Conflicting Views Between Epileptologists and General Neurologists Hinder Adoption of New Refractory Epilepsy Treatments
08 Julio 2024 - 10:36AM
Chronic epilepsy is often well managed by neurologists, but a
sizable proportion of adults with epilepsy continue to experience
seizures at varying frequencies despite using typically-effective
pharmacological interventions. Every seizure is one too many, and
experts recognize that if seizures are not fully controlled after a
patient tries their third medication, the risk of developing
recurrent epilepsy increases dramatically.1
In Market Dynamix™: Adult Refractory Epilepsy (US),
Spherix Global Insights dives into the variations in patient
management and beliefs between epileptologists and general
neurologists, who often manage epilepsy patients. Findings indicate
that one-quarter of epilepsy patients seen by general neurologists
have developed refractory epilepsy. Thus, a sizable portion of the
refractory epilepsy patient population remains under the care of
general neurologists.
The study reveals that while general neurologists and
epileptologists typically choose the same drug classes for patients
with new-onset seizures, differences between the two subspecialties
emerge when the initial treatment fails to adequately control
seizures. Epileptologists prefer to maximize the dose of the first
medication through meticulous dose titrations, while general
neurologists are more inclined to introduce a second medication.
These differences become more pronounced as their patients progress
toward refractory epilepsy status.
When determining the next course of action for patients whose
seizures are not quickly controlled, over half of general
neurologists delay referring patients to an epileptologist until
seizures are ‘clearly’ uncontrolled. None of the general
neurologists surveyed said they would refer to an epileptologist
after the first medication failed to stop seizures, despite
literature suggesting that achieving seizure control with the
second medication is more likely than with the third or later
medication.1 Even after referral to epilepsy centers,
differences between subspecialties persist: Epileptologists report
that approximately two-thirds of refractory patients referred for
seizure management remain indefinitely under their care, whereas
general neurologists indicate that only one-third of their patients
receive ongoing management at comprehensive epilepsy centers.
Typically, general neurologists are less informed than
epileptologists about the latest therapies and those in development
for refractory partial and generalized epilepsy. Therefore,
Spherix’s findings indicate that epileptologists give higher
favorability ratings to newer therapies, such as SK Life Science’s
Xcopri, compared to general neurologists. Epileptologists also show
greater enthusiasm for pipeline assets Staccato® alprazolam,
XEN1101, and bexicaserin (LP352) being developed respectively by
UCB, Xenon and Longboard.
Spherix Global Insights will continue to monitor these trends
and provide valuable insights to improve patient outcomes through
our Market Dynamix™ services.
1 Kwan, P & Brodie, M. (2000). Early Identification of
Refractory Epilepsy, NEJM, 342:314-319
Market Dynamix™ is an independent service providing
analysis of markets anticipated to experience a paradigm shift
within the next three to five years. Insights highlight market
size, current treatment approaches, unmet needs, and expert
opinions on the likely disruption introduced by pipeline
agents.
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NOTICE: All company, brand or product names in this press
release are trademarks of their respective holders. The findings
and opinions expressed within are based on Spherix Global Insight's
analysis and do not imply a relationship with or endorsement.
Blaine Cloud, Ph.D., Neurology Franchise Head
Spherix Global Insights
(484) 879-4284
blaine.cloud@spherixglobalinsights.com