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https://www.readbyqxmd.com/read/29761351/economic-evaluation-of-stiripentol-for-dravet-syndrome-a-cost-utility-analysis
#1
Jesse Elliott, Bláthnaid McCoy, Tammy Clifford, George A Wells, Doug Coyle
BACKGROUND: Dravet syndrome is a catastrophic form of pediatric treatment-resistant epilepsy with few effective treatment options. Stiripentol is approved for use in Canada for treatment of Dravet syndrome, but the associated long-term costs and benefits have not been well-studied and its cost effectiveness is unclear. OBJECTIVE: The aim of this study was to evaluate the cost effectiveness of stiripentol as an adjunctive treatment to clobazam and valproate for treatment of Dravet syndrome from the perspective of the Canadian public healthcare payer...
May 15, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29747241/stiripentol-add-on-therapy-for-focal-refractory-epilepsy
#2
REVIEW
Francesco Brigo, Stanley C Igwe, Nicola Luigi Bragazzi
BACKGROUND: This is an updated version of the Cochrane review last published in 2015 (Issue 10). For nearly 30% of people with epilepsy, seizures are not controlled by current treatments. Stiripentol is a new antiepileptic drug (AED) that was developed in France and was approved by the European Medicines Agency (EMA) in 2007 for the treatment of Dravet syndrome as an adjunctive therapy with valproate and clobazam, with promising effects. OBJECTIVES: To evaluate the efficacy and tolerability of stiripentol as add-on treatment for people with focal refractory epilepsy who are taking AEDs...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29746397/impact-of-drug-interactions-on-clobazam-and-n-desmethylclobazam-concentrations-in-pediatric-patients-with-epilepsy
#3
Gabrielle R Russell, Stephanie J Phelps, Chasity M Shelton, James W Wheless
BACKGROUND: Clobazam (CLB) is approved as adjunctive treatment for seizures associated with Lennox-Gastaut syndrome in patients ≥2 years of age. It is converted to an active metabolite N-desmethylclobazam (NCLB) by CYP3A4, which is then broken down to an inactive metabolite by CYP2C19. This study characterizes the impact of CYP3A4 and CYP2C19 drug interactions on CLB and NCLB serum concentrations (Cp) and concentration/dose (Cp/D) ratios in pediatric patients with epilepsy. METHODS: This was a retrospective chart review including patients >1 month of age, who received CLB between April 2012 and March 2017...
May 4, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29719278/clinical-and-electrocorticographic-response-to-antiepileptic-drugs-in-patients-treated-with-responsive-stimulation
#4
Tara L Skarpaas, Thomas K Tcheng, Martha J Morrell
OBJECTIVE: The objective of this study was to explore whether chronic electrocorticographic (ECoG) data recorded by a responsive neurostimulation system could be used to assess clinical responses to antiepileptic drugs (AEDs). METHODS: Antiepileptic drugs initiated and maintained for ≥3 months by patients participating in clinical trials of the RNS® System were identified. Such "AED Starts" that produced an additional ≥50% reduction in patient-reported clinical seizure frequency were categorized as clinically beneficial, and the remaining as not beneficial...
April 29, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29605792/determination-of-benzodiazepines-in-beverages-using-green-extraction-methods-and-capillary-hplc-uv-detection
#5
Maurizio Piergiovanni, Achille Cappiello, Giorgio Famiglini, Veronica Termopoli, Pierangela Palma
Dispersive liquid-liquid microextraction with and without ultrasound assistance (DLLME, UA-DLLME) and microextraction with packed sorbent (MEPS) methods for the extraction and determination of eight different benzodiazepines (BDZ) (chlordiazepoxide, flurazepam, bromazepam, oxazepam, lorazepam, clobazam, clonazepam, and flunitrazepam) in three commercial non-alcoholic and light alcoholic beverages were optimized and compared. Benzodiazepines are frequently used for their extensive diffusion and strong numbing effect in drug-facilitated crimes (DFC)...
