Use of extended-release and immediate-release anti-seizure medications with a long half-life to improve adherence in epilepsy: A guide for clinicians

Gidal, Barry E.; Ferry, Jim; Reyderman, Larisa; Piña-Garza, J. Eric

doi:10.1016/j.yebeh.2021.107993

Cited by 20 publications

(15 citation statements)

References 80 publications

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“…Poor adherence to ASDs has been identified in approximately 30% to 40% of patients with epilepsy and is a cause of approximately 45% of breakthrough seizures . ASDs with extended-release formulations (carbamazepine, oxcarbazepine, valproic acid, levetiracetam, topiramate) or a long half-life (lamotrigine, zonisamide, eslicarbazepine) that can be given once a day may improve adherence.…”

Section: Methodsmentioning

confidence: 99%

Antiseizure Medications for Adults With Epilepsy

Kanner

Bicchi

2022

JAMA

199

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Section: Methodsmentioning

confidence: 99%

Antiseizure Medications for Adults With Epilepsy

Kanner

Bicchi

2022

JAMA

199

View full text Add to dashboard Cite

“…It should be noted that although most ER formulations are once‐daily dosing, twice‐daily dosing of ER formulations (i.e., carbamazepine) is still possible. With this, regimen simplification via IR formulations with longer half‐lives and ER formulations may improve medication adherence and improve drug efficacy 39 . When a clinician switches a patient from IR to an ER formulation, it is important to note that these two formulations may not always be bioequivalent and may require dosing adjustments 39 .…”

Section: Sources Of Pk Variability and Effect On Patient Response To ...mentioning

confidence: 99%

Sources of pharmacokinetic and pharmacodynamic variability and clinical pharmacology studies of antiseizure medications in the pediatric population

Maglalang,

Wen,

Hornik

et al. 2024

Clinical Translational Sci

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Multiple treatment options exist for children with epilepsy, including surgery, dietary therapies, neurostimulation, and antiseizure medications (ASMs). ASMs are the first line of therapy, and more than 30 ASMs have U.S. Food and Drug Administration (FDA) approval for the treatment of various epilepsy and seizure types in children. Given the extensive FDA approval of ASMs in children, it is crucial to consider how the physiological and developmental changes throughout childhood may impact drug disposition. Various sources of pharmacokinetic (PK) variability from different extrinsic and intrinsic factors such as patients' size, age, drug–drug interactions, and drug formulation could result in suboptimal dosing of ASMs. Barriers exist to conducting clinical pharmacological studies in neonates, infants, and children due to ethical and practical reasons, limiting available data to fully characterize these drugs' disposition and better elucidate sources of PK variability. Modeling and simulation offer ways to circumvent traditional and intensive clinical pharmacology methods to address gaps in epilepsy and seizure management in children. This review discusses various physiological and developmental changes that influence the PK and pharmacodynamic (PD) variability of ASMs in children, and several key ASMs will be discussed in detail. We will also review novel trial designs in younger pediatric populations, highlight the role of extrapolation of efficacy in epilepsy, and the use of physiologically based PK modeling as a tool to investigate sources of PK/PD variability in children. Finally, we will conclude with current challenges and future directions for optimizing the efficacy and safety of these drugs across the pediatric age spectrum.

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“…Status epilepticus is a prolonged seizure that damages neurons and neural networks; its appearance precedes drug resistance [ 1 , 2 ]. Although more than 30 anti-seizure medications (ASM) are currently available [ 3 ], unfortunately, long-term regular ASM intake allows only 40–60% of patients to achieve remission [ 4 ]. Surgical correction is an effective method for DRE treatment, however the positive results of surgery are noted only in 55–74% of patients [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Neuroglial Apoptosis and Neuroinflammation in the Epileptic Focus of the Brain and in the Blood of Patients with Drug-Resistant Epilepsy

Соколова

Zabrodskaya

Литовченко

et al. 2022

IJMS

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Neuroglial apoptosis and neuroinflammation play an important role in epileptogenesis. The aim of this study is to evaluate neuronal and glial apoptosis in association with neuroinflammation in brain epileptic focus and inflammatory changes in blood in patients with focal drug-resistant epilepsy (DRE). Pathological changes in the temporal lobe in epilepsy (histology, transmission electron microscopy), levels of apoptotic and neuroinflammatory proteins: active caspase-3 (immunohistochemistry), full-length form caspase-3, caspase-9, FAS, FAS-L, NF-kB, TNF-α, p53 (Western blot), and cytokine levels in blood: IL-1β, IL-2, IL-4, IL-7, TNF-α, etc. (multiplex analysis) were studied. In the present work, ultrastructural and immunohistochemical apoptotic signs were found in neurons and oligodendrocytes in the temporal lobe of DRE patients. Levels of proinflammatory cytokines that play a role in apoptosis (TNF-α, FAS, NF-kB) were increased. The blood concentration of IL-4, IL-7, TNF-α is increased and IL-2 is reduced. Oligodendroglial apoptosis has been shown to play an important role in DRE pathogenesis and to explain demyelination. Thus, a comprehensive analysis of revealed changes in the blood and brain in DRE patients showed the neuroinflammation in the epileptic focus, which was combined with the development of apoptosis of glial cells and neurons. This creates conditions for the development of drug resistance and the epilepsy progression.

show abstract

Use of extended-release and immediate-release anti-seizure medications with a long half-life to improve adherence in epilepsy: A guide for clinicians

Cited by 20 publications

References 80 publications

Antiseizure Medications for Adults With Epilepsy

Antiseizure Medications for Adults With Epilepsy

Sources of pharmacokinetic and pharmacodynamic variability and clinical pharmacology studies of antiseizure medications in the pediatric population

Relationship between Neuroglial Apoptosis and Neuroinflammation in the Epileptic Focus of the Brain and in the Blood of Patients with Drug-Resistant Epilepsy

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