Edibe PEMBEGÜL YILDIZ, ZEYNEP HIZLI DEMİRKALE, Gonca BEKTAŞ, Melis ULAK ÖZKAN, Burak TATLI, NUR AYDINLI, Mine ÇALIŞKAN, Meral ÖZMEN

Efficacy of rufinamide in childhood refractory epilepsy

Rufinamide has been used as a new antiepileptic drug in the treatment ofdrug-resistant epilepsy, in recent years. The objective of this study was toevaluate the reliability of rufinamide and its impact on seizure frequency inpatients diagnosed with drug-resistant epilepsy, where seizures could not becontrolled with ‘classical’ antiepileptic drugs. We retrospectively reviewedthe data of epileptic patients who were followed up between January 2004and December 2014 in the Pediatric Neurology Department. Patients whowere diagnosed with ‘drug resistant epilepsy’ and treated with rufinamidewere evaluated. Decrease in seizure frequency and drug side effects wereassessed as parameters. A total of 38 patients (14 girls, 24 boys) with amean age of 8.5 (range, 3.5-17) years were included in the study. The meanfollow-up duration was 25.5 (23-29.5) months, while the mean maximaldose of rufinamide was 32.5 (28-42) mg/kg/day. Response to treatmentwas assessed by the reduction in frequency of seizures. The decrease was50%) was 55.5%. In the LGS group, patients withdrop/attacks showed the best response to treatment. Rufinamide was noteffective in two patients diagnosed with Dravet syndrome. Rufinamide canbe safely used in pediatric patients who use multiple antiepileptic drugs andare unresponsive to the treatment. It was seen to be effective especially inpatients diagnosed with LGS and drop/attacks types of seizures.

PDF

___

1. Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000; 342: 314-319.

2. Vendrame M, Loddenkemper T, Gooty VD, et al. Experience with rufinamide in a pediatric population: A single center’s experience. Pediatr Neurol 2010; 43: 155-158.

3. Coppola G, Grosso S, Franzoni E, et al. Rufinamide in refractory childhood epileptic encephalopathies other than Lennoxe-Gastaut syndrome. Eur J Neurol 2011; 18: 246-251.

4. Vendrame M, Poduri A, Loddenkemper T, Kluger G, Coppola G, Kothare SV. Treatment of malignant migrating partial epilepsy of infancy with rufinamide: Report of five cases. Epileptic Disord 2011; 13: 18-21.

5. Kluger G, Kurlemann G, Haberlandt E, et al. Effectiveness and tolerability of rufinamide in children and adults with refractory epilepsy: First European experience. Epilepsy Behav 2009; 14: 491-495.

6. Grosso S, Coppola G, Dontin SD, et al. Efficacy and safety of rufinamide in children under four years of age with drug-resistant epilepsies. Eur J Paediatr Neurol 2014: 18; 641-645.

7. White HS, Franklin MR, Kupferberg HJ, Schmutz M, Stables JP, Wolf HH. The anticonvulsant profile of rufinamide (CGP 33101) in rodent seizure models. Epilepsia 2008; 49: 1213-1220.

8. Perucca E, Cloyd J, Critchley D, Fuseau E. Rufinamide: Clinical pharmacokinetics and concentration-response relationships in patients with epilepsy. Epilepsia 2008; 49: 1123-1141.

9. Wirrell EC. Predicting pharmacoresistance in pediatric epilepsy. Epilepsia 2013; 54(Suppl 2): 19-22.

10. Epilepsy ILa. [Accessed 2nd July 2015]; Guidelines for Publications from League Commissions and Task Forces. 2014 Available at: http://www.ilae.org/visitors/ centre/guidelines.cfm.

11. Jaraba S, Santamarina E, Miró J, et al. Rufinamide in children and adults in routine clinical practice. Acta Neurol Scand 2017; 135: 122-128.

12. McMurray R, Striano P. Treatment of Adults with Lennox-Gastaut Syndrome: Further Analysis of Efficacy and Safety/Tolerability of Rufinamide. Neurol Ther 2016; 5: 35-43.

13. Glauser T, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo S. Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome. Neurology 2008; 70: 1950-1958.

14. Coppola G, Grosso S, Franzoni E, et al. Rufinamide in children and adults with Lennox-Gastaut syndrome: First Italian multicenter experience. Seizure 2010; 19: 587-591.

15. Kim SH, Eun SH, Kang HC, et al. Rufinamide as an adjuvant treatment in children with Lennox-Gastaut syndrome. Seizure 2012; 21: 288-291.

16. Lee EH, Yum MS, Ko TS. Effectiveness and tolerability of rufinamide in children and young adults with Lennox-Gastaut syndrome: A single center study in Korea. Clin Neurol Neurosurg 2013; 115: 926-929.

17. Mueller A, Boor R, Coppola G, et al. Low long-term efficacy and tolerability of add-on rufinamide in patients with Dravet syndrome. Epilepsy Behav 2011; 21: 282- 284.

18. Moavero R, Cusmai R, Specchio N, et al. Rufinamide efficacy and safety as adjunctive treatment in children with focal drug resistant epilepsy: the first Italian prospective study. Epilepsy Res 2012; 102: 94-99.

19. von Stulpnagel C, Leichsenring M, Muller A, Staudt M, Kluger G. Refractory focal epilepsy in a patient with methylmalonic aciduria: case report on positive and long lasting effect of rufinamide. Neuropediatrics 2011; 42: 71-73