New anti-epileptic drugs in Paediatrics
New anti-epileptic drugs in Paediatrics
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DOI：
10.1016/j.anpedi.2019.09.008
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发表时间：
2019-12-01
影响因子：
2.1
通讯作者：
Jose Garcia-Penas, Juan
中科院分区：
文献类型：
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作者：
Malaga, Ignacio;Sanchez-Carpintero, Rocio;Jose Garcia-Penas, Juan
据估计，全世界约有7000万人患有癫痫，其中一半是儿童，其患病率约为0.5%至0.8%。虽然有几种治疗方法，但癫痫的治疗主要是基于药物，根据上市年份的不同，药物可分为第一代、第二代或第三代。本文介绍了最新一代抗癫痫药物(乳糖胺、乙酸埃斯利卡西平、溴伐西坦、帕拉帕坦、瑞加滨、伊维洛莫斯和大麻二醇)的主要特点。除了雷替加宾(尚未上市)外，这些药物在儿科人群中被认为是安全有效的。依维莫司和大麻二醇具有非常特殊的适应症(结节性硬化症、Dravet综合征和Lennox Gastaut综合征)，而其余的用于治疗4岁起儿童的局灶性癫痫发作。开发这些新分子是为了提供比以前可用的药物更好的药学特性和耐受性，据预测，随着它们的使用增加，它们的真正潜力和特性将会扩大。此外，在儿科癫痫学中，首次使用了成人疗效数据的外推(连同儿科人群中的特定安全性和药代动力学研究)，以加快批准其在儿童人群中使用。(C)2019年西班牙儿科协会。作者：Elsevier Espana，S.L.U
It is estimated that about 70 million people all over the world suffer from epilepsy, half of which are children, in whom the prevalence is around 0.5 to 0.8%. Although there are several therapies, the treatment of epilepsy is based mainly on drugs, which, depending on the year of coming onto the market are classified as first, second, or third generation. In this article, a description is presented on the main characteristics of the latest generation of anti epileptic drugs (lacosamide, eslicarbazepine acetate, brivaracetam, perampanel, retigabine, everolimus and cannabidiol). These, with the exception of retigabine (is not yet on the market), are considered safe and effective in the paediatric population. Everolimus and cannabidiol have very specific indications (tuberous sclerosis, Dravet syndrome, and Lennox Gastaut syndrome), while the rest are indicated in the management of seizures of focal origin in children from 4 years-old. These new molecules have been developed in order to provide a pharmaceutical profile and tolerance superior to the previously available drugs, and it is forecast that as their use increases, their true potential and profile will widen. Furthermore, for the first time in Paediatric Epileptology, the extrapolation of the efficacy data in adults have been used (together with specific safety and pharmacokinetic studies in the paediatric population), in order to speed up their approval for use in the child population. (C) 2019 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.