卢非酰胺(Rufinamid)治疗癫痫能完全控制发作吗？

Rufinamid (Rufinamid) can completely control seizures in the treatment of epilepsy, but it cannot completely control all types of epileptic seizures. Rufinamid is an effective anti-epileptic drug that can reduce the frequency and severity of epileptic seizures.

Rufinamide

Rufinamide was granted orphan drug status in 2004 for the adjuvant treatment of Lennox-Gastaut syndrome-related seizures in patients aged ≥4 years and was subsequently approved for this indication in several countries, including Europe and the United States. Structurally unrelated to other antiepileptic drugs, rufinamide is thought to act primarily by prolonging the inactivation period of voltage-gated sodium channels.

The mechanism of action of rufinamide

It is a triazole derivative that can reduce the recovery ability of nerve sodium channels after inactivation, limit the firing of nerve sodium-dependent action potentials and mediate anticonvulsant effects.

Rufinamide can completely control seizures in the treatment of epilepsy

About 80% of patients can completely control seizures after treatment with rufinamide. After regular treatment, 50% of patients can have no seizures for life. Rufinamide was well tolerated and effective in significantly reducing the frequency of fall episodes and total seizures.

However, epilepsy is a complex neurological disease with many types of seizures. The type and degree of seizures vary depending on individual differences. Rufinamide has certain curative effects on different types of epilepsy seizures, but it is not guaranteed to be completely effective for all patients with epilepsy.

Rufinamide for seizure control

Adjuvant oral rufinamide was more effective than placebo in the treatment of seizures associated with refractory Lennox-Gastaut syndrome in children, adolescents and adults in a well-designed 16-week trial.

Compared with placebo, the rufinamide group had a significant reduction from baseline in total seizure frequency and median tonic-flaccid seizure frequency per 28 days and showed an improvement in seizure severity. Furthermore, these beneficial effects of rufinamide on seizure frequency were maintained during a subsequent 3-year open-label extension study.

Adjuvant rufinamide treatment significantly reduced the frequency of partial seizures per 28 days in adult patients with inadequate partial seizure control compared with placebo in two well-designed trials lasting approximately 3 months, with a higher proportion of the rufinamide treatment group having a ≥50% reduction in partial seizure frequency per 28 days.

A pivotal, 12-week, randomized, double-blind trial demonstrated the effectiveness of oral rufinamide as an adjunctive treatment for patients with LGS uncontrolled on 1-3 concomitant antiepileptic drugs. Compared with placebo, rufinamide significantly reduced 28-day drop seizure frequency and total seizure frequency, and significantly increased the proportion of patients with a ≥50% reduction in each seizure frequency.

The effects of rufinamide

mainly include drowsiness, nausea, vomiting, headache, fatigue, dizziness, loss of appetite, upper abdominal pain, attention disorder, itching, etc.

Measures for dealing with side effects

1. Drowsiness: Maintain a good work and rest routine, ensure adequate sleep, and carry out appropriate activities during the day to avoid excessive fatigue.

2. Nausea and vomiting: Pay attention to a light diet, eat more easily digestible foods, such as porridge, noodles, vegetables, etc., and avoid spicy and greasy foods. Maintain good dining habits and eat small meals more frequently. If symptoms of nausea and vomiting persist, anti-nausea medication may be considered.

3. Headache and fatigue: Pay attention to rest and avoid overexertion. You can do appropriate exercises, such as walking, yoga, etc., to improve your physical fitness.

4. Dizziness, attention disorder: Avoid working at heights, driving and other tasks that require concentration.

5. Decreased appetite: Keep a diversified diet and try to match it with rich colors and flavors to increase appetite.

6. Itching: Maintain personal hygiene and use mild skin care products to avoid skin irritation and scratching.

Summary

The use of anti-epileptic drugs needs to be individualized, and each patient's situation is different. Therefore, when using rufinamide or other anti-epileptic drugs, a suitable treatment plan needs to be developed based on the individual situation.

References:

1. Deeks ED, Scott LJ. Rufinamide. CNS Drugs. 2006;20(9):751-60; discussion 761. doi: 10.2165/00023210-200620090-00007. PMID: 16953653.

2. McCormack PL. Rufinamide: a pharmacoeconomic profile of its use as adjunctive therapy in Lennox-Gastaut syndrome. Pharmacoeconomics. 2012 Mar;30(3):247-56. doi: 10.2165/11208630-000000000-00000. PMID: 22332960.

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