癫痫新药苯巴那酯(cenobamate)的疗效？

The efficacy of the new epilepsy drug cenobamate is remarkable. The drug has shown high efficacy potential in reducing epileptic seizures. Its seizure-free rate has reached an unprecedented 28%. The frequency of epileptic seizures has been significantly reduced. In some patients, the frequency of seizures has been reduced by ≥50%. It is also safe and tolerable.

Studies have shown that adjunctive use of phenobarnate in adults with uncontrolled focal-onset epilepsy results in greater reductions in seizure frequency.

Phenomenate

It is one of the latest anti-epileptic drugs (ASMs) developed for the treatment of focal epileptic seizures in adults. The exact mechanism by which phenobarnate exerts its therapeutic effect in patients with partial epileptic seizures is unclear, but it has been shown that phenobarnate reduces repetitive neuronal discharges by inhibiting voltage-gated sodium currents.

Research on cenobamate

Purpose of the study: To evaluate the efficacy and safety of daily administration of 200 mg of phenobarnate in patients with focal (partial) epileptic seizures that cannot be controlled by taking 1-3 anti-epileptic drugs.

Methods: In a multicenter, double-blind, placebo-controlled study, 222 adults aged 18-65 years with focal epileptic seizures were randomly assigned in a 1:1 ratio after an 8-week baseline period to receive phenobarnate, with 113 receiving placebo and 109 receiving placebo.

Study results: Patients in the phenobarate group had a higher median percent seizure reduction compared to placebo, at 55.6%, compared with 21.5% in the placebo group. The remission rate was 50.4% in the phenobarate group, compared with 22.2% in the placebo group.

Phenobarate significantly reduced focal seizures with motor components, disturbance of consciousness, and focal to bilateral tonic-clonic seizures compared with placebo. During the maintenance period, 28.3% of patients in the phenobarnate group and 8.8% of patients in the placebo group were seizure-free.

Adjuvant therapy with 200 mg of phenobarate daily significantly improves control of uncontrollable focal seizures in adults and is well tolerated.

Phenobarnate can cause dependence

Clinical studies in healthy subjects have shown that phenobarate may cause physical dependence and lead to a withdrawal syndrome, mainly manifested by insomnia, decreased appetite, depressed mood, tremor, and amnesia. Phenobarate should be discontinued gradually to avoid withdrawal symptoms and signs after sudden discontinuation.

Phenomenate

Common ones include drowsiness, fatigue, weakness, sedation, dizziness, gait and coordination disorders, cognitive dysfunction, and visual changes. Serious adverse reactions mainly include increased eosinophils and systemic symptoms, multi-organ hypersensitivity reactions, QT shortening, suicidal behavior, and thoughts. Pay attention to observation during medication. If serious side effects occur, consult a doctor to stop medication promptly.

References:

Chung SS, French JA, Kowalski J, Krauss GL, Lee SK, Maciejowski M, Rosenfeld WE, Sperling MR, Mizne S, Kamin M. Randomized phase 2 study of adjunctive cenobamate in patients with uncontrolled focal seizures. Neurology. 2020 Jun 2;94(22):e2311-e2322. doi: 10.1212/WNL.0000000000009530. Epub 2020 May 14. PMID: 32409485; PMCID: PMC7357293.

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