Palleria Caterina, Coppola Antonietta, Citraro Rita, Del Gaudio Luigi, Striano Salvatore, De Sarro Giovambattista, Russo Emilio
a 1 University of Catanzaro, Science of Health Department, School of Medicine , Naples, Italy +39 0 96 13 69 41 91 ; +39 0 96 13 69 41 92 ;
b 2 Federico II University, Epilepsy Centre, Reproductive and Odontostomatological Sciences, Department of Neuroscience , Naples, Italy.
Expert Opin Pharmacother. 2015;16(15):2355-71. doi: 10.1517/14656566.2015.1084504. Epub 2015 Sep 2.
Mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) is a syndrome that is often refractory to drug treatment. The effects on specific syndromes are not currently available from the pre-marketing clinical development of new AEDs; this does not allow the prediction of whether new drugs will be more effective in the treatment of some patients.
We have reviewed all the existing literature relevant to the understanding of a potential effectiveness in MTLE-HS patients for the latest AEDs, namely brivaracetam, eslicarbazepine, lacosamide, perampanel and retigabine also including the most relevant clinical data and a brief description of their pharmacological profile. Records were identified using predefined search criteria using electronic databases (e.g., PubMed, Cochrane Library Database of Systematic Reviews). Primary peer-reviewed articles published up to the 15 June 2015 were included.
All the drugs considered have the potential to be effective in the treatment of MTLE-HS; in fact, they possess proven efficacy in animal models; currently considered valuable tools for predicting drug efficacy in TLE. Furthermore, for some of these (e.g., lacosamide and eslicarbazepine) data are already available from post-marketing studies while brivaracetam acting on SV2A like levetiracetam might have the same potential effectiveness with the possibility to be more efficacious considering its ability to inhibit voltage gated sodium channels; finally, perampanel and retigabine are very effective drugs in animal models of TLE.
伴海马硬化的内侧颞叶癫痫（MTLE-HS）是一种药物治疗常常难以奏效的综合征。新抗癫痫药物（AEDs）上市前的临床研发中目前尚无针对特定综合征的疗效数据；这使得无法预测新药对某些患者的治疗效果是否会更佳。
我们已查阅了所有现有文献，这些文献与理解最新的抗癫痫药物（即布瓦西坦、艾司利卡西平、拉科酰胺、吡仑帕奈和瑞替加滨）对MTLE-HS患者的潜在疗效相关，还包括了最相关的临床数据及其药理学特征的简要描述。通过使用电子数据库（如PubMed、Cochrane系统评价图书馆数据库）中的预定义搜索标准来识别记录。纳入了截至2015年6月15日发表的经同行评审的主要文章。
所有所考虑的药物都有治疗MTLE-HS的潜在疗效；事实上，它们在动物模型中已证实具有疗效；目前被视为预测颞叶癫痫药物疗效的有价值工具。此外，对于其中一些药物（如拉科酰胺和艾司利卡西平），上市后研究中已有相关数据，而布瓦西坦像左乙拉西坦一样作用于SV2A，可能具有相同的潜在疗效，考虑到其抑制电压门控钠通道的能力，可能更具疗效；最后，吡仑帕奈和瑞替加滨在颞叶癫痫动物模型中是非常有效的药物。
