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Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine
Epilepsy is among the most common neurological chronic disorders, with a prevalence of 0.5–1%. Despite the introduction of new antiepileptic drugs during recent years, about one third of the epileptic population remain drug-resistant. Hence, especially in the pediatric population limited by differen...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9164301/ https://www.ncbi.nlm.nih.gov/pubmed/35668937 http://dx.doi.org/10.3389/fphar.2022.832929 |
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author | Dini, Gianluca Tulli, Eleonora Dell’Isola, Giovanni Battista Mencaroni, Elisabetta Di Cara, Giuseppe Striano, Pasquale Verrotti, Alberto |
author_facet | Dini, Gianluca Tulli, Eleonora Dell’Isola, Giovanni Battista Mencaroni, Elisabetta Di Cara, Giuseppe Striano, Pasquale Verrotti, Alberto |
author_sort | Dini, Gianluca |
collection | PubMed |
description | Epilepsy is among the most common neurological chronic disorders, with a prevalence of 0.5–1%. Despite the introduction of new antiepileptic drugs during recent years, about one third of the epileptic population remain drug-resistant. Hence, especially in the pediatric population limited by different pharmacokinetics and pharmacodynamics and by ethical and regulatory issues it is needed to identify new therapeutic resources. New molecules initially used with other therapeutic indications, such as fenfluramine, are being considered for the treatment of pharmacoresistant epilepsies, including Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS). Drug-refractory seizures are a hallmark of both these conditions and their treatment remains a major challenge. Fenfluramine is an amphetamine derivative that was previously approved as a weight loss drug and later withdrawn when major cardiac adverse events were reported. However, a new role of fenfluramine has emerged in recent years. Indeed, fenfluramine has proved to be a promising antiepileptic drug with a favorable risk–benefit profile for the treatment of DS, LGS and possibly other drug-resistant epileptic syndromes. The mechanism by which fenfluramine provide an antiepileptic action is not fully understood but it seems to go beyond its pro-serotoninergic activity. This review aims to provide a comprehensive analysis of the literature, including ongoing trials, regarding the efficacy and safety of fenfluramine as adjunctive treatment of pharmacoresistant epilepsies. |
format | Online Article Text |
id | pubmed-9164301 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91643012022-06-05 Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine Dini, Gianluca Tulli, Eleonora Dell’Isola, Giovanni Battista Mencaroni, Elisabetta Di Cara, Giuseppe Striano, Pasquale Verrotti, Alberto Front Pharmacol Pharmacology Epilepsy is among the most common neurological chronic disorders, with a prevalence of 0.5–1%. Despite the introduction of new antiepileptic drugs during recent years, about one third of the epileptic population remain drug-resistant. Hence, especially in the pediatric population limited by different pharmacokinetics and pharmacodynamics and by ethical and regulatory issues it is needed to identify new therapeutic resources. New molecules initially used with other therapeutic indications, such as fenfluramine, are being considered for the treatment of pharmacoresistant epilepsies, including Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS). Drug-refractory seizures are a hallmark of both these conditions and their treatment remains a major challenge. Fenfluramine is an amphetamine derivative that was previously approved as a weight loss drug and later withdrawn when major cardiac adverse events were reported. However, a new role of fenfluramine has emerged in recent years. Indeed, fenfluramine has proved to be a promising antiepileptic drug with a favorable risk–benefit profile for the treatment of DS, LGS and possibly other drug-resistant epileptic syndromes. The mechanism by which fenfluramine provide an antiepileptic action is not fully understood but it seems to go beyond its pro-serotoninergic activity. This review aims to provide a comprehensive analysis of the literature, including ongoing trials, regarding the efficacy and safety of fenfluramine as adjunctive treatment of pharmacoresistant epilepsies. Frontiers Media S.A. 2022-05-20 /pmc/articles/PMC9164301/ /pubmed/35668937 http://dx.doi.org/10.3389/fphar.2022.832929 Text en Copyright © 2022 Dini, Tulli, Dell’Isola, Mencaroni, Di Cara, Striano and Verrotti. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pharmacology Dini, Gianluca Tulli, Eleonora Dell’Isola, Giovanni Battista Mencaroni, Elisabetta Di Cara, Giuseppe Striano, Pasquale Verrotti, Alberto Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine |
title | Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine |
title_full | Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine |
title_fullStr | Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine |
title_full_unstemmed | Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine |
title_short | Improving Therapy of Pharmacoresistant Epilepsies: The Role of Fenfluramine |
title_sort | improving therapy of pharmacoresistant epilepsies: the role of fenfluramine |
topic | Pharmacology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9164301/ https://www.ncbi.nlm.nih.gov/pubmed/35668937 http://dx.doi.org/10.3389/fphar.2022.832929 |
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