Evidence map›Paper›PMID 42096179›Full record

Trial reportEpilepsia2026

Increased interval between seizure clusters across time in pediatric patients treated with the immediate-use seizure medication diazepam nasal spray.

James W Wheless, Eric Segal, Jurriaan M Peters, Steven M Wolf, Genei Bougher, Charles Davis, Leock Y Ngo, Enrique Carrazana, Adrian L Rabinowicz

Abstract readClinical Trial, Phase IClinical Trial, Phase II
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. Not yet cited in PubMed.

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

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

James W WhelessLe Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA.ORCID https://orcid.org/0000-0002-4735-3431
Eric SegalHackensack University Medical Center and Northeast Regional Epilepsy Group and Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA.ORCID https://orcid.org/0000-0002-9986-6394
Jurriaan M PetersHarvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-6725-2814
Steven M WolfDepartment of Pediatric Neurology, Boston Children's Health Physicians, New York, USA.ORCID https://orcid.org/0000-0002-7602-3474
Genei BougherNorthwest Florida Clinical Research Group, Gulf Breeze, Florida, USA.
Charles DavisCSD Biostatistics, Inc., Oro Valley, Arizona, USA.
Leock Y NgoNeurelis, Inc., San Diego, California, USA.ORCID https://orcid.org/0000-0002-8184-1367
Enrique CarrazanaNeurelis, Inc., San Diego, California, USA.ORCID https://orcid.org/0000-0001-8788-0722
Adrian L RabinowiczNeurelis, Inc., San Diego, California, USA.ORCID https://orcid.org/0000-0003-1299-0606

Funding

Neurelis, Inc.
6 · The paper itself

Abstract

objectiveSeizure clusters, intermittent increases in seizure activity that differ from a patient's usual seizure pattern, may occur despite treatment with a daily anti-seizure medication. Benzodiazepine-containing immediate-use seizure medications (ISMs; also called rescue therapies) are the cornerstone of treatment for seizure clusters. Diazepam nasal spray is approved by the U.S. Food and Drug Administration to treat seizure clusters in patients with epilepsy ≥2 years of age. A prior long-term safety study of diazepam nasal spray showed an increased inter-seizure cluster interval (SEIzure interVAL [SEIVAL]) in days across a year in patients 6 to 65 years of age. The current analysis focused on changes in SEIVAL over time in a separate study in children with epilepsy 2 to 5 years of age.

methodsPatients with epilepsy 2 to 5 years of age were enrolled in an open-label, Phase 1/2a trial of diazepam nasal spray that included a single-dose pharmacokinetics period, 180-day safety period, and optional extension period. Doses of 5, 10, or 15 mg were administered based on weight (0.5 mg/kg). A post hoc analysis evaluated SEIVAL for consecutive 90-day periods overall and in a consistent cohort of patients with persistent use and SEIVALs in each period.

resultsAmong enrolled patients (n = 36), 22 (61.1%) had ≥1 SEIVAL, with a total of 315 SEIVALs recorded. Mean SEIVAL (±SD) doubled from 25.2 (±21.3) days in Period 1 (n = 20) to 51.9 (±72.4) days in Period 3 (n = 8). In the consistent cohort (n = 7), mean SEIVAL increased from 22.1 (±12.7) days in Period 1 to 27.7 (±25.4) days in Period 3. SIGNIFICANCE: These results corroborate those of the earlier post hoc analysis of data from patients 6 to 65 years of age who received diazepam nasal spray for seizure clusters. These findings suggest a beneficial long-term treatment effect of diazepam nasal spray beyond acute use as an ISM.

Indexed as

AnticonvulsantsDiazepamSeizuresAdministration, IntranasalAdolescentChildChild, PreschoolFemaleHumansMaleNasal SpraysTime FactorsAnticonvulsantsDiazepamNasal Spraysacute repetitive seizuresbenzodiazepineintranasalrescue

Identifiers

PMID42096179
PMCPMC13360902

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.