Managing drug resistant epilepsy (DRE)

Effectiveness of cenobamate and vagus nerve stimulation (VNS) highlighted at recent EAN congress

At the recent 10th Congress of the European Academy of Neurology (EAN), two investigator-led ePresentation sessions on epilepsy outlined the effectiveness of a combination of anti-seizure medication (ASM) cenobamate and vagus nerve stimulation (VNS) in managing drug-resistant epilepsy (DRE). The combination therapy demonstrated significant improvements in seizure control, highlighting its potential as a safe and effective treatment option, according to GlobalData.

Jos Opdenakker, Neurology Analyst at GlobalData, comments: “Epilepsy is often treated in combination therapy as many patients do not achieve complete seizure control through monotherapy. Combination therapies are beneficial as they result in fewer side effects in comparison to using a single drug at a high dose.”

Research at the University of Ghent demonstrated that the addition of cenobamate to VNS treatment resulted in a worthwhile improvement in patients with DRE. The findings were supported by a case study at the University of Messina, Italy.

Opdenakker continues: “The efficacy data presented at EAN instills confidence in the combination of cenobamate and VNS for the treatment of DRE and points towards a potential roadmap of seizure control for patients living with DRE. Furthermore, the data presented by the University of Ghent, and the University of Messina may signify cenobamate’s candidacy as a monotherapy for epilepsy.”

This supports insights from the key opinion leaders (KOLs) previously interviewed by GlobalData, who have highlighted the high level of efficacy of cenobamate in clinical trials involving patients living with DRE.

There is a Phase IV open-label study currently being planned in the US, which aims to assess the efficacy and safety of cenobamate monotherapy in adult subjects with newly diagnosed or recurrent partial-onset epilepsy (NCT06453213). This is a testament that cenobamate’s potential as a monotherapy is being recognised. Furthermore, KOLs previously interviewed by GlobalData have stated that drug regulatory bodies, such as the FDA and the EMA, are considering changing the approval patterns of ASMs to allow for additional monotherapies to treat epilepsy. This is provided that the treatment has displayed efficacy in combination therapy.   Opdenakker concludes: “Given cenobamate’s success when used in combination with VNS, it is not difficult to envision a future for cenobamate as a monotherapy for epilepsy. However, further research into the combination of cenobamate and VNS is warranted to optimize treatment protocols and confirm its benefit and reliability. Cenobamate’s potential as a monotherapy for epilepsy can then be further evaluated.”

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