News Topics: Treatments

Positive airway pressure therapy improved seizure control in epileptic patients with obstructive sleep apnea

A Sleep study, “1145 Long-Term Seizure Control in Epileptic Patients with Obstructive Sleep Apnea Using Positive Airway Pressure Therapy” found [1]:

[There were] better 1-year seizure outcomes in people with epilepsy and Positive Airway Pressure-treated Obstructive Sleep Apnea compared with Untreated Obstructive Sleep Apnea and No Obstructive Sleep Apnea.

[Researchers] investigated the effect of positive airway pressure therapy on long-term seizure outcomes in adults with epilepsy who underwent polysomnography at Cleveland Clinic (1997–2016). Seizure outcomes included mean % seizure reduction, ?50% seizure reduction from baseline (%, responder rate), and ? 50% seizure reduction or seizure free at both baseline and follow up (%, successful outcome).

Successful outcome was achieved more often in Positive Airway Pressure-treated (84%) than Untreated Obstructive Sleep Apnea (57%; p=0.002) or No Obstructive Sleep Apnea (66%; p=0.009) groups. [The results] expand existing literature supporting the impact of sleep therapies on seizure control in people with epilepsy.

Fenfluramine provides significant seizure reduction in Dravet syndrome, according to European Journal of Neurology study

The study “Low-dose fenfluramine significantly reduces seizure frequency in Dravet syndrome: a prospective study of a new cohort of patients” found [1]:

Patients with Dravet syndrome experienced sustained periods of clinically meaningful improved seizure control during fenfluramine treatment with a favorable tolerability and no echocardiographic or clinical evidence of cardiac valvulopathy or pulmonary hypertension.

Nine patients (aged 1.2–29.8 years) enrolled in the study and were treated with fenfluramine for a median duration of 1.5 (range, 0.3–5.1) years.

All patients demonstrated a reduction in seizure frequency during the treatment period with a median reduction of 75% (range, 28–100%). Seven patients (78%) experienced a ?50% reduction in major motor seizure frequency.

FDA Approves Lundbeck’s New Drug

The Food and Drug Administration (FDA) has approved Lundbeck’s Carnexiv™ (carbamazepine) injection as a short-term replacement therapy for oral carbamazepine formulations in adults with certain seizure types when oral administration is temporarily not feasible. Carnexiv will be the first available intravenous (IV) formulation of the antiepileptic drug (AED) carbamazepine, and Lundbeck plans to make it commercially available in the US in early 2017. Carnexiv is a short-term (7 days) intravenous replacement therapy for oral carbamazepine formulations that provides continuity of care for adult patients who are unable to take carbamazepine by mouth and have seizure types: partial seizures with complex symptomatology; generalized tonic-clonic seizures; and mixed seizure patterns.

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CURE Responds to DEA’s Decision on Marijuana Scheduling

Chicago, IL – This month the Drug Enforcement Administration (DEA) announced their decision to maintain marijuana as a Schedule I drug, despite petitions from Citizens United for Research in Epilepsy (CURE) and many other research and patient-focused organizations concerned with the federal barriers prohibiting researchers from fully understanding the potential of medical cannabis. Despite this setback, CURE is pleased with the DEA’s decision to expand the number of DEA-registered marijuana manufacturers for research, of which there is currently only one, so more researchers will be able to conduct much-needed research on cannabidiol (CBD) – the major non-psychoactive ingredient in marijuana, as well as the many other cannabinoids found in marijuana.

An estimated 3 million Americans currently live with epilepsy and for two-thirds of them, the cause is unknown, making treatment difficult if not impossible to pinpoint. The positive results that some people with epilepsy have been seeing from CBD-rich marijuana extracts are giving so many parents what they have been lacking for so long – hope. CBD may not be the answer for all of these families, but when available medications and surgeries do not stop the uncontrollable seizures, every avenue must be explored.

As the leading nongovernmental agency fully committed to funding research in epilepsy, we believe researchers should be encouraged and supported to test not only pure CBD, but also high CBD/low-THC cannabis, pure-THC and other types of medical marijuana to determine the efficacy of these and other combinations on seizure control and the genesis of epilepsy. We are hoping for more changes to marijuana access that makes it easier for researchers to continue their vital work.

The Fight to Improve Research Access to Cannabis Continues

WASHINGTON, D.C.— Due to its incredible medicinal potential, we continue to believe that more research must be done on marijuana rich in cannabidiol (CBD). In late April, CURE signed a group letter addressed to Chuck Rosenberg, the head of the Drug Enforcement Administration (DEA), urging him to remove cannabis from Schedule I in the Controlled Substances Act.

This would eradicate federal barriers to research, paving the way for more progressive research and new treatments. CURE has joined with other organizations in support of the Compassionate Access, Research Expansion, and Respect States Act (CARERS, S. 683, H.R. 1538) which would facilitate safe and legal access to medical cannabis for patients and physicians acting in accordance with state law and lift federal barriers to research. The CARERS Act would also remove low-THC cannabis from the CSA allowing individuals in states that have created protections for low-THC therapies to more easily access this potential treatment option.

Current regulatory hurdles make it difficult for researchers to gain access to marijuana rich in CBD. There is no debate that the hoops through which researchers must jump to acquire marijuana, or any chemical found in it, are hindering scientific advancement—and CURE is committed to helping researchers overcome these obstacles to advance research in this important area.

Acorda Therapeutics, Inc. Announces Discontinuation of PLUMIAZ™ (diazepam)

WASHINGTON, D.C.— Acorda Therapeutics, Inc. announced May 20 it will discontinue development of PLUMIAZ™ (diazepam) Nasal Spray, an investigational therapy which was being studied for the treatment of seizure clusters in people with epilepsy. Data from ongoing clinical trials do not demonstrate its bioequivalence to Diastat® gel, which is needed for New Drug Applications (NDA).

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Epilepsy, Seizures, Physical Exercise, and Sports: A Report From the ILAE Task Force on Sports and Epilepsy

Article, published in Epilepsia

Summary 

People with epilepsy (PWEs) are often advised against participating in sports and exercise, mostly because of fear, overprotection, and ignorance about the specific benefits and risks associated with such activities. Available evidence suggests that physical exercise and active participation in sports may favorably affect seizure control, in addition to producing broader health and psychosocial benefits. This consensus paper prepared by the International League Against Epilepsy (ILAE) Task Force on Sports and Epilepsy offers general guidance concerning participation of PWEs in sport activities, and provides suggestions on the issuance of medical fitness certificates related to involvement in different sports. Sports are divided into three categories based on potential risk of injury or death should a seizure occur: group 1, sports with no significant additional risk; group 2, sports with moderate risk to PWEs, but no risk to bystanders; and group 3, sports with major risk. Factors to be considered when advising whether a PWE can participate in specific activities include the type of sport, the probability of a seizure occurring, the type and severity of the seizures, seizure precipitating factors, the usual timing of seizure occurrence, and the person’s attitude in accepting some level of risk. The Task Force on Sports and Epilepsy considers this document as a work in progress to be updated as additional data become available.