March 17, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29594870/treatment-strategies-for-dravet-syndrome
#6
REVIEW
Kelly G Knupp, Elaine C Wirrell
Dravet syndrome (DS) is a medically refractory epilepsy that onsets in the first year of life with prolonged seizures, often triggered by fever. Over time, patients develop other seizure types (myoclonic, atypical absences, drops), intellectual disability, crouch gait and other co-morbidities (sleep problems, autonomic dysfunction). Complete seizure control is generally not achievable with current therapies, and the goals of treatment are to balance reduction of seizure burden with adverse effects of therapies...
March 28, 2018: CNS Drugs
https://www.readbyqxmd.com/read/29571152/comparative-efficacy-of-unique-antiepileptic-drug-regimens-in-focal-epilepsy-an-exploratory-study
#7
Alexander W Legge, Kamil Detyniecki, Asif Javed, Lawrence J Hirsch, Kenneth Kato, Richard Buchsbaum, Baibing Chen, Hyunmi Choi
OBJECTIVE: To compare efficacy of unique antiepileptic drug (AED) polytherapy regimens among patients with focal epilepsy. METHODS: From a longitudinal study of AED treatment, we identified patients with active focal epilepsy who had attempted at least two unique AED regimens (mono-, duo-, or tri-therapy). Efficacy was defined as the presence of at least one six-month period of continuous seizure freedom during exposure to a regimen. To control for individual variations in response and epilepsy severity, we used within-patient comparison approaches, in which we: 1) compared head-to-head unique regimens tried within the same patients; 2) compared one regimen versus aggregate of other regimens attempted in that patient; and 3) compared aggregated monotherapy versus polytherapy regimens...
March 10, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29555100/myoclonus-in-angelman-syndrome
#8
Sarah F Pollack, Olivia R Grocott, Kimberly A Parkin, Anna M Larson, Ronald L Thibert
Angelman syndrome (AS) is a neurogenetic imprinting disorder caused by loss of the maternally inherited Ube3a gene and is characterized by generalized epilepsy, limited expressive speech, sleep dysfunction, and movement disorders. Myoclonic seizures are often the first seizure type to appear, and myoclonic status, associated with developmental regression, may occur in the first few years of life. Additionally, there have been rare reports of prolonged episodes of myoclonus without electrographic correlate in adults with AS...
May 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29540584/randomized-dose-ranging-safety-trial-of-cannabidiol-in-dravet-syndrome
#9
Orrin Devinsky, Anup D Patel, Elizabeth A Thiele, Matthew H Wong, Richard Appleton, Cynthia L Harden, Sam Greenwood, Gilmour Morrison, Kenneth Sommerville
OBJECTIVE: To evaluate the safety and preliminary pharmacokinetics of a pharmaceutical formulation of purified cannabidiol (CBD) in children with Dravet syndrome. METHODS: Patients aged 4-10 years were randomized 4:1 to CBD (5, 10, or 20 mg/kg/d) or placebo taken twice daily. The double-blind trial comprised 4-week baseline, 3-week treatment (including titration), 10-day taper, and 4-week follow-up periods. Completers could continue in an open-label extension. Multiple pharmacokinetic blood samples were taken on the first day of dosing and at end of treatment for measurement of CBD, its metabolites 6-OH-CBD, 7-OH-CBD, and 7-COOH-CBD, and antiepileptic drugs (AEDs; clobazam and metabolite N -desmethylclobazam [N-CLB], valproate, levetiracetam, topiramate, and stiripentol)...
April 3, 2018: Neurology
https://www.readbyqxmd.com/read/29517622/pharmgkb-summary-clobazam-pathway-pharmacokinetics
#10
Rachel Huddart, J Steven Leeder, Russ B Altman, Teri E Klein
No abstract text is available yet for this article.
