Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Soticlestat · 9 trials · 7 indications
MMD seizure frequency per 28 days was defined as the total number of MMD seizures reported during the period divided by the number of days during the period seizures were assessed multiplied by 28. Percent change from Baseline was defined as (frequency of seizures per 28 days during the full Treatment Period - frequency of seizures per 28 days at Baseline) divided by the frequency of seizures per 28 days at Baseline multiplied by 100.
MMD seizure frequency per 28 days was defined as the total number of MMD seizures reported during the period divided by number of days during the period seizures were assessed multiplied by 28. Percent change from Baseline was defined as (frequency of seizures per 28 days during the Maintenance Period - frequency of seizures per 28 days at Baseline) divided by the frequency of seizures per 28 days at Baseline multiplied by 100.
Convulsive seizure frequency per 28 days was defined as the total number of convulsive seizures reported during the period divided by the number of days during the period seizures were assessed multiplied by 28. Percent change from Baseline was defined as (frequency of seizures per 28 days during the Full Treatment Period - frequency of seizures per 28 days at Baseline) divided by the frequency of seizures per 28 days at Baseline multiplied by 100.
Convulsive seizure frequency per 28 days was defined as the total number of convulsive seizures reported during the period divided by number of days during the period seizures were assessed multiplied by 28. Percent change from Baseline was defined as (frequency of seizures per 28 days during Maintenance Period - frequency of seizures per 28 days at Baseline) divided by the frequency of seizures per 28 days at Baseline multiplied by 100.
The 24-hour average pain intensity was calculated from current pain intensity scores collected three times a day as measured by the electronic pain diary daily using NPS. NPS is an 11-point scale, where scores range from 0-10, 0= no pain to 10 = most pain imaginable. Negative change from Baseline indicated improvement.
Seizure frequency per 28 days is defined as total number of Seizures reported during the period divided by number of days with no missing seizure count during the period multiplied by 28. Percent Change from Baseline is defined as (frequency of seizures per 28 days during maintenance period - frequency of seizures per 28 days at Baseline) divided by frequency of seizures per 28 days at Baseline multiplied by 100. Positive percent change from Baseline indicates seizure increase and negative percent change from Baseline indicates seizure decrease.
Drug liking ("at this moment") assessed how much a participant likes or dislikes a drug effect at the time the question was being asked. It was scored using a 0 to 100-point bipolar VAS, where 0: Strong disliking, 50: Neither like nor dislike (neutral point), 100: Strong liking. A higher score indicates stronger liking.
| Arm | Type | Description |
|---|---|---|
| Placebo | PLACEBO_COMPARATOR | Soticlestat placebo-matching mini-tablets or tablets, orally or via G-tube or MIC-KEY button or J-tube, BID, up to 4 weeks during titration. Participants continued to receive soticlestat placebo-matching mini-tablets or tablets for 12 weeks during maintenance. The total duration of the treatment was up to 16 weeks (Full Treatment Period). Soticlestat matching tapering was done to maintain the blind if participants decided to discontinue the treatment. |
| Soticlestat | EXPERIMENTAL | Participants weighing \<45 kg: Soticlestat, mini-tablets, at the dose of 40 mg to 200 mg, orally or via G-tube or MIC-KEY button or J-tube, BID based on body weight up to 4 weeks during titration. Participants continued to receive the dose that they were on at the end of the titration, for 12 weeks during maintenance. The total duration of the treatment was up to 16 weeks (Full Treatment Period) with the dose tapered down if participants decided to discontinue the treatment. Participants weighing ≥45 kg: Soticlestat mini-tablets or tablets with a starting dose of 100 mg BID followed by 200 mg BID and, then 300 mg BID, up to 4 weeks during titration. Participants continued to receive 300 mg BID for 12 weeks during maintenance. The total duration of the treatment was up to 16 weeks (Full Treatment Period) with the dose tapered down if participants decided to discontinue the treatment. |
