Bender Lena, Hirsch Martin, Schulze-Bonhage Andreas
Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany.
Front Pharmacol. 2025 Apr 1;16:1571376. doi: 10.3389/fphar.2025.1571376. eCollection 2025.
Cenobamate is a new antiseizure medication approved for polytherapy of focal epilepsy with complex hepatic metabolism and effects on liver enzymes. So far, data are limited with regard to possible interactions with other antiseizure medications. We here report effects of Cenobamate on serum levels of Brivaracetam, a SV2-agent modulating presynaptic neurotransmitter release.
Retrospective analysis of Brivaracetam serum concentrations with new introduction of Cenobamate with Brivaracetam as a constant baseline antiseizure medication in 19 patients with focal epilepsy. Statistical analysis using paired Fisher´s exact t-Test.
New introduction of Cenobamate lead to a statistically significant increase in Brivaracetam serum concentrations with a mean increase by 27%. This was infrequently accompanied by adverse effects.
New introduction of Cenobamate to a pre-existing antiseizure regimen containing Brivaracetam leads to considerably increases in Brivaracetam, probably related to inhibition of CYP2C19. This needs to be taken into account when interpreting changes in treatment efficacy, but also when relating potential adverse effects to baseline vs. newly introduced treatment.
西诺巴胺是一种新型抗癫痫药物，被批准用于局灶性癫痫的联合治疗，其肝脏代谢复杂且会影响肝酶。到目前为止，关于它与其他抗癫痫药物可能的相互作用的数据有限。我们在此报告西诺巴胺对布立伏胺血清水平的影响，布立伏胺是一种调节突触前神经递质释放的SV2药物。
对19例局灶性癫痫患者进行回顾性分析，以布立伏胺作为固定的基线抗癫痫药物，新引入西诺巴胺后分析布立伏胺的血清浓度。采用配对Fisher精确t检验进行统计分析。
新引入西诺巴胺导致布立伏胺血清浓度有统计学意义的升高，平均升高27%。这种情况很少伴有不良反应。
在已有的含布立伏胺的抗癫痫治疗方案中新加西诺巴胺会导致布立伏胺显著增加，这可能与抑制CYP2C19有关。在解释治疗效果变化时需要考虑到这一点，在将潜在不良反应与基线治疗和新引入治疗相关联时也需要考虑到这一点。
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