Despite decades of research, current treatments still fail people with epilepsy. Finding a suitable drug is often a ‘trial and error’ process – an ordeal which, for one in three people, never leads to a treatment that completely controls their seizures.
However, this is beginning to change. A recent article has provided an overview of major advances and new approaches that are pushing forward epilepsy drug development.
We may finally be able to move away from uncertainty, and towards precision medicine, where everyone with epilepsy will get the right drug from day one. Also, by aiming to treat the underlying causes, scientists are hoping to stop the progression of epilepsies – and perhaps prevent some from developing at all.
Here are just a few of examples of how this shift in focus could help deliver new treatments for everyone with epilepsy.
New models, new understanding, new treatments
The most recent developments are built on years of research investment, which have led us to a better understanding of the different forms of epilepsy.
New mouse models of ‘genetic’ forms of epilepsy, such as many developmental and epileptic encephalopathies (DEEs), have helped scientists identify potential drug targets.
Other advances include a broader understanding of how epilepsies develop. For example, we now know seizures are not solely caused by a problem with the neurones, but other brain cells can be involved too.
As a result, more than 200 anti-seizure drugs are in clinical development right now, according to the review article.
Treating causes, not symptoms
A key shift in thinking has been moving away from just controlling seizures, and towards addressing the underlying causes.
One example of this work, funded by the Epilepsy Research Institute, is work being led by Dr Amanda Almacellas Barbanoj. She is studying epilepsy linked to tuberous sclerosis complex (TSC), a disease where benign tumours grow all over the body and brain.
In the past, TSC-related epilepsy has been treated with drugs used to treat other forms of epilepsy. By using new models of TSC, Dr Almacellas Barbanoj hopes to better understand the root cause of the seizures in the disease, and identify new, more effective therapies.
Could we prevent epilepsy?
Focusing on the underlying causes of epilepsy raises an exciting possibility: prevention.
This was explored in the EPISTOP trial, where children diagnosed with TSC shortly after birth were treated with vigabatrin. The drug halved the number of children developing epilepsy, and reduced neurological and behavioural problems.
While the results were not replicated in a later trial, the EPISTOP trial showed intervening with the right treatment at the right time might prevent epilepsy in some cases.
Prevention might also be possible for epilepsies caused by head injuries, strokes, or brain tumours. In these situations, there is often a delay between the initial brain injury and the first seizures, providing a window of opportunity to prevent the brain changes that lead to epilepsy.
Building on momentum
These examples reflect a paradigm shift happening in epilepsy research. If we’re to translate this into better treatments for everyone, we must continue investing in research. Only then will we make sure everyone can finally live free from epilepsy.
Learn more about our ‘Advanced Therapeutics and Disease Modification’ research theme, where we are driving forward research into new approaches to treating epilepsy.