| Double-Blind Treatment Period - Part A: Placebo | PLACEBO_COMPARATOR | Soticlestat matching placebo tablets, orally, twice daily (BID) for Weeks 1, 2 and 3 in Double blind Titration Period. Soticlestat matching placebo tablets, orally BID for 12 weeks in Double blind Maintenance Period. Taper period (if participant did not continue to Part B): Dose of soticlestat matching placebo tablets was reduced to next lower dose every 3 days (maximum 6 days) until discontinuation. |
| Double-Blind Treatment Period - Part A: Soticlestat | EXPERIMENTAL | Soticlestat, tablet, orally, 100 mg BID for Week 1, followed by 2×100 mg tablets, soticlestat, orally BID for Week 2, further followed by 3×100 mg tablets, soticlestat, orally BID for Week 3. Dose was uptitrated every week based on safety and tolerability. Part A (Double blind Maintenance Period): 3×100 mg tablets, soticlestat, orally BID for 12 weeks. Dose was adjusted during Maintenance Period due to safety and tolerability. Taper Period (if participant did not continue to Part B): Dose of soticlestat was reduced to next lower dose every 3 days (maximum 6 days) until soticlestat was discontinued. |
| Open-Label Extension Period - Part B: Soticlestat | EXPERIMENTAL | Soticlestat, 2×100 mg tablets, orally, BID for Week 1, followed by 3×100 mg tablets, soticlestat, orally, BID for Week 2. Dose was uptitrated every week based on safety and tolerability. Part B (Open label extension: Maintenance Period): 3×100 mg tablets, soticlestat, orally, BID for 12 weeks. Dose was adjusted during Maintenance Period due to safety and tolerability. Taper Period: Dose of soticlestat was reduced to next lower dose every 3 days (maximum 6 days) until soticlestat was discontinued. |
| Soticlestat Dup 15q | EXPERIMENTAL | Soticlestat tablets twice daily (BID) orally or via gastrostomy tube (G-tube)/ percutaneous endoscopic gastrostomy (PEG) tube, BID. Participants with Dup 15q weighing \<60 kg at Baseline received total daily dose of study drug calculated based on body weight. Participants weighing ≥60 kg at Baseline, were administered with 200 mg/day followed by 400 mg/day, then 600 mg/day, up to Week 20. |
| Soticlestat CDD | EXPERIMENTAL | Soticlestat tablets BID orally or via G-tube/ PEG tube, BID. Participants with CDD weighing \<60 kg at Baseline received total daily dose of study drug calculated based on body weight. Participants weighing ≥60 kg at Baseline, were administered with 200 mg/day followed by 400 mg/day, then 600 mg/day, up to Week 20. |
| Soticlestat 300 mg | EXPERIMENTAL | Participants will receive a single oral dose of soticlestat 300 milligrams (mg). |
| Soticlestat 600 mg | EXPERIMENTAL | Participants will receive a single oral dose of soticlestat 600 mg. |
| Soticlestat 900 mg | EXPERIMENTAL | Participants will receive a single oral dose of soticlestat 900 mg. |
| Alprazolam 2 mg | ACTIVE_COMPARATOR | Participants will receive a single oral dose of over encapsulated alprazolam 2 mg. |
| Part A, Sequence 1: Treatment A + Treatment B + Treatment C | EXPERIMENTAL | Soticlestat T4 tablets 300 mg, orally, once on Day 1 of Period 1 under fasted condition as Treatment A, followed by soticlestat T3 mini-tablets 300 mg, orally, once on Day 1 of Period 2 under fasted condition as Treatment B, and followed by soticlestat T3 commercial tablets 300 mg, orally, once on Day 1 of Period 3 under fasted condition as Treatment C. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part A, Sequence 2: Treatment A + Treatment C + Treatment B | EXPERIMENTAL | Soticlestat T4 tablets 300 mg, orally, once on Day 1 of Period 1 under fasted condition as Treatment A, followed by soticlestat T3 commercial tablets 300 mg, orally, once on Day 1 of Period 2 under fasted condition as Treatment C, and followed by soticlestat T3 mini-tablets 300 mg, orally, once on Day 1 of Period 3 under fasted condition as Treatment B. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part A, Sequence 3: Treatment B + Treatment A + Treatment C | EXPERIMENTAL | Soticlestat T3 mini-tablets 300 milligram (mg), orally, once on Day 1 of Period 1 under fasted condition as Treatment B, followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 2 under fasted condition as Treatment A, and followed by soticlestat T3 commercial tablets 300 mg, orally, once on Day 1 of Period 3 under fasted condition as Treatment C. