New Antiepileptic drugs
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Seizure control New Antiepileptic drugs
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New Antiepileptic drugs
- 1. Amr Hassan M.D.,FEBN Associate professor of Neurology - Cairo University NOVEL ANTIEPILEPTIC DRUGS
- 2. Antiepileptic drug development 1840 1860 1880 1900 1920 1940 1960 1980 2000 0 5 10 15 20 Bromide Phenobarbital Phenytoin Primidone Ethosuximide Sodium Valproate Benzodiazepines Carbamazepine Zonisamide Felbamate Gabapentin Topiramate Fosphenytoin OxcarbazepineTiagabine Levetiracetam Rufinamide Lacosamide Pregabalin Calendar Year NumberofLicensedAntiepilepticDrugs Lamotrigine Vigabatrin Perampanel Retigabine Levetiracetam eslicarbazepine 2
- 3. Seizure control Safety/tolerability Compliance ARS and SE Detection and Prediction of seizures New Devices New drugs OD dosing, XR formula Rapid drug delivery Do we need more new epilepsy drugs?
- 4. How do we make progress? 4 Evolutionary Drugs • Improve on existing drugs Revolutionary Drugs • Drugs that work with new mechanisms never tried before
- 5. Epilepsy’s new pipeline therapeutics 5 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial
- 6. Epilepsy’s new pipeline therapeutics 6 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial
- 7. UCB:Company Approval Status: Approved February 2016 Brivaracetam (BRV) 7
- 8. Brivaracetam (BRV): Mechanism of Action Inhibitory synapse Excitatory synapse Brivaracetam 8
- 9. Brivaracetam (BRV) • A novel high-affinity synaptic vesicle protein 2A (SV2A) ligand. • Also displays inhibitory activity at neuronal voltage- dependent sodium channels. • Adjunctive treatment of adults with POS. 1.Kenda et al. J Med Chem 2004;47:530–549 2.Zona et al. Epilepsy Res 2010;8846–54 9
- 12. Levetiracetam • Company: Aprecia Pharmaceuticals Company • Approval Status: Approved August 2015 • a 3D printed drug product 12
- 13. ZipDose Technology using 3D printing: How it’s made 13
- 15. Topiramate Extended-Release Formulation 15 Company: Upsher-Smith Laboratories Approval Status: Approved March 2014 Specific Treatments: • Partial onset and primary generalized tonic-clonic seizures • Lennox-Gastaut Syndrome
- 16. Topiramate Extended-Release Formulation (Qudexy XR ) 16
- 17. Eslicarbazepine Acetate (Aptiom) • Company: Sunovion Pharmaceuticals • Approval Status: Approved November 2013 • Indications: Partial-onset seizures 17
- 18. Eslicarbazepine Acetate : Mechanism of Action Inhibitory synapse Excitatory synapse Eslicarbazepine 18
- 19. Oxcarbazepine extended release • Company: Supernus Pharmaceuticals • Approval Status: Approved October 2012 • Indications: Partial seizures in adults and in children 6 years to 17 years of age 19
- 20. Oxcarbazepine extended release (Oxtellar XR ) 20
- 21. Perampanel • Company: Eisai Inc. • Approval Status: Approved October 2012 • Indications: Partial-onset seizures 21
- 22. Inhibitory synapse Excitatory synapse Perampanel 22 Perampanel
- 24. •Serious Psychiatric Changes •Behavioral Changes •Homicidal Or Suicidal Thoughts. Perampanel (Fycompa®)
- 25. Ezogabine = Retigabine • Company: Valeant Pharmaceuticals • Approval Status: Approved June 2011 • Indications: Partial-onset seizures 25
- 26. Retigabine: Mechanism of Action Inhibitory synapse Excitatory synapse Retigabine 26 Retigabine
- 27. Ezogabine = Retigabine (Potiga) 27
- 28. Rufinamide • Company: Eisai Medical Research Inc. • Approval Status: Approved November 2008 • Specific treatments: Lennox-Gastaut Syndrome 28
- 29. Rufinamide 29
- 30. Rufinamide: Mechanism of Action Inhibitory synapse Excitatory synapse Rufinamide 30
- 32. Epilepsy’s new pipeline therapeutics 32 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial
- 33. Epilepsy’s new pipeline therapeutics 33 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial
- 35. Selurampanel 35 • Phase II. • a competitive antagonist of the AMPA and kainate receptors. • It has also been studied in the acute treatment of migraine(some pain relief, but with a relatively high rate of side effects
- 37. Cannabidiol (Epidiolex) 37 March 14, 216 (GLOBE NEWSWIRE) Dravet syndrome
- 38. Company: Laboratoires Biocodex Approval Status: Not FDA approved Specific treatments: Dravet syndrome Stiripentol increases GABAergic activity. It enhances central GABA neurotransmission through a barbiturate-like effect. Stiripentol (Diacomit) 38
- 39. Ganaxolone 39 PCDH 19 female pediatric epilepsy
- 40. PCDH 19 female pediatric epilepsy 40 • Serious and rare epileptic syndrome. • An inherited mutation of the protocadherin 19 (PCDH19) gene (X chromosome). • Early-onset cluster seizures, cognitive and sensory impairment and behavioral disturbances.
