Think Big with Dr. Jackie French: New Therapies in the Pipeline

Dr. Jacqueline French is the chief medical and innovation officer at the Epilepsy Foundation.

For 20 years, I have been involved in evaluating new therapies for epilepsy that are in the pipeline. Even though there are many new medications available, some studies suggest that we have not really made any big advances towards better epilepsy treatments, only small incremental ones. Nonetheless, I can truly say that there is reason to be very excited in 2019.

Future Trends

Here are a few trends that we see for the near future:

• Treatments for focal (partial) epilepsy that has not responded to other medications:
  • There are medications that are being evaluated for approval by the FDA that could be of benefit, even when other anti-seizure medicines have failed. These could reach the clinic within the next year!
• Treatments for rare epilepsies:
  • ​Drug makers have really been focusing on treatments for rare epilepsies, some of which have no current available treatments. Several examples include: 
    • The recent approval of Epidiolex ^® as the first drug proven to work in a rare epilepsy called Dravet syndrome. Another new drug for Dravet is close behind.
    • The approval of Everolimus as the first drug to specifically treat seizures associated with Tuberous Sclerosis Complex. 
    • There are also drugs being developed for other rare syndromes such as CDKL5 Disorder, Lafora disease, and KCNQ2 encephalopathy (a severe epilepsy of infancy), to name a few. 

​​​From Anti-Seizure to Anti-Epilepsy

​Up until now, all of the drugs available to treat epilepsy are actually anti-seizure drugs. They do not act to stop the cause of seizures. They just prevent the seizures from occurring. 

In other words, they treat seizures as a symptom. (It’s the same as giving an anti-itch treatment for a rash, but not treating the cause of the rash.) As we gain a better understanding of what causes seizures (in many people we still don’t know), we will be able to treat the root cause. 

This could lead to so-called disease-modifying treatments that eventually lead to either a cure, or a reduction not only in seizures, but also some of the problems that go along with epilepsy such as mood and memory problems. Some drugs are already in development that could do exactly that.

Hope for the Future

All of the above advances are a real reason to be hopeful for the future.