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Innovations in Seizure Management: Exploring New Antiseizure Medications and Targeted Therapies

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 2266

Special Issue Editors


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Guest Editor

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Guest Editor
Dipartimento di Scienze Pediatriche, Università degli Studi di Messina, Messina, Italy
Interests: neurodevelopmental disorders; genetics; neonatal neurology; epilepsy; pediatric neurology; developmental neurology

Special Issue Information

Dear Colleagues,

Epilepsy treatment has undergone notable advancements owing to novel pharmacological approaches and targeted therapies, spanning across age groups from adults to children. This shift towards precision medicine aims to tackle the diverse etiologies of epilepsy and individual patient responses. By emphasizing personalized treatment strategies such as therapeutic drug monitoring and the integration of pharmacogenomic data, clinicians can optimize therapy efficacy and safety.

This Special Issue of IJMS will focus on the recent developments in pharmacological treatments for epilepsy, highlighting the potential of targeted therapy to revolutionize patient care. By targeting the specific molecular pathways underlying seizure disorders, these therapies offer promising avenues for seizure control and an enhanced quality of life. Additionally, the incorporation of precision medicine principles into clinical practice has the potential of tailoring treatment regimens, minimizing adverse reactions, and optimizing therapeutic outcomes.

Furthermore, epilepsy encompasses various medical conditions characterized by recurrent seizures, presenting a management challenge due to the plethora of syndromes, seizure types, and variable treatment responses among individuals. Over the past two decades, genetic etiology has been unveiled in over half of all epilepsies, with single gene defects in ion channels or neurotransmitter receptors associated with the most inherited forms. The advent of genetic tests, ranging from targeted assays to whole exome and whole genome sequencing, has propelled genetic discovery in epilepsy, shedding light on molecular mechanisms and providing targets for precision medicine in select syndromes. While precision medicine in epilepsy has primarily focused on seizure control, addressing neurodevelopmental and neuropsychiatric comorbidities remains a future avenue. This Special Issue aims to explore the recent advances in genetic testing and outline the tailored treatments applicable to some monogenic epilepsies, envisioning a future where epilepsy treatment adopts a widespread precision medicine approach.

Dr. Antonio Gennaro Nicotera
Prof. Dr. Gabriella Di Rosa
Guest Editors

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Keywords

  • antiseizure medications
  • targeted therapies
  • epilepsy
  • monogenic epilepsies
  • new antiseizures medications
  • developmental and epileptic encephalopathies

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Published Papers (1 paper)

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Review

14 pages, 298 KiB  
Review
Cenobamate, a New Promising Antiseizure Medication: Experimental and Clinical Aspects
by Barbara Błaszczyk, Stanisław J. Czuczwar and Barbara Miziak
Int. J. Mol. Sci. 2024, 25(23), 13014; https://doi.org/10.3390/ijms252313014 - 3 Dec 2024
Cited by 1 | Viewed by 1991
Abstract
About 40–50% of patients with drug-resistant epilepsy do not properly respond to pharmacological therapy with antiseizure medications (ASMs). Recently approved by the US Food and Drug Administration and European Medicines Agency as an add-on drug for focal seizures, cenobamate is an ASM sharing [...] Read more.
About 40–50% of patients with drug-resistant epilepsy do not properly respond to pharmacological therapy with antiseizure medications (ASMs). Recently approved by the US Food and Drug Administration and European Medicines Agency as an add-on drug for focal seizures, cenobamate is an ASM sharing two basic mechanisms of action and exhibiting a promising profile of clinical efficacy. The drug preferably inhibits persistent sodium current and activates GABA-mediated events via extrasynaptic, non-benzodiazepine receptors. Thus, its antiseizure potential is dependent on both reducing excitation and enhancing inhibition in the central nervous system. In experimental seizure models, cenobamate exhibited a clear-cut activity in many of them with promising protective indexes, with only bicuculline-induced seizures being unaffected. Randomized clinical trials indicate that combinations of cenobamate, with already prescribed ASMs, resulted in significant percentages of seizure-free patients and patients with a significant reduction in seizure frequency, compared to other ASMs in the form of an add-on therapy. Its greater antiseizure efficacy was accompanied by adverse events comparable to other ASMs. Cenobamate has also been shown to possess neuroprotective activity, which may be of importance in affecting the process of epileptogenesis and, thus, modifying the course of epilepsy. Full article
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