Treatment stores

The new set of bars for therapies in treatment-resistant epilepsy: Jacqueline A. French, MD

WATCHING TIME: 5 minutes

“We’ve now kind of set a new bar, and it’s going to be very difficult for any other drug to be developed in the field that doesn’t really have substantial demonstrable seizure improvement. We are not going to go back over what may show a median reduction of 40% compared to 20% in the placebo group.

Treatment-resistant or refractory epilepsy has impeded patients’ quality of life and proven to be a difficult hurdle for physicians in the field. Over the past 2 decades, 10-15 new therapies have come onto the market to treat epilepsy, but the number of people with refractory disease has mostly remained steady.

Although, quite recently, some of the most innovative therapies have made their way through the pipeline, particularly cenobamate (Xcopri; SK Life Science), which was approved in 2019. Recently, an analysis from the 2021 annual meeting of the American Epilepsy Society (AES), Dec. 3-7, Chicago, Illinois, showed that cenobamate treatment provided additional seizure-free benefits for patients with uncontrolled focal seizures taking 1-3 anticonvulsant medications that were refractory to previous epilepsy-related surgery.1

Recently, at the annual meeting of the American Academy of Neurology (AAN), April 2-7, in Seattle, Washington, Jacqueline A. French, MD, professor, department of neurology, NYU Langone Health Center, and co-director, Epilepsy Clinical Trials, NYU Langone, Comprehensive Epilepsy Center, spoke with NeurologyLive® on another therapy that could help reduce this number, XEN1101. The investigational agent is a potent KCNQ2/3 (Kv7.2/7.3) positive allosteric potassium channel opener developed by Xenon Pharmaceuticals. French, who is also the founder/director of the Epilepsy Study Consortium and chair of the steering committee for the Phase 2 X-TOLE study (NCT03796962), presented the data to the AAN.2.3

French also discussed his hopes for the future in developing drugs for treatment-resistant epilepsy that include disease-modifying rather than just symptomatic therapies, noting the reclassification of current agents as anticonvulsant drugs from the older term, antiepileptic drugs, as a sign of this change in mentality.

Click here for more AAN 2022 coverage.

1. Abou-Khalil B, Aboumatar S, Klein P, Krauss GL, Sperling MR, Rosenfeld WE. Efficacy of cenobamate for uncontrolled focal seizures in patients with prior epilepsy-related surgery: post-hoc analysis of a phase 3, multicenter, open-label study. Presented at: AES Annual Meeting; December 3-7, 2021; Chicago, Illinois and virtual. Summary 2.206
2. French JA, Porter R, Perucca E, et al. Phase 2b efficacy and safety of XEN1101, a novel potassium channel opener, in adults with focal epilepsy (X-TOLE). Presented at: Annual Meeting of the American Academy of Neurology; April 2-7, 2022; Seattle, WA and virtual. Abstract 000415.
3. Xenon Pharmaceuticals announces the first positive results of the Phase 2b “X-TOLE” clinical trial of XEN1101 for the treatment of focal epilepsy. Press release. Xenon Pharmaceuticals, Inc. October 4, 2021. Accessed October 5, 2021. -Results-from-Phase-2b-X-TOLE-Clinical-Trial-of-XEN1101-for-the-Treatment-of-Focal-Epilepsy.html