Literature Review

New AEDs Have Not Increased Seizure Control


 

Is Better Seizure Control Possible?

“The observation that newer drugs have not increased the percentage of people who are rendered seizure-free is not new and should not be surprising,” said W. Allen Hauser, MD, Special Lecturer in the Gertrude H. Sergievsky Center at Columbia University in New York, in an accompanying editorial. “Even though mechanisms of action of specific drugs may differ, the same animal models have been used to predict successful suppression of seizures in preclinical studies for the last 80 years, and successful response has been the basis for clinical drug development for both old and new therapeutic agents.”

Nevertheless, the data “are sobering and somewhat disconcerting,” Dr. Hauser added. “In 1881, pioneering neurologist Sir William Gowers reported that he could not control seizures in 36% of the patients to whom he prescribed bromide compounds. It seems that we might not have improved our initial management results for a much longer period than the 30 years covered in the current study. While biologically unlikely, it is possible that a two-thirds proportion represents a ceiling for the initial control of epilepsy.”

—Erik Greb

Suggested Reading

Chen Z, Brodie MJ, Liew D, Kwan P. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study. JAMA Neurol. 2017 Dec 26 [Epub ahead of print].

Hauser WA. Questioning the effectiveness of newer antiseizure medications. JAMA Neurol. 2017 Dec 26 [Epub ahead of print].

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