April 2018: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/29487964/-use-of-antiepileptic-drugs-during-breastfeeding-what-do-we-tell-the-mother
#11
M Crettenand, A O Rossetti, T Buclin, U Winterfeld
BACKGROUND: Knowledge about the passage of various antiepileptic drugs into breast milk and its consequences for the infant is limited. Faced with this uncertainty, breastfeeding is often discouraged for these patients. The aim of this study was to comprehensively review the available data regarding antiepileptic drugs during breastfeeding, to compare these data with information provided by the summary of product characteristics (SmPCs), and to provide recommendations for the use of these drugs in breastfeeding women...
February 27, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29477837/a-survey-of-antiepileptic-drug-responses-identifies-drugs-with-potential-efficacy-for-seizure-control-in-wolf-hirschhorn-syndrome
#12
Karen S Ho, Leah M Markham, Hope Twede, Amanda Lortz, Lenora M Olson, Xiaoming Sheng, Cindy Weng, E Robert Wassman, Tara Newcomb, E Robert Wassman, John C Carey, Agatino Battaglia
Seizures are present in over 90% of infants and children with Wolf-Hirschhorn syndrome (WHS). When present, they significantly affect quality of life. The goal of this study was to use caregiver reports to describe the comparative efficacies of commonly used antiepileptic medications in a large population of individuals with WHS. A web-based, confidential caregiver survey was developed to capture seizure semiology and a chronologic record of seizure treatments as well as responses to each treatment. Adverse events for each drug were also cataloged...
April 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29429908/efficacy-of-artisanal-preparations-of-cannabidiol-for-the-treatment-of-epilepsy-practical-experiences-in-a-tertiary-medical-center
#13
Giulia S Porcari, Cary Fu, Emily D Doll, Emma G Carter, Robert P Carson
Medically refractory epilepsy continues to be a challenge worldwide, and despite an increasing number of medical therapies, approximately 1 in 3 patients continues to have seizures. Cannabidiol (CBD), one of many constituents of the Cannabis sativa or marijuana plant, has received renewed interest in the treatment of epilepsy. While highly purified CBD awaits Food and Drug Administration (FDA) approval, artisanal formulations of CBD are readily available and are seeing increased use in our patient population...
March 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29363217/predicting-drug-efficacy-in-chronic-low-back-pain-by-quantitative-sensory-tests
#14
J Schliessbach, A Siegenthaler, L Bütikofer, P Vuilleumier, P Jüni, U Stamer, L Arendt-Nielsen, M Curatolo
BACKGROUND: Drugs are prescribed for chronic low back pain without knowing in advance whether a patient will respond to them or not. Quantitative sensory tests (QST) can discriminate patients according to sensory phenotype, possibly reflecting underlying mechanisms of pain processing. QST may therefore be a screening tool to identify potential responders to a certain drug. The aim of this study was to investigate whether QST can predict analgesic effects of oxycodone, imipramine and clobazam in chronic low back pain...
May 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29344464/cannabinoids-in-the-treatment-of-epilepsy-hard-evidence-at-last
#15
REVIEW
Emilio Perucca
The interest in cannabis-based products for the treatment of refractory epilepsy has skyrocketed in recent years. Marijuana and other cannabis products with high content in Δ(9) - tetrahydrocannabinol (THC), utilized primarily for recreational purposes, are generally unsuitable for this indication, primarily because THC is associated with many undesired effects. Compared with THC, cannabidiol (CBD) shows a better defined anticonvulsant profile in animal models and is largely devoid of adverse psychoactive effects and abuse liability...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29330897/cyclodextrin-assisted-dispersive-liquid-liquid-microextraction-for-the-preconcentration-of-carbamazepine-and-clobazam-with-subsequent-sweeping-micellar-electrokinetic-chromatography
#16
Szu-Ying Chen, Wen-Chi Chen, Sarah Y Chang
A new version of dispersive liquid-liquid microextraction, namely, cyclodextrin-assisted dispersive liquid-liquid microextraction, with subsequent sweeping micellar electrokinetic chromatography has been developed for the preconcentration and sensitive detection of carbamazepine and clobazam. α-Cyclodextrin and chloroform were used as the dispersive agent and extraction solvent, respectively. After the extraction, carbamazepine and clobazam were analyzed using micellar electrokinetic chromatography with ultraviolet detection...
