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Drug-resistant epilepsy — time to target mechanisms

Despite the development of many new anti-seizure drugs over the past two decades, around one-third of individuals with epilepsy are without effective treatment. This pharmacoresistance is poorly understood, but new treatments targeting epileptogenesis instead of seizures have shown potential in animal models and are now being translated into the clinic.

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References

  1. Devinsky, O. et al. Epilepsy. Nat. Rev. Dis. Primers 4, 18024 (2018).

    Article  Google Scholar 

  2. Löscher, W., Potschka, H., Sisodiya, S. M. & Vezzani, A. drug resistance in epilepsy: clinical impact, potential mechanisms, and new innovative treatment options. Pharmacol. Rev. 72, 606–638 (2020).

    Article  Google Scholar 

  3. Chen, Z., Brodie, M. J., Liew, D. & Kwan, P. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs. JAMA Neurol. 75, 279 (2018).

    Article  Google Scholar 

  4. Lerche, H. et al. Ion channels in genetic and acquired forms of epilepsy. J. Physiol. 591, 753–764 (2013).

    Article  CAS  Google Scholar 

  5. Doeser, A. et al. Targeting pharmacoresistant epilepsy and epileptogenesis with a dual-purpose antiepileptic drug. Brain 138, 371–387 (2015).

    Article  Google Scholar 

  6. Tang, M., Park, S. H., De Vivo, D. C. & Monani, U. R. Therapeutic strategies for glucose transporter 1 deficiency syndrome. Ann. Clin. Transl Neurol. 6, 1923–1932 (2019).

    Article  CAS  Google Scholar 

  7. Wolff, M. et al. Genetic and phenotypic heterogeneity suggest therapeutic implications in SCN2A-related disorders. Brain 140, 1316–1336 (2017).

    Article  Google Scholar 

  8. French, J. A. et al. Adjunctive everolimus therapy for treatment-resistant focal-onset seizures associated with tuberous sclerosis (EXIST‑3): a phase 3, randomised, double-blind, placebo-controlled study. Lancet 388, 2153–2163 (2016).

    Article  CAS  Google Scholar 

  9. Wykes, R. C. et al. Optogenetic and potassium channel gene therapy in a rodent model of focal neocortical epilepsy. Sci. Transl Med. 4, 161ra152 (2012).

    Article  Google Scholar 

  10. Han, Z. et al. Antisense oligonucleotides increase Scn1a expression and reduce seizures and SUDEP incidence in a mouse model of Dravet syndrome. Sci. Transl Med. 12, eaaz6100 (2020).

    Article  Google Scholar 

Download references

Acknowledgements

The work of H.L. is supported by the German Research Foundation (DFG, Research Unit FOR-2715, grants Le 1030/14-1, /15-1 and /16-1) and by the Federal Ministry for Education and Research (BMBF, Treat-ION, 01GM1907A).

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Correspondence to Holger Lerche.

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H.L. has received personal honoraria for consulting or speaking from Arvelle, Bial, Biomarin, Desitin, Eisai and UCB; travel support from Bial, Desitin, Eisai and UCB; and research support from Bial, none directly related to any of the work presented here. He is a clinical investigator of the eslicarbazepine acetate trial (EudraCT Number: 2018-002747-29).

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Lerche, H. Drug-resistant epilepsy — time to target mechanisms. Nat Rev Neurol 16, 595–596 (2020). https://doi.org/10.1038/s41582-020-00419-y

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