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part A, Sequence 4: Treatment B + Treatment C + Treatment A | EXPERIMENTAL | Soticlestat T3 mini-tablets 300 mg, orally, once on Day 1 of Period 1 under fasted condition as Treatment B, followed by soticlestat T3 commercial tablets 300 mg, orally, once on Day 1 of Period 2 under fasted condition as Treatment C, and followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 3 under fasted condition as Treatment A. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part A, Sequence 5: Treatment C + Treatment A + Treatment B | EXPERIMENTAL | Soticlestat T3 commercial tablets 300 mg, orally, once on Day 1 of Period 1 under fasted condition as Treatment C, followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 2 under fasted condition as Treatment A, and followed by soticlestat T3 mini-tablets 300 mg, orally, once on Day 1 of Period 3 under fasted condition as Treatment B. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part A, Sequence 6: Treatment C + Treatment B + Treatment A | EXPERIMENTAL | Soticlestat T3 commercial tablets 300 mg, orally, once on Day 1 of Period 1 under fasted condition as Treatment C, followed by soticlestat T3 mini-tablets 300 mg, tablets, orally, once on Day 1 of Period 2 under fasted condition as Treatment B, and followed by soticlestat T4 tablets 300 mg, orally, once on Day 1 of Period 3 under fasted condition as Treatment A. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part B, Sequence 1: Treatment D + Treatment E + Treatment F | EXPERIMENTAL | Soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 1 under fasted condition as Treatment D, followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 2 under fed condition as Treatment E, and followed by soticlestat T4 300 mg tablets crushed and mixed with applesauce, orally, once on Day 1 of Period 3 under fasted condition as Treatment F. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part B, Sequence 2: Treatment D + Treatment F + Treatment E | EXPERIMENTAL | Soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 1 under fasted condition as Treatment D, followed by soticlestat T4 300 mg, tablets crushed and mixed with applesauce, orally, once on Day 1 of Period 2 under fasted condition as Treatment F, and followed by soticlestat T4 300 mg, orally, once on Day 1 of Period 3 under fed condition as Treatment E. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part B, Sequence 3: Treatment E + Treatment D + Treatment F | EXPERIMENTAL | Soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 1 under fed condition as Treatment E, followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 2 under fasted condition as Treatment D, and followed by soticlestat T4 300 mg, tablets crushed and mixed with applesauce, orally, once on Day 1 of Period 3 under fasted condition as Treatment F. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part B, Sequence 4: Treatment E + Treatment F + Treatment D | EXPERIMENTAL | Soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 1 under fed condition as Treatment E, followed by soticlestat T4 300 mg tablets crushed and mixed with applesauce, orally, once on Day 1 of Period 2 under fasted condition as Treatment F, and followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 3 under fasted condition as Treatment D. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part B, Sequence 5: Treatment F + Treatment D + Treatment E | EXPERIMENTAL | Soticlestat T4 300 mg tablets crushed and mixed with applesauce, orally, once on Day 1 of Period 1 under fasted condition as Treatment F, followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 2 under fasted condition as Treatment D, and followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 3 under fed condition as Treatment E. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Part B, Sequence 3: Treatment F + Treatment E + Treatment D | EXPERIMENTAL | Soticlestat T4 300 mg tablets, crushed and mixed with applesauce, orally, once on Day 1 of Period 1 under fasted condition as Treatment F, followed by soticlestat T4 300 mg, tablets, orally, once on Day 1 of Period 2 under fed condition as Treatment E, and followed by soticlestat T4 300 mg tablets, orally, once on Day 1 of Period 3 under fasted condition as Treatment D. A washout interval of exactly 4 days will be maintained between each Treatment Period. |
