Moving Beyond Symptom Management, Using Antiseizure Medicines and Disease Modifying Therapies: Jacqueline French, MD

WATCH TIME: 6 minutes

“Up until now, all of our treatments have been antiseizure medicines, which means that they treat the symptom of seizure, but they don't treat the underlying cause. We need to work on disease modification treatments, and we are getting closer. The first place that we started to see disease modification treatments creep in was in the diseases that are genetically driven.”

XEN1101 (Xenon Pharmaceuticals), a potent small-molecule selective KCNQ2/3 potassium channel opener, is among many antiseizure medications currently being assessed in clinical trials. The medication is being assessed for primary generalized tonic-clonic seizures and major depressive disorder in addition to its clinical development for focal onset seizures.

Recent data from the open-label extension of the phase 2b study, X-TOLE (NCT03796962), of XEN1101 was presented by Jacqueline French, MD, at the 2023 American Academy of Neurology (AAN) Annual Meeting, April 22-27, in Boston, Massachusetts. Findings from the study demonstrated that 20 mg doses of the agent was well-tolerated and showed a safety profile similar to that observed in the double-blinded period, and was comparable to other antiseizure medicines used in patients with focal epilepsy.¹ French, a professor of neurology at NYU Grossman School of Medicine and the chief medical officer of the Epilepsy Foundation, also gave a talk at the meeting on new treatments for drug-resistant epilepsies.²

During the meeting, French sat down with NeurologyLive® in an interview to discuss the topics she presented on. She spoke about the frustration associated with current antiseizure medications, and the need for disease modification treatments in epilepsy. French also talked about how antisense oligonucleotides are being used in clinical trials for addressing underlying causes of monogenetic epilepsies, and the potential benefits they may offer. In addition, she mentioned some of the new disease-modifying approaches that are being explored for epilepsies with various causes, and how they differ from traditional symptomatic therapies.

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REFERENCES
1. French J, Porter R, Perucca E, et al. XEN1101, a novel potassium channel modulator: Interim data from an ongoing, long-term, open-label extension of a phase 2b study (X-TOLE) in adults with focal epilepsy. Presented at: 2023 AAN Annual Meeting; April 22-27, Boston, Massachusetts. Abstract 008. Epilepsy/Clinical Neurophysiology (EEG): Epilepsy Outcomes session.
2. French J. New Treatments for Drug Resistant Epilepsy. Presented at: 2023 AAN Annual Meeting; April 22-27, Boston, Massachusetts. Neurology Year in Review Plenary Session.