0030

CBD 20 mg/kg/day: 39.5%, P = .0006

Placebo: 23.5%

CBD 20 mg/kg/day: 44.2%, P = .0043

Placebo: 27.1%

CBD 20 mg/kg/day: 42.6%, P = .0784

Placebo: 26.2%

CBD 10 mg/kg/day: 43.9%, P = .0332

CBD 20 mg/kg/day: 49.3%, P = .0069

The seizures are drop seizures in LGS (atonic, tonic, or tonic‐clonic) and convulsive seizures in DS (tonic‐clonic, tonic, clonic, or atonic).

Abbreviations: ASD, antiseizure drug; CBD, cannabidiol; DS, Dravet syndrome; LGS, Lennox‐Gastaut syndrome; OLE, open‐label extension; QOD, every other day.