Stiripentol, pharmaceutical-grade cannabidiol, fenfluramine hydrochloride, and soticlestat are tolerated and efficient in treating seizures associated with Dravet syndrome (DS), according to a new study that appeared in the journal Drugs.
This finding “allows discussion about the expected outcomes regarding seizure frequency reduction and tolerability profiles,” the authors noted.
Read more about the treatment of DS
The team used a network meta-analysis to assess the tolerability and efficacy of antiseizure medications in treating seizures associated with DS.
The researchers analyzed a total of 8 placebo-controlled trials in which the active add-on treatments were stiripentol, pharmaceutical-grade cannabidiol, fenfluramine hydrochloride, or soticlestat.
A total of 680 participants were recruited in these studies. Of these, 409 received treatment, while 271 received placebo.
The researchers found that pharmaceutical-grade cannabidiol was associated with a lower rate of seizure response compared to fenfluramine hydrochloride. Moreover, stiripentol was associated with a higher rate of seizure response compared to pharmaceutical-grade cannabidiol.
There were no statistically significant differences between the different antiseizure medications in terms of seizure freedom outcome.
The researchers also reported that stiripentol was associated with a lower risk of drug discontinuation compared to pharmaceutical-grade cannabidiol, which itself was associated with a lower proportion of participants experiencing any adverse events compared to fenfluramine hydrochloride.
Finally, the risk of adverse events was higher with stiripentol than pharmaceutical-grade cannabidiol.
“The study found high-quality evidence of efficacy and tolerability of the 4 [antiseizure medications] in the treatment of convulsive seizures in DS,” the researchers wrote.
DS is a severe type of epilepsy characterized by life-long seizures that first appear in infancy and are often resistant to antiseizure medications.
In recent years, there have been many antiseizure medications that were approved for the treatment of seizures.
Lattanzi S, Trinka E, Russo E, et al. Pharmacotherapy for Dravet syndrome: A systematic review and network meta-analysis of randomized controlled trials. Drugs. Published online September 11, 2023. doi:10.1007/s40265-023-01936-y