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Cenobamate


Authors: prof. MUDr. Milan Brázdil, Ph.D.
Authors place of work: 1. neurologická klinika ;  LF MU a FN u sv. Anny v Brně ;  Centrum pro epilepsie Brno
Published in the journal: Cesk Slov Neurol N 2022; 85(5): 417-420
Category: Lékový profil

Summary

Cenobamate (CNB) is a novel antiepileptic drug with a dual mechanism of action indicated for the adjunctive treatment of focal-onset seizures in adult patients with epilepsy inadequately controlled despite prior treatment with at least two antiepileptic drugs. In therapeutic doses, it most likely acts through positive allosteric modulation of γ-aminobutyric acid type A (GABAA) receptors at the non-benzodiazepine binding site, as well as preferential inhibition of persistent sodium currents and enhancement of the deactivated state of voltage-gated sodium channels. Numerous clinical experiences with cenobamate testify to its high effectiveness in terms of achieving seizure-freedom, even in patients who are still drug-resistant. At the same time, CNB appears to be a well-tolerated drug with a minimum of adverse events. However, attention must be paid to potential pharmacokinetic interactions and gradual titration when starting treatment. It is contraindicated in patients with a rare familial occurrence of a short QT interval. Its recommended dosage is 200–400 mg/d taken in one daily dose.

Keywords:

pharmacoresistance – Epilepsy – cenobamate – adjunctive treatment


Zdroje

1. Latimer DR, Edinoff AN, Ruff RD et al. Cenobamate, a sodium channel inhibitor and positive allosteric modulator of GABAA ion channels, for partial onset seizures in adults: a comprehensive review and clinical implications. Neurol Int 2021; 13 (2): 252–265. doi: 10.3390/neurolint13020026.

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6. Krauss GL, Klein P, Brandt C et al. Safety and efficacy of adjunctive cenobamate (YKP3089) in patients with uncontrolled focal seizures: a multicentre, double-blind, randomised, placebo-controlled, dose-response trial. Lancet Neurol 2020; 19 (1): 38–48. doi: 10.1016/S1474-4422 (19) 30399-0.

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10. Connor GS, Williamson A. Effectiveness and safety of adjunctive cenobamate for focal seizures in adults with developmental disability treated in clinical practice. Epilepsy Behav Rep 2022; 18: 100533. doi: 10.1016/j.ebr.2022.100533.

11.Rosenfeld WE, Ferrari L, Kamin M. Efficacy of cenobamate by focal seizure subtypes: Post-hoc analysis of a phase 3, multicenter, open-label study. Epilepsy Res 2022; 183: 106940. doi: 10.1016/j.eplepsyres.2022.106940.

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Štítky
Dětská neurologie Neurochirurgie Neurologie

Článek vyšel v časopise

Česká a slovenská neurologie a neurochirurgie

Číslo 5

2022 Číslo 5
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