Abstract Details

Title Efficacy and Safety of Fenfluramine in Lennox-Gastaut Syndrome: A Systematic Review

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-007

Objective

This systematic review aims to explore the efficacy, safety, and tolerability of fenfluramine for seizure control in patients with Lennox-Gastaut syndrome (LGS).

Background Fenfluramine has been recently approved as an adjunctive medication for seizure control in patients with Lennox-Gastaut syndrome (LGS). Previously, it has been used in treatment of patients with Dravet syndrome.

Design/Methods We conducted a systematic literature search on MEDLINE, Cochrane, and EMBASE as per guidelines of Preferred Reporting Items for Systematic Reviews (PRISMA). Two clinical trials analysing the effects of different doses of fenfluramine were included in this review.

Results In a double-blind phase 3 randomised control trial (RCT), participants were randomised to receive fenfluramine (0.2 or 0.7mg/kg/d) or a placebo. In another open-label clinical trial (Lagae et al.), patients were administered fenfluramine with median dose being 0.4mg/kg/d. 50% or greater reduction in seizure frequency was assessed in both trials. The responder rate in the open-label trial was 62% at 20 weeks and 66.7% at 15 months, while responder rate in the RCT was also significant in both groups (28% in the 0.2mg/kg/day group and 25% in the 0.7mg/kg/day). The median percentage reduction in seizure frequency in the open-label trial was 53% in core and 58% in extension period, while 14.2% reduction in 0.2mg/kg/d and 26.5% reduction in 0.7mg/kg/d were reported in the RCT. Adverse effects were reported in 70% of patients in the open-label trial while the RCT reported ≥1 adverse effects in 78%, 90% and 75% of the participants from 0.2mg/kg/d , 0.7mg/kg/d and placebo groups, respectively. Adverse effects commonly seen were decreased appetite, somnolence, and fatigue.

Conclusions Adjunctive use of fenfluramine results in significant improvement in LGS patients refractory to standardised anti-seizure therapies. The side effects reported are usually mild.

Authors/Disclosures
Bakhtawar Ahmad, MBBS PRESENTER	Dr. Ahmad has nothing to disclose.
Muhammad Qasim Qureshi	Mr. Qureshi has nothing to disclose.
Rutaab Kareem	Ms. Kareem has nothing to disclose.
Zainab Mehdi (King Edward Medical University)	Miss Mehdi has nothing to disclose.
Aimen Nadeem	Miss Nadeem has nothing to disclose.
Zuha Majid (Mayo Hospital Lahore.)	Miss Majid has nothing to disclose.
	No disclosure on file
Muhammad Aemaz Ur Rehman, MD	Dr. Aemaz Ur Rehman has nothing to disclose.
	No disclosure on file
	No disclosure on file

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