January 13, 2018: Journal of Separation Science
https://www.readbyqxmd.com/read/29282644/a-case-of-nephrogenic-syndrome-of-inappropriate-antidiuresis-caused-by-carbamazepine
#17
Naoko Sekiya, Midori Awazu
We report a case of nephrogenic syndrome of inappropriate antidiuresis caused by carbamazepine (CBZ). CBZ, an antiepileptic drug, is known to cause hyponatremia. The mechanism is generally considered to be inappropriate secretion of antidiuretic hormone, whereas an experimental study suggests a direct effect of CBZ on the kidney by stimulating vasopressin receptor. An 18-year-old male with atypical autism and epilepsy has been treated with CBZ and clobazam since age 9 and 10 years, respectively. At age 11, he was found to have asymptomatic hyponatremia...
December 27, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29218701/a-longitudinal-cohort-study-on-the-impact-of-the-clobazam-shortage-on-patients-with-epilepsy
#18
Sara Lukmanji, Khara M Sauro, Colin B Josephson, K Chelsea Altura, Samuel Wiebe, Nathalie Jetté
OBJECTIVE: Drug shortages are occurring at an increasing rate. From May to October 2016, there was a shortage of a level I critical antiepileptic drug, clobazam. We aimed to study the impact of this shortage on patients with epilepsy. METHODS: Adult patients from Calgary's Comprehensive Epilepsy Program who were taking clobazam were approached to participate in the study. Baseline data from the clinic prospective registry included clinical variables and presurvey patient-reported outcomes (PROs) such as the Global Assessment of Severity of Epilepsy, the Global Assessment of Disability Associated with Seizures, and the Quality of Life in Epilepsy questionnaire...
February 2018: Epilepsia
https://www.readbyqxmd.com/read/29202277/optimizing-clobazam-treatment-in-patients-with-lennox-gastaut-syndrome
#19
Jouko Isojarvi, Barry E Gidal, Steve Chung, Robert T Wechsler
Given the complexities managing Lennox-Gastaut syndrome (LGS)-comorbid conditions, multiple associated seizure types that tend to be refractory to treatment-dosage optimization of antiepileptic drug (AED) treatment is a challenge. In the absence of clinical trial data on optimization of AED dosage in patients with LGS, dose titration is guided by personal experience, anecdotal evidence, and specific patient factors (age, comorbid conditions and medications, seizure types, etc.). The goal of this study was to determine whether a 20% increase in adjunctive clobazam was a reasonable benchmark for improved seizure response in patients with LGS who had responded to adjunctive clobazam treatment during a 12-week lead-in trial...
January 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29168169/response-to-clobazam-in-continuous-spike-wave-during-sleep
#20
Clemente Vega, Ivan Sánchez Fernández, Jurriaan Peters, Maria S Thome-Souza, Michele Jackson, Masanori Takeoka, Greta N Wilkening, Phillip L Pearl, Kevin Chapman, Tobias Loddenkemper
AIM: To evaluate the efficacy of clobazam treatment in reducing epileptiform discharges and modifying neuropsychological function in continuous spike-wave during slow wave sleep. METHOD: We performed a prospective clinical trial in patients with continuous spike-wave during sleep aged 4 to 10 years. Patients underwent neuropsychological assessment and overnight electroencephalographic monitoring before treatment, and subsequent repeat assessment and overnight electroencephalographic monitoring 3 months after treatment...
March 2018: Developmental Medicine and Child Neurology
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