RecruitingPhase 3NCT06907173

Ketamine add-on Therapy for Established Status Epilepticus Treatment Trial (KESETT)


Sponsor

University of Virginia

Enrollment

770 participants

Start Date

Feb 1, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to determine if treatment of patients with two doses of ketamine plus levetiracetam versus levetiracetam alone leads to more effective control of status epilepticus.


Eligibility

Min Age: 1 Year

Inclusion Criteria6

  • The patient was witnessed to have a convulsive seizure for greater than 5-minute duration
  • The patient received an adequate dose of benzodiazepines. The doses may be divided.
  • The last dose of a benzodiazepine was administered 5-30 minutes before study drug administration.
  • Continued or recurring seizures in the Emergency Department.
  • Age 1 years or older
  • Known or estimated weight ≥10 Kg

Exclusion Criteria12

  • Known pregnancy
  • Prisoner
  • Opt-out identification or otherwise known to be previously enrolled in KESETT
  • Treatment with a second line anticonvulsant (FOS, PHT, VPA, LEV, phenobarbital, or other agents defined in the MoP) for this episode of SE
  • Treatment with sedatives with anticonvulsant properties other than benzodiazepines for this episode of SE(propofol, etomidate, ketamine or other agents defined in the MoP)
  • Endotracheal intubation prior to enrollment
  • Acute traumatic brain injury clearly precedes seizures
  • Scalp injury or burn preventing EEG placement
  • Known allergy or other known contraindication to KET or LEV
  • Hypoglycemia \< 50 mg/dL
  • Hyperglycemia \> 400 mg/dL
  • Cardiac arrest / post-anoxic seizures

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Interventions

DRUGLevetiracetam (LEV) (60 mg/Kg) + 1 mg/kg Ketamine (KET)

The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study. All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded.

DRUGLevetiracetam (LEV) (60 mg/Kg) + 3 mg/kg Ketamine (KET)

The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study. All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded.

DRUGLevetiracetam (LEV) (60 mg/Kg)

The study drug will be produced at the central pharmacy, a GMP facility at the University of California, Davis. Diluted formulations are expected to remain stable for months when stored at room temperature. Expiration dates for study drugs will be determined and adjusted based on ongoing stability testing performed on study drugs prepared at the GMP facility for the study. All three formulations will be transparent solutions. None of the formulations are reported to consistently cause adverse effects at the infusion site. The method of drug administration, including volume and rate of infusion, is identical for all three drugs. These factors ensure that drug administration will be blinded.


Locations(31)

Arthur M. Blank Hospital

Georgia, Alabama, United States

Banner University Medical Center - Tucson Campus

Tucson, Arizona, United States

Ronald Reagan UCLA Medical Center

Los Angeles, California, United States

Children's Hospital Los Angeles

Los Angeles, California, United States

UC Davis Medical Center

Sacramento, California, United States

Yale New Haven Hospital

New Haven, Connecticut, United States

Christiana Hospital

Newark, Delaware, United States

Nemours Children's Hospital

Wilmington, Delaware, United States

Children's National Medical Center

Washington D.C., District of Columbia, United States

Orlando Regional Medical Center

Orlando, Florida, United States

Grady Memorial Hospital

Atlanta, Georgia, United States

Northwestern Memorial Hospital

Chicago, Illinois, United States

Comer Children's Hospital

Chicago, Illinois, United States

University of Chicago Medical Center

Chicago, Illinois, United States

Massachusetts General Hospital

Boston, Massachusetts, United States

University of Michigan University Hospital

Ann Arbor, Michigan, United States

SUNY Upstate Medical University

Syracuse, New York, United States

Duke Regional Hospital

Durham, North Carolina, United States

Duke University Hospital

Durham, North Carolina, United States

Nationwide Children's Hospital

Columbus, Ohio, United States

Oregon Health & Science University Hospital

Portland, Oregon, United States

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Temple University Hospital

Philadelphia, Pennsylvania, United States

UPMC Presbyterian Hospital

Pittsburgh, Pennsylvania, United States

UPMC Children's Hospital of Pittsburgh

Pittsburgh, Pennsylvania, United States

Reading Hospital

West Reading, Pennsylvania, United States

Children's Medical Center Dallas

Dallas, Texas, United States

University of Utah Healthcare

Salt Lake City, Utah, United States

University of Virginia Medical Center

Charlottesville, Virginia, United States

Harborview Medical Center

Seattle, Washington, United States

Children's Hospital of Wisconsin

Milwaukee, Wisconsin, United States

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NCT06907173


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