Steinhoff Bernhard J
Epilepsiezentrum Kork, Landstraße 1, 77694, Kehl-Kork, Deutschland.
Klinik für Neurologie, Albert-Ludwigs Universität Freiburg, Freiburg, Deutschland.
Nervenarzt. 2021 Feb;92(2):150-160. doi: 10.1007/s00115-020-01000-0. Epub 2020 Sep 29.
In spite of the introduction of numerous new antiseizure drugs (ASD) over the last decades, the percentage of drug-resistant epilepsies has remained almost stable. To achieve seizure freedom in such patients with any modified ASD regimen is an exception. Cenobamate (CNB) is a new ASD that showed unusually high efficacy in the pivotal placebo controlled, randomized trials. In both studies (C013 and C017), the rate of seizure-free patients was sometimes more than 20% and thus in a range never reached over the last decades in comparable trials with other new ASDs. This suggests that CNB which is already approved in the USA might actually offer a new and encouraging perspective for epilepsy treatment concerning efficacy. In this review the pharmacological profile, the currently known mode of action, and the results of the clinical trials are summarized.
尽管在过去几十年中引入了众多新型抗癫痫药物(ASD),但耐药性癫痫的比例几乎保持稳定。通过任何改良的ASD治疗方案使此类患者实现无癫痫发作的情况实属罕见。司替戊醇(CNB)是一种新型ASD,在关键的安慰剂对照随机试验中显示出异常高的疗效。在两项研究(C013和C017)中,无癫痫发作患者的比例有时超过20%,因此在过去几十年与其他新型ASD的类似试验中从未达到过这一范围。这表明已在美国获批的CNB在疗效方面可能确实为癫痫治疗提供了一个新的、令人鼓舞的前景。在本综述中,总结了其药理学特性、目前已知的作用机制以及临床试验结果。