Multiple drugs and devices to treat seizures are under development or review by the Food and Drug Administration (FDA), but experts continue to debate whether these new treatments get the industry attention they deserve when the annual number of new epilepsy cases equals that of breast cancer. A team of leading neurologists, companies, investors, press and nonprofit groups from around the world got a sneak peek at new treatments for epilepsy and discussed their pros and cons at the recent Epilepsy Pipeline Conference, hosted by the Epilepsy Therapy Project.
Epilepsy affects more than 3 million Americans and more than 30 percent of them live with uncontrolled seizures. Countless more live on one or more medications, continually weighing side effects and benefits of the drugs.
“Ten years ago there were only a handful of seizure medications to choose from. Now there are more than 15, with multiple new drugs under development,” Epilepsy Foundation board member D. Andrew Neff writes in a review of the conference. “Just over a decade ago, the first hardware device, the Vagus Nerve Stimulator (VNS) entered the market and now other devices are under development or review by the FDA.”
While the news is promising, Neff says epilepsy treatments remain a dichotomy, “both promising and frustrating.” He points out that while available medications have more than doubled in the past 10 years, the percent of patients with retractable seizures has improved only slightly. Pharmaceutical companies are committing resources to AEDs, yet conditions like Alzheimer’s Disease, pain and Parkinson’s Disease get the lion’s share of R&D budgets. Therapeutic devices are a growing segment but are a serious treatment option for patients as surgical implantation is required; and while many new drugs will soon be available for the treatment of seizures, there does not seem to be any breakthrough drugs in the mix, like Keppra was when it was introduced more than a decade ago.
In 2009, the FDA approved the marketing for generic versions of the revolutionary AED Keppra, which gave patients – and their insurance companies – a less expensive alternative to the brand name drug. However, many patients found that by switching to a generic version of the drug, known as levetiracetam, they began to experience a return of seizure and other difficult side effects. Formulation-switching has become one of the issues the Epilepsy Foundation and other epilepsy experts advocate against.
“On the positive side,” Neff says, “the two-day Pipeline Conference presented a truly comprehensive view of mediations and devices under development.”