Advancing Epilepsy Research Through Implementation Science and Biomarkers: Adam Numis, MD; Laura Kirkpatrick, MD

WATCH TIME: 3 minutes

“I think the most important thing from a general practice standpoint, is limiting the exposure of these antiseizure medications and stopping them early.”

Infantile epileptic spasms syndrome (IESS) is a prevalent form of epilepsy that begins in infancy, affecting approximately 1 in 3000 children. Although there is widespread agreement on first-line treatments such as adrenocorticotropic hormone, corticosteroids, and vigabatrin, approaches to second- and third-line therapies, EEG monitoring, and managing adverse effects differ across medical institutions. To better understand this variation, a recent study was conducted by the Pediatric Epilepsy Research Consortium (PERC) to examine current treatment practices at leading U.S. pediatric epilepsy centers.

A survey sent to 75 PERC-member centers received a 48% response rate, with most centers following institution-specific IESS treatment protocols. These protocols uniformly recommended first- and second-line therapies, with 83% of centers suggesting a repeat EEG and treatment adjustments after 14 days for cases that did not show remission. However, the study revealed significant differences in practices related to the use of dual therapy at onset, third-line treatments, ketogenic diet recommendations, and adverse effect monitoring.

The findings, presented by senior author Adam Numis, MD, pediatric epilepsy specialist at University of California, San Francisco, at the recently concluded 2024 American Epilepsy Society Annual Meeting, held December 6-10, in Los Angeles, underscored the necessity for a standardized, consensus-driven treatment approach. Drawing from these results, Numis and his team plan to develop a modified Delphi survey aimed at establishing publicly available guidelines to ensure consistent and improved care for infants with IESS.

In an interview with NeurologyLive^® at AES 2024, Numis, and Laura Kirkpatrick, MD, pediatric epilepsy specialist at UPMC Children's Hospital of Pittsburgh, discussed key challenges and opportunities in advancing epilepsy care. The duo highlighted the significant barriers to securing funding for implementation science, emphasizing the need for greater support to translate research into widespread clinical practice. In addition, the two also explored how validated blood biomarkers could revolutionize epilepsy prevention and treatment by enabling earlier, more precise interventions. Furthermore, they stressed the importance of collaboration between basic scientists and clinical researchers, noting that platforms like AES provide a valuable space for cross-disciplinary exchange that could drive further innovation in the field.

Click here for more AES 2024 coverage.

REFERENCES
1. Abath CB, Katyayan A, Harini C, et al. Treatment Practices for Infantile Epileptic Spasms Syndrome: Consensus and Variation in Major U.S. Pediatric Epilepsy Centers. Presented at: AES 2024; December 6-10; Los Angeles, CA. Abstract 1.333.