Current role of rufinamide in the treatment of childhood epilepsy: Literature review and treatment guidelines

Giangennaro Coppola, Frank Besag, Raffaella Cusmai, Olivier Dulac, Gerhard Kluger, Romina Moavero, Rima Nabbout, Marina Nikanorova, Francesco Pisani, Alberto Verrotti, Celina Von Stülpnagel, Paolo Curatolo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose The literature on the efficacy and safety of rufinamide in childhood-onset epilepsy syndromes currently includes approximately 600 paediatric patients. This paper summarizes the views of a panel of experienced European epileptologists with regard to the current role of rufinamide in the treatment of childhood epilepsies.

Results Rufinamide is effective in decreasing the seizure frequency in the Lennox-Gastaut syndrome (LGS), especially tonic and atonic seizures. It might consequently be preferred to other drugs as a second-line treatment for LGS when drop-attacks are frequent. The mean responder rate in the published studies is 38% with seizure freedom achieved in 2.4% of patients. Rufinamide has shown some efficacy in epileptic encephalopathies other than LGS. It can be also effective as adjunctive therapy in children and adolescents with drug-resistant partial seizures. The available data suggest that rufinamide has an acceptable risk/benefit ratio with quite a low risk of aggravating seizures. Common adverse effects (somnolence, nausea and vomiting) are usually mild and self-limiting; they are more frequently observed during titration than in the maintenance phase, suggesting that low escalation rates might be associated with fewer adverse effects. Rufinamide appears to have a favourable cognitive profile compared with other antiepileptic drugs.

Conclusion Rufinamide is only approved for adjunctive treatment of seizures associated with LGS in children 4 years of age and older. There are very few data on rufinamide treatment at the onset of LGS or early in the course of the disorder; whether early treatment will improve outcome has yet to be determined.

Original languageEnglish
Pages (from-to)685-690
Number of pages6
JournalEuropean Journal of Paediatric Neurology
Volume18
Issue number6
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • Antiepileptic drug interactions
  • Epileptic encephalopathy
  • Focal seizures
  • Lennox-Gastaut syndrome
  • Paediatric epilepsy
  • Rufinamide

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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