New anti-seizure medications are all effective as add-on treatments for focal seizures, according to a new review in the journal Seizure.
The study looked at the effectiveness of newer, ‘third-generation’ anti-seizure medications treatments in teens and adults.
The medications included in the study were lacosamide (LCM), eslicarbazepine (ESL), perampanel (PER), brivaracetam (BRV), cenobamate (CNB), pregabalin (PGB) and rufinamide (RUF), as well as ganaxolone and XEN1101.
The review, by Zhijun Le and colleagues, analysed the effectiveness of the ASMs using a 50% responder rate metric (half the participants had a significant improvement compared to placebo) and a 100% responder rate metric (everyone had a significant improvement compared to placebo) at eight and 12 weeks.
The researchers believe this is the first comprehensive comparison of the newer group of ASMs in terms of effectiveness, as well as how well tolerated they were.
Study results
The results showed that all medications gave significant improvements in focal seizures compared to placebo, but cenobamate had significantly higher 100% responder rate at eight and 12 weeks.
Most medications also didn’t increase the risk of treatment side effects over the placebo, apart from cenobamate and XEN1101. Brivaracetam had the lowest risk of side effects.
The researchers concluded that “all third-generation ASMs demonstrated substantial efficacy and acceptable safety”. They added that cenobamate “remains the most favourable agent” because of its effectiveness and “favourable safety”.
However, they added that “these results warrant cautious interpretation”, and ongoing trials will further clarify how the effectiveness of these medications compare.
Focal seizure information
Focal seizures are a common type of seizure in epilepsy. People can experience these where they remain conscious, or ones where their consciousness is affected.
Focal seizures can involve repetitive movements and strange sensations and emotions. People with epilepsy have shared what they can feel like to them, including déjà vu, anxiety and confusion.
A focal seizure is usually short, lasting seconds or minutes.
The Epilepsy Action website has more information about epilepsy medications, focal seizures and first aid for focal epilepsy.
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