Evidence map›Paper›PMID 41891667›Full record

Trial reportEpilepsia2026

A phase 3, randomized clinical trial of soticlestat as adjunctive therapy for Lennox-Gastaut syndrome.

Renzo Guerrini, Eric D Marsh, Wei-Ping Liao, Katsumi Imai, Ruzica Kravljanac, Anna Altmann, Cecil D Hahn, Stéphane Auvin, Jimmy Schiemann, Yasir Khan and 6 more

Registry-linked trialAbstract readRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04938427 (A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy, Safety, and Tolerability of Soticlestat as Adjunctive Therapy in Pediatric and Adult Subjects With Lennox-Gastaut Syndrome), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT04938427 phase3completednot on this map

A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy, Safety, and Tolerability of Soticlestat as Adjunctive Therapy in Pediatric and Adult Subjects With Lennox-Gastaut Syndrome (LGS)

TypeinterventionalSponsorTakedaRan2021 to 2024Enrolled270ConditionsLennox Gastaut Syndrome (LGS)ArmsPlacebo, Soticlestat
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

16 authors.

Renzo GuerriniNeuroscience and Human Genetics Department, Meyer Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Florence, Italy.ORCID https://orcid.org/0000-0002-7272-7079
Eric D MarshDivision of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-3264-0902
Wei-Ping LiaoInstitute of Neuroscience, Guangzhou Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0001-9929-9185
Katsumi ImaiNational Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
Ruzica KravljanacFaculty for Medicine, University of Belgrade, Institute for Mother and Child Health Care of Serbia, Belgrade, Serbia.
Anna AltmannSzent Janos Korhaz es Eszak-Budai Egyesitett Korhazak, Budapest, Hungary.
Cecil D HahnDivision of Neurology, Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-0887-8761
Stéphane AuvinAssistance Publique - Hôpitaux de Paris, Pediatric Neurology Department, Reference Center for Rare Epilepsies, member of European Reference Network EpiCARE, Hôpital Universitaire Robert-Debré, Paris, France.ORCID https://orcid.org/0000-0003-3874-9749
Jimmy SchiemannTakeda Development Center Americas, Cambridge, Massachusetts, USA.
Yasir KhanTakeda Development Center Americas, Cambridge, Massachusetts, USA.
Pranab MitraTakeda Development Center Americas, Cambridge, Massachusetts, USA.
Sarah I SheikhTakeda Development Center Americas, Cambridge, Massachusetts, USA.
Philipp von RosenstielTakeda Development Center Americas, Cambridge, Massachusetts, USA.
Mahnaz AsgharnejadTakeda Development Center Americas, Cambridge, Massachusetts, USA.ORCID https://orcid.org/0000-0001-8060-2148
Dennis DlugosDepartments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-3088-7645
Venkatesha MurthyTakeda Development Center Americas, Cambridge, Massachusetts, USA.ORCID https://orcid.org/0000-0001-5053-560X

Funding

Takeda Development Center Americas, Inc.
6 · The paper itself

Abstract

objectiveThere remains a need for new treatments for Lennox-Gastaut syndrome (LGS), a developmental and epileptic encephalopathy with a heterogenous patient population that often requires polytherapy. The phase 3, randomized SKYWAY study (NCT04938427) investigated the efficacy and safety of the cholesterol 24-hydroxylase inhibitor soticlestat (TAK-935) in participants with LGS.

methodsThis global, double-blind, placebo-controlled trial enrolled participants aged 2-55 years with LGS (adjudicated by the Epilepsy Study Consortium). Participants were randomized 1:1 to stable background medication plus either soticlestat (≤300 mg twice daily, weight-adjusted) or placebo over 16 weeks (4-week titration plus 12-week maintenance). The primary endpoint was percentage change from baseline in major motor drop (MMD) seizure frequency per 28 days.

resultsSKYWAY enrolled 270 participants (placebo, n = 136; soticlestat, n = 134); mean age was 12.9 years; 95% were receiving ≥2 antiseizure medications. The difference in median change from baseline in MMD seizure frequency for soticlestat versus placebo was -1.17% (p = .785) during the full treatment period and 2.43% (p = .778) during maintenance. No meaningful difference was observed between soticlestat and placebo for most key secondary endpoints; numerical trends for small effects favoring soticlestat were seen in the proportions of participants showing improvement in the Clinical Global Impression of Improvement (CGI-I) Non-seizure Symptoms Disruptive Behaviors domain (odds ratio = 1.91, nominal p = .032) and CGI-I Seizure Intensity and Duration (odds ratio = 1.67, nominal p = .029). Treatment-related adverse events (TEAEs; mostly mild or moderate) were reported in 68.4% of placebo-treated and 74.6% of soticlestat-treated participants; the most frequent treatment-related TEAE with soticlestat was somnolence. Serious treatment-related TEAEs occurred in one placebo-treated and three soticlestat-treated participants. SIGNIFICANCE: Soticlestat did not demonstrate efficacy versus placebo in reducing MMD seizure frequency; the safety findings were consistent with those of previous studies. These data suggest that targeting cholesterol 24-hydroxylase is not a suitable pharmacotherapeutic strategy for LGS.

Indexed as

AnticonvulsantsCholesterol 24-HydroxylaseLennox Gastaut SyndromeAdolescentAdultChildChild, PreschoolDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPiperidinesPyridinesTreatment OutcomeAnticonvulsantsCholesterol 24-HydroxylasePiperidinesPyridinessoticlestatcholesterol 24‐hydroxylaseLennox–Gastaut syndromesoticlestatTAK‐935

Identifiers

PMID41891667
PMCPMC13360899

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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.