| Soticlestat 300 mg + Rifampin 600 mg | EXPERIMENTAL | Soticlestat 3\*100 mg tablets, orally, administered once on Day 1 in fasted state in Period 1, followed by a washout period of 4 days, further followed by Rifampin 600 mg, administered as 2\*300mg capsules, orally, once daily for 13 consecutive days, from Day 1 to Day 13 in fasted state in Period 2. Soticlestat 3\*100 mg tablets, will be administered orally along with rifampin 600 mg (2\*300mg) capsules, orally in the morning of Day 11 in Period 2. |
| Arm 1, Moderate HI: Soticlestat 300 mg | EXPERIMENTAL | Soticlestat 300 mg, tablets, orally, once on Day 1 to participant with moderate HI. |
| Arm 2, Mild HI: Soticlestat 300 mg | EXPERIMENTAL | Soticlestat 300 mg, tablets, orally, once on Day 1 to participant with mild HI. |
| Arm 3, Normal hepatic function: Soticlestat 300 mg | EXPERIMENTAL | Soticlestat 300 mg, tablets, orally, once on Day 1 to healthy participants. |
| Part 1: Soticlestat 300 mg + Itraconazole 200 mg | EXPERIMENTAL | Soticlestat 300 milligram (mg), tablets, orally, once on Day 1 in Period 1, followed by 4 days washout period, followed by itraconazole 200 mg solution, orally, once daily from Day 1 up to Day 11, further followed by soticlestat 300 mg tablet, orally along with itraconazole 200 mg solution, orally on the morning of Day in Period 2. |
| Part 2: Soticlestat 300 mg + Mefenamic Acid 500 mg | EXPERIMENTAL | Soticlestat 300 mg, tablets, orally, once on Day 1 in Period 1, followed by 4 days washout period, followed by single dose of mefenamic acid 500 mg capsule (first dose only), orally on the morning of Day 1 and 250 mg subsequent doses at every six hours up to Day 7 in Period 2, further followed by soticlestat 300 mg tablet, orally, followed by mefenamic acid 250 mg capsule, orally in morning of Day 2 in Period 2. |
| Name | Type | Description |
|---|---|---|
| Placebo | DRUG | Soticlestat placebo-matching mini-tablets or tablets. |
| Soticlestat | DRUG | Soticlestat mini-tablets or tablets. |
| Soticlestat 300 mg | DRUG | Administered orally. |
| Soticlestat 600 mg | DRUG | Administered orally. |
| Soticlestat 900 mg | DRUG | Administered orally. |
| Alprazolam | DRUG | Administered orally. |
| Rifampin | DRUG | Rifampin capsules. |
| Itraconazole | DRUG | Itraconazole oral solution. |
| Mefenamic acid | DRUG | Mefenamic acid capsule. |
Inclusion Criteria: 1. Has documented clinical diagnosis of LGS. 2. Has had ≥8 MMD seizures each month in the 3 months prior to Screening based on the historical information and has had ≥8 MMD seizures per 28 days during the 4 to 6 week prospective Baseline Period. 3. Weighs ≥10 kg at the Screening...
Soticlestat is an investigational small molecule being studied for rare epilepsy and related conditions, including Dravet Syndrome, Lennox Gastaut Syndrome, 15q Duplication Syndrome, and CDKL5 Deficiency Disorder. It has also been studied in healthy volunteers, in hepatic impairment, and in complex regional pain syndrome. It is not approved and remains in clinical development.
Soticlestat is being developed by Takeda Pharmaceutical Company Limited, which trades under the ticker TAK. The drug is also known as TAK-935 and OV935 in clinical trial records.
Soticlestat is in Phase 2 clinical development, with completed Phase 1 and Phase 3 trials also on record. It is an investigational drug and is not FDA approved. All four listed trials for Soticlestat have been completed.
Soticlestat has completed four clinical trials. These include NCT03694275, a Phase 2 pilot study in 15q Duplication Syndrome and CDKL5 Deficiency Disorder; NCT04940624, a Phase 3 add-on study in Dravet Syndrome; and two Phase 1 healthy volunteer studies, NCT05064449 and NCT05602818.
Yes, Soticlestat is the same drug as TAK-935 and OV935. Clinical trial records use these alternative names interchangeably when referring to the same investigational compound.
Soticlestat is a small molecule that targets cholesterol 24-hydroxylase, an enzyme that converts cholesterol into 24S-hydroxycholesterol in the brain. By inhibiting this enzyme, the drug is thought to reduce excess excitatory signaling associated with seizures, though its exact mechanism in treating epilepsy is still under investigation.