Evidence map›Paper›PMID 40775196›Full record

Trial reportCNS drugs2025

Clinically Meaningful Reduction in Drop Seizures in Patients with Lennox-Gastaut Syndrome Treated with Cannabidiol: Post Hoc Analysis of Phase 3 Clinical Trials.

Nicola Specchio, Stéphane Auvin, Teresa Greco, Lieven Lagae, Charlotte Nortvedt, Sameer M Zuberi

2 registry-linked trialsAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
In one paragraph

Trial report in CNS drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

NCT02224560 phase3completednot on this map

A Randomized, Double-blind, Placebo-controlled Study to Investigate the Efficacy and Safety of Cannabidiol (GWP42003-P; CBD) as Adjunctive Treatment for Seizures Associated With Lennox-Gastaut Syndrome in Children and Adults.

TypeinterventionalSponsorJazz PharmaceuticalsRan2015 to 2016Enrolled225ConditionsEpilepsy, Lennox Gastaut SyndromeArmsGWP42003-P, Placebo control
NCT02224690 phase3completednot on this map

A Randomized, Double-blind, Placebo-controlled Study to Investigate the Efficacy and Safety of Cannabidiol (GWP42003-P; CBD) as Adjunctive Treatment for Seizures Associated With Lennox-Gastaut Syndrome in Children and Adults.

TypeinterventionalSponsorJazz PharmaceuticalsRan2015 to 2016Enrolled171ConditionsEpilepsy, Lennox-Gastaut SyndromeArmsGWP42003-P 20 mg/kg/day Dose, Placebo
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
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

6 authors.

Nicola SpecchioNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Rome, Italy. nicola.specchio@opbg.net.ORCID 0000-0002-8120-0287
Stéphane AuvinAPHP, Robert Debré University Hospital, Pediatric Neurology Department, CRMR epilepsies rares, EpiCare Member, Paris, France.ORCID 0000-0003-3874-9749
Teresa GrecoJazz Pharmaceuticals, Inc., Gentium Srl, Villa Guardia, Italy.ORCID 0000-0003-0532-0364
Lieven LagaeUniversity Hospitals of Leuven, Leuven, Belgium.ORCID 0000-0002-7118-0139
Charlotte NortvedtJazz Pharmaceuticals, Switzerland GmbH, Zug, Switzerland.ORCID 0000-0002-1956-8259
Sameer M ZuberiRoyal Hospital for Children and University of Glasgow, Glasgow, UK.ORCID 0000-0002-4489-4697

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveIn clinical trials of patients with Lennox-Gastaut syndrome (LGS), a ≥ 50% reduction in drop seizure frequency is generally accepted as a key endpoint. However, smaller reductions (< 50%) may yet be impactful for patients in real-world settings. This exploratory analysis evaluated the threshold for a clinically important response in drop seizures that is associated with the Caregiver Global Impression of Change (CGIC) scale score in patients with LGS treated with cannabidiol (CBD) oral solution and assessed the suitability of CGIC as an anchor for meaningful change.

methodsThis exploratory post hoc analysis included patients with LGS (N = 215, age 2-55 years) receiving CBD (Epidiolex

resultsIn the 215 patients receiving CBD with a CGIC score recorded, CGIC was "slightly improved" or better in 60% of patients, and "much improved" or better in 31% after 14 weeks of treatment. With a CGIC rating of "slightly improved" or better, the best threshold for a clinically important response in drop seizure reduction was - 30.6% (57.7% of patients). Mean and median percentage reductions in drop seizures were - 46.9% and - 58.6%, respectively. Using "much improved" or better, the best threshold was - 49.6% (40.5% of patients). Mean and median percentage reductions in drop seizures were - 57.6% and - 66.0%, respectively. Spearman's correlation was 0.47.

conclusionAnchoring to CGIC of "slightly improved" or better, the threshold for a clinically meaningful reduction in drop seizure frequency was 31%, suggesting that a 50% cutoff may overlook patients with meaningful improvements in their overall condition, as perceived by their caregivers. CGIC scores, although potentially less nuanced than other standardized clinical assessments, were appropriate anchors to determine thresholds. This exploratory analysis may help contextualize clinical trial data to better understand potential patient benefit attained by reductions in drop seizure frequency observed in real-world settings that are < 50%. CLINICAL TRIALS REGISTRATION NUMBERS: NCT02224560 and NCT02224690.

Indexed as

AnticonvulsantsCannabidiolLennox Gastaut SyndromeSeizuresAdolescentAdultChildChild, PreschoolDouble-Blind MethodFemaleHumansMaleMiddle AgedTreatment OutcomeYoung AdultAnticonvulsantsCannabidiol

Identifiers

PMID40775196
PMCPMC12423233

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

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.