Rufinamide for the treatment of Lennox-Gastaut syndrome.
Author(s): Besag FM.
Affiliation(s): South Essex Partnership Foundation NHS Trust, Milton Road, Bedford, MK41 6AT, UK.
FBesag@aol.com
Publication date & source: 2011, Expert Opin Pharmacother. , 12(5):801-6
INTRODUCTION: Lennox-Gastaut syndrome (LGS) is a severe treatment-resistant
childhood-onset epilepsy. This review examines the role of the new drug
rufinamide for the treatment of LGS. AREAS COVERED: MEDLINE and Google Scholar
searches were undertaken. The pharmaceutical company was contacted for the latest
information. LGS is characterized by the triad of diffuse slow spike-wave
discharges in the electroencephalogram (EEG), learning disability (mental
retardation) and frequent generalized seizures of multiple types, usually
including tonic, atonic and atypical absence seizures. Felbamate, lamotrigine and
topiramate have resulted in significant reductions in some seizure types, but no
treatment has achieved acceptable seizure control in most patients. In a pivotal
randomized, double-blind, placebo-controlled trial, the new drug rufinamide
achieved significant improvements in seizure control in previously resistant
subjects when added to up to three concomitant antiepileptic drugs. Open studies
including patients with LGS have also demonstrated efficacy. These trials and a
large open trial in adults and adolescents with partial seizures have revealed no
serious adverse effects so far. The most common adverse events were
fatigue/somnolence and vomiting. Rufinamide is of value in decreasing seizure
frequency in LGS, but seizure freedom is seldom achieved. Although no serious
adverse effects have been identified, the limited data available at present allow
no firm conclusions to be drawn with regard to safety. EXPERT OPINION: The data
support a role for rufinamide in treating LGS. However, more efforts are required
to provide antiepileptic drugs for this treatment-resistant epilepsy syndrome.
Rufinamide might also be of value in treating other forms of epilepsy.
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