- 41. IV Ganaxolone April 15, 2016 41 Status epilepticus
- 42. Synthetic Huperzine A • Company:Biscayne ph • Derived from Chinese plant Chinese club moss • AchEI • Phase II 2016 CPS • Phase II 2017 Dravet syndrome 42
- 51. AEG
- 52. Epilepsy’s new pipeline therapeutics 52 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 52
- 53. Epilepsy’s new pipeline therapeutics 53 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 53
- 54. IV Carbamazepine (Carnexiv) • Company: Lundbeck • Approval Status: Approved October 2016 • Lundbeck plans to make Carnexiv commercially available in the United States in early 2017. 54
- 56. Diazepam rectal gel (Diastat) 56
- 59. Epilepsy’s new pipeline therapeutics 59 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 59
- 60. Epilepsy’s new pipeline therapeutics 60 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 60
- 61. Inhaled alprazolam • Originator Alexza Pharmaceuticals • Mechanism of Action GABA A receptor agonists • Phase II 61
- 63. Transdermal CBD gel ZYN002 63
- 64. Transdermal cannabidiol (CBD) gel 64
- 67. Epilepsy’s new pipeline therapeutics 67 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 67
- 68. Epilepsy’s new pipeline therapeutics 68 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 68
- 69. Triheptanoin in GLUT1 deficiency •GDD •Epilepsy •Movement disorders 69
- 70. Triheptanoin in GLUT1 deficiency 70
- 71. Epilepsy’s new pipeline therapeutics 71 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 71
- 72. Epilepsy’s new pipeline therapeutics 72 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 72
- 73. Responsive Neurostimulation • FDA Approved November 2013 • Adjunctive treatment for adults with medically refractory partial seizures
- 74. Epilepsy Alarm Bed Seizure Detection
- 76. Watches
- 77. Epilepsy’s new pipeline therapeutics 77 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 77
- 78. Epilepsy’s new pipeline therapeutics 78 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 78
- 79. Trigeminal nerve stimulation (TNS) 79
- 80. Epilepsy’s new pipeline therapeutics 80 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 80
- 81. Epilepsy’s new pipeline therapeutics 81 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 81
- 83. IV Lacosamide
- 84. IV Levetiracetam
- 85. Inhibitory synapse Excitatory synapse Levetiracetam 85 Levetiracetam: Mechanism of action
- 86. Epilepsy’s new pipeline therapeutics 86 New Drugs New route (Enhanced Drug Delivery) Dietary Supplement New Therapeutic Devices New in Egyptian Market Marketed Marketed Marketed Under Trial Under Trial Under Trial 86
- 87. Seizure control Safety/tolerability Compliance ARS and SE Detection and Prediction of seizures New Devices New drugs OD dosing, XR formula Rapid drug delivery DO WE NEED MORE NEW EPILEPSY DRUGS?