Are antiseizure medications disease modifiers?

Area of Science:

• Neurology
• Pharmacology
• Epileptology

Background:

• The term antiepileptic drugs (AEDs) is being replaced by antiseizure medications (ASMs) by the International League Against Epilepsy (ILAE).
• This change is driven by emerging treatments exhibiting antiepileptogenic or disease-modifying effects.
• Disease-modifying effects imply altering the epilepsy's temporal course, potentially even after treatment cessation.

Purpose of the Study:

• To introduce and justify the proposed nomenclature shift from AEDs to ASMs.
• To explore the concept and complexity of disease-modifying effects in epilepsy treatments.
• To highlight the need for further research into novel epilepsy therapies.

Main Methods:

• Conceptual analysis and literature review regarding epilepsy nomenclature and treatment effects.
• Examination of the factors influencing disease-modifying properties of antiseizure medications.
• Discussion of the implications for future drug development and clinical practice.

Main Results:

• The term antiseizure medications (ASMs) offers a more accurate description of current and future epilepsy treatments.
• Demonstrating disease-modifying effects of ASMs is challenging and depends on multiple factors.
• These factors include the drug's target, brain maturation, treatment timing, dosage, and duration.

Conclusions:

• The transition to ASMs reflects a deeper understanding of epilepsy as a progressive disease.
• Further research is crucial to define target populations and develop new diagnostic/prognostic markers for epilepsy.
• Developing truly disease-modifying treatments requires a comprehensive understanding of epileptogenesis.