Evidence map›Paper›PMID 42400405›Full record

Trial reportEpilepsia2026

Prolonged fenfluramine use in open-label studies of Dravet or Lennox-Gastaut syndromes: Long-term safety, tolerability, patient global functioning, and considerations for interpreting effectiveness.

Antonio Gil-Nagel, Kelly G Knupp, Boudewijn Gunning, Domenica Immacolata Battaglia, Elizabeth A Thiele, Ingrid E Scheffer, An-Sofie Schoonjans, Rima Nabbout, Nathalie Villeneuve, Kerstin Alexandra Klotz and 9 more

Registry-linked trialAbstract readClinical 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 NCT03936777 (An Open-Label Extension Trial to Assess the Long-Term Safety of ZX008), 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.

NCT03936777 phase3completednot on this map

An Open-Label Extension Trial to Assess the Long-Term Safety of ZX008 (Fenfluramine Hydrochloride) Oral Solution as an Adjunctive Therapy for Seizures in Patients With Rare Seizure Disorders Such as Epileptic Encephalopathies Including Dravet Syndrome and Lennox-Gastaut Syndrome

TypeinterventionalSponsorZogenix, Inc.Ran2019 to 2025Enrolled412ConditionsDravet Syndrome, Lennox Gastaut Syndrome, Epileptic EncephalopathyArmsZX008 (Fenfluramine Hydrochloride)
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

19 authors.

Antonio Gil-NagelHospital Ruber Internacional, Madrid, Spain.
Kelly G KnuppUniversity of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.ORCID https://orcid.org/0000-0002-1967-0827
Boudewijn GunningStichting Epilepsie Instellingen Nederland, Zwolle, the Netherlands.
Domenica Immacolata BattagliaFondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
Elizabeth A ThieleMassachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-3431-4713
Ingrid E SchefferUniversity of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
An-Sofie SchoonjansUniversity Hospital Antwerp, Antwerp, Belgium.ORCID https://orcid.org/0000-0001-7545-518X
Rima NabboutReference Center for Rare Epilepsies, Necker Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris (APHP), member of European Reference Network EpiCARE, Paris, France.
Nathalie VilleneuveLa Timone Children Hospital, Assistance Publique - Hôpitaux de Marseille (APHM), Marseille, France.
Kerstin Alexandra KlotzUniversity Hospital of Bonn, member of European Reference Network EpiCARE, Bonn, Germany.ORCID https://orcid.org/0000-0002-1601-5384
Nicola SpecchioBambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), member of European Reference Network EpiCARE, Rome, Italy.
Rocio Sanchez-CarpinteroClínica Universidad de Navarra, Pamplona, Spain.ORCID https://orcid.org/0000-0002-5058-0686
Marta ZolnowskaPlejady Medical Center, Kraków, Poland.
Anne-Liv SchulzUCB, Monheim am Rhein, Germany.
Lily PerrinUCB, Slough, UK.
Najla DicksonUCB, Morrisville, North Carolina, USA.
Mélanie LangloisUCB, Courbevoie, France.
Amélie LotheUCB, Courbevoie, France.ORCID https://orcid.org/0009-0001-9337-054X
Joseph SullivanWeill Institute for Neurosciences and Benioff Children's Hospital, University of California, San Francisco, San Francisco, California, USA.

Funding

UCB
6 · The paper itself

Abstract

objectiveLong-term safety and global functioning are reported in patients with Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS) treated with fenfluramine in an open-label extension (OLE) study after participating in a previous open-label feeder study.

methodsPatients could enroll in this international, multicenter OLE (NCT03936777) after completing one of three fenfluramine open-label studies. The latest feeder study fenfluramine dose was continued, then flexibly titrated (maximum: .7 mg/kg/day [26 mg/day] without stiripentol or .4 mg/kg/day [17 mg/day] with stiripentol), with ≥1 concomitant antiseizure medication administered. Primary endpoint was fenfluramine long-term safety/tolerability. Global functioning using caregiver- and investigator-reported Clinical Global Impression of Improvement (CGI-I) ratings, globally and for subdomains (cognition, behavior, motor function), at last visit relative to study baseline was evaluated. Overall treatment exposure and age groups were analyzed post hoc.

resultsA total of 412 patients enrolled (DS: 265 [64.3%], LGS: 147 [35.7%]); 30.8% were ≥18 years old. Median fenfluramine treatment duration in this OLE was 729.5 days (range = 8-1544), and overall median fenfluramine exposure, including feeder studies, was 1464.5 days (range = 171-2800). In this OLE, ≥1 treatment-emergent adverse event (TEAE) was reported in 311 (75.5%) patients; fenfluramine-related (per investigator) serious TEAEs were reported in five (1.2%) patients. Three patients died in this OLE (deemed unrelated to fenfluramine by investigators). After starting this OLE already receiving fenfluramine, 373 of 401 (93.0%) and 376 of 401 (93.8%) patients were rated by caregiver and investigator, respectively, as "improved or no change" on CGI-I versus this study baseline; subdomain ratings of "improved or no change" were largely consistent with global assessment. SIGNIFICANCE: In our OLE study of patients with DS or LGS treated with fenfluramine (up to 4 years), no new or unexpected safety signals were observed; global functioning was improved or stable (vs. study baseline) in >90% of patients, supporting long-term fenfluramine use in pediatric and adult patients with DS or LGS.

Indexed as

AnticonvulsantsEpilepsies, MyoclonicFenfluramineLennox Gastaut SyndromeAdolescentAdultChildChild, PreschoolFemaleHumansMaleTreatment OutcomeYoung AdultAnticonvulsantsFenfluramineCGI–Idevelopmental and epileptic encephalopathyDSLGSseizure

Identifiers

PMID42400405
PMCPMC13675763

What OpenQuestion holds

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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.