Evidence map›Paper›PMID 34033266›Full record

Trial reportEpilepsia open2021

Consistent safety and tolerability of Valtoco

Ian Miller, James W Wheless, Robert E Hogan, Dennis Dlugos, Victor Biton, Gregory D Cascino, Michael R Sperling, Kore Liow, Blanca Vazquez, Eric B Segal and 6 more

Open access · goldAbstract readClinical Trial, Phase III
In one paragraph

Trial report in Epilepsia open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.4field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Population Pharmacokinetics of Intranasal Amiloride in Healthy Volunteers.European journal of drug metabolism and pharmacokinetics · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 11 institutions in 1 country.

Ian MillerFormerly Nicklaus Children's Hospital, Miami, FL, USA.ORCID 0000-0003-0416-1015
James W WhelessLe Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Robert E HoganWashington University in St. Louis, St. Louis, MO, USA.ORCID 0000-0003-2272-5005
Dennis DlugosChildren's Hospital of Philadelphia, Philadelphia, PA, USA.
Victor BitonArkansas Epilepsy Program, Little Rock, AR, USA.
Gregory D CascinoMayo Clinic, Rochester, MN, USA.
Michael R SperlingThomas Jefferson University, Philadelphia, PA, USA.ORCID 0000-0003-0708-6006
Kore LiowHawaii Pacific Neuroscience, Honolulu, HI, USA.
Blanca VazquezComprehensive Epilepsy Center, New York University, New York, NY, USA.
Eric B SegalHackensack University Medical Center and Northeast Regional Epilepsy Group, Hackensack, NJ, USA.
Daniel TarquinioCenter for Rare Neurological Diseases, Atlanta, GA, USA.
Weldon MauneyNorthwest Florida Clinical Research Group, Gulf Breeze, FL, USA.
Jay DesaiChildren's Hospital of Los Angeles, Los Angeles, CA, USA.
Adrian L RabinowiczNeurelis, Inc., San Diego, CA, USA.
Enrique CarrazanaNeurelis, Inc., San Diego, CA, USA.
DIAZ.001.05 Study Group
Neurelis (United States) · USChildren's Hospital of Los Angeles · USChildren's Hospital of Philadelphia · USHackensack University Medical Center · USHawaii Pacific University · USMayo Clinic in Arizona · USMiami Children's Hospital · USNew York University · USThomas Jefferson University · USUniversity of Tennessee Health Science Center · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNeed for rescue therapy differs among patients with seizure clusters. Diazepam nasal spray is approved to treat seizure clusters in patients with epilepsy ≥6 years of age. This analysis used interim data from a phase 3 safety study to assess safety profile and effectiveness of diazepam nasal spray using average number of doses/month as a proxy measurement.

methodsThis phase 3, open-label, repeat-dose, safety study of diazepam nasal spray enrolled patients (6-65 years) with epilepsy and need of benzodiazepine rescue. Patients were stratified by average number of doses/month (<2, moderate frequency; 2-5, high frequency; >5, very-high frequency). Safety was evaluated based on treatment-emergent adverse events (TEAEs), assessed nasal irritation, and olfaction. The proportion of treatments given as a second dose was used as an exploratory proxy for effectiveness.

resultsOf 175 enrolled patients (data cutoff, October 31, 2019), 158 received ≥1 dose of diazepam nasal spray. Frequency of use was moderate in 43.7% of patients, high in 50.6% of patients, and very high in 5.7% of patients. Patients treated 3397 seizure episodes (moderate frequency, 14.2%; high frequency, 59.9%; very high frequency, 25.8%). Nasal discomfort was the most common treatment-related TEAE in all groups. No notable changes in nasal irritation or olfaction were observed. Second doses represented only 2.5%, 7.5%, and 17.2% of all doses in the moderate-, high-, and very-high-frequency groups, respectively. Overall retention rate was 82.9%, without an observed relationship to frequency of use. SIGNIFICANCE: Frequency of dosing diazepam nasal spray had little impact on the safety/tolerability profile across a range of <2 to >5 doses/month. Effectiveness was suggested for all dosing frequencies by the high proportion of seizure clusters not treated with a second dose. These results support the utility, safety profile, and effectiveness of diazepam nasal spray across frequencies of seizure cluster burden.

Indexed as

EpilepsyNasal SpraysAdministration, IntranasalDiazepamHumansSeizuresDiazepamNasal Spraysacute repetitive seizurediazepamdosing frequencyintranasalnasal sprayseizure cluster

Identifiers

PMID34033266
PMCPMC8408590
OpenAlexW3158250907

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.