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Remacemide for drug-resistant localization related epilepsy
J P Leach1, A G Marson, J L Hutton
1Institute of Neurology, Southern General Hospital, Glasgow, Scotland, UK, G51 4TF. JPLEACH246@aol.com
The Cochrane Database of Systematic Reviews
|January 10, 2003
Summary
Remacemide showed a modest effect in reducing seizures for drug-resistant epilepsy but had a high withdrawal rate. Dizziness was a significant side effect, making its future development as an antiepileptic drug unlikely.
Area of Science:
- Neurology
- Pharmacology
Background:
- Epilepsy affects 0.5-1% of the population, with nearly 30% experiencing drug-resistant seizures.
- Remacemide is an investigational drug developed to address treatment-resistant epilepsy.
Purpose of the Study:
- To evaluate remacemide's efficacy and safety as an add-on treatment for drug-resistant localization-related epilepsy.
- Assessed impact on seizure frequency, adverse effects, cognition, and quality of life.
Main Methods:
- Systematic review of randomized placebo-controlled add-on trials.
- Searched Cochrane Epilepsy Group, Cochrane Controlled Trials Register, and MEDLINE.
- Included trials with adequate randomization concealment and an 8-week minimum treatment period.
Main Results:
- Two trials with 514 participants evaluated remacemide doses of 300-1200mg.
- A modest, non-significant reduction in seizure frequency (RR 1.59) was observed.
- Higher doses (800-1200mg) suggested a significant effect, but withdrawal rates (RR 1.90) and dizziness (RR 3.08) were significantly increased.
Conclusions:
- Remacemide demonstrated a modest effect on seizure reduction.
- Significant treatment withdrawal rates and adverse effects like dizziness limit its potential.
- Unlikely to be further developed as an antiepileptic drug due to these limitations.