New drugs for epilepsy and multiple sclerosis

By | May 17, 2023

A new medication for the treatment of epilepsy, with the active principle kenobamate, was added to the electronic prescription a week ago and is covered by insurance funds.

This medication comes in pill form and reduces seizures in adult patients by 50%. In addition, it is expected that in 2024 another two drugs will enter the market in our country, which are indicated for the treatment of Dravet, Lennox Gastaut and Rett syndromes in children.

“Kenobamati has been approved by the European Medicines Agency (EMA) in March 2021, but only a few days ago it was included in the electronic prescription. It is in the form of a pill and is taken once a day. It is mainly indicated for adult patients with drug-resistant epilepsy with focal seizures, with or without secondary generalization.That is, it affects 1/3 of patients who are not controlled by other pharmaceutical options.Taking kenobamate achieves a 50% reduction in seizures, improving the patients’ quality of life”, said -among others- the Associate Professor of Neurology, AUTH, 1st PGNT AHEPA Neurological Clinic Martha Spilioti, during his theme speech “Newer Antiepileptic Drugs in the Treatment of Epilepsy”, in the context of the 9th Panhellenic Congress of Applied Pharmacy (PSEF), organized by the Pharmaceutical Association of Thessaloniki.

At the same time, he noted that in 2024 two more drugs are expected in the form of an oral solution. The only drug with the active substance fenfluramine was approved in 2020 by the FDA and in 2021 by the European Medicines Agency for the treatment of seizures in Dravet syndrome, a childhood myoclonic epilepsy that usually presents between 4 months and the 3 years old. In 2023, it also received approval for Lennox Gastaut syndrome, one of the most severe forms of epilepsy in children from the age of 2, as well as in adults.

In addition, the drug trofinetide, which reduces inflammation and neuronal apoptosis, was approved in 2023 for children 2 years and older and for adults as first-line treatment for Rett syndrome, a genetic neurological disorder that occurs only in girls. mentally retarded. , motor disability and epilepsy. Research with the well-known ketamine (antiepileptic used intravenously in status epilepticus in the ICU) in oral administration for Rett syndrome will also go to phase 3.

The messages for the treatment of multiple sclerosis (multiple sclerosis) are also encouraging. As pointed out by aAssociate Professor of Neurology-Neuroimmunology AUTH, 1st PGNT AHEPA Neurological Clinic, Efrosony Koutsourakiin his theme speech “Disease-modifying drugs in multiple sclerosis” During the 9th PSEF, it is estimated that more than 2.8 million people worldwide suffer from multiple sclerosis, in Greece more than 18,000 and in Europe more than 800,000 with an age of onset more frequent between 20-40 years and a prevalence in women (1.5 -3 times more than men).

“The early initiation of treatment changes the natural course of the disease leading to reduced functionality in patients, because it appears that the degenerative process begins very early, significantly affects the progression of disability, and is related to neuroinflammation, which it is the primary target of more than the drugs approved for the disease. 15 drugs to treat the disease are already on sale in Greece, while six more are expected. Early initiation of treatment in patients with active multiple sclerosis can lead to long-term remission of disease symptoms and avoidance of severe disability, although of course no definitive treatment for the disease has yet been found,” said Ms. .Koutsouraki.

According to her, the choice of drugs is based on the greatest benefit for each patient depending on the particularities of his life and the type of multiple sclerosis he presents, as well as the least possibility of serious side effects in the long term.

“What is important for women with multiple sclerosis to know is that everyone can have a child if they want to. The conditions for this are planning, that the disease is in remission, stabilized, without relapses. In the event that the disease has not stabilized, but a pregnancy continues, if the treating neurologist considers it necessary, the patient can also take some medications during pregnancy so that the disease does not worsen, but also does not overwhelm the fetus.In addition, studies have shown that the Breastfeeding reduces the hereditary predisposition to multiple sclerosis in children whose parents have the disease,” emphasized Ms. Koutsouraki.

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