Role of clobazam in pediatric epilepsy

2.  Background
 Principles of selection of adjuvant AEDs
 Clobazam, How is it different
 Seizure Control, What Clobazam offers as an add-on
in Children , in adults
 Long term experience with Clobazam
 Clobazam – Is it an ideal add-on
 Safety considerations with Clobazam
 New facets in use
 Summary

3. Brief history of anti‐seizure drug development
Epilepsia Open, Volume: 3, Issue: S2, Pages: 114-119, First published: 24 October 2018, DOI: (10.1002/epi4.12268)

5.  Epilepsy – a Serious condition affecting approx. 1% of world
population
 Characterized by recurrent seizures, with other comorbid
conditions as well
 1/3rd pts. On AEDs fail to have seizures controlled for at
least 1 year.
 Need for more effective and safe add-on AEDs

6.  Should be effective for the type of epilepsy/syndrome
 Should have different mechanism of action
 Should not have complex pharmacokinetic interactions
 Should not have a similar adverse effect profile
 Can be combined in minimum doses to produce maximum effect
 Right for the patient age, gender, comorbidities.

7.  From antianxiety to anticonvulsant
 Anticonvulsant for almost 4 decades
 Safe & Efficacious for children as well adults
 Effective in partial as well as generalized
 Evidence - >50 studies on more than 3000 epileptic patients.
 In 1970 as Anti-anxiety > 1974 as a Antiepileptic in France > 1998
Launched in India. > Adjunct in LGS in USA in 2011.

8.  Clobazam…… IS DIFFERENT

9. Carlos A. M. Guerreiro
Department of Neurology, Campinas
University
CEP: 13083-887, Campinas, SP, Brazil
guerreiro@fcm.unicamp.b
The phoenix drug (from the very old to the brand new)
Indian J Med Res 140, August 2014, pp 163-164

10. SEIZURE CONTROL – WHAT MATTERS THE
MOST

11.  Adults:
- Koeppen et al: 129 therapy-resistant Complex Partial Seizures – 19% Seizures
free.
- Montenegro et al: 97 refractory partial epilepsy pts – 57% >50% improvement in
seizure control.
 Children:
- Keene et al: 52% with 50% reduction in seizure frequency
- Kalra et al: 88 Children: 60.2% of pts achieved complete seizure control.

12.  It is 1,5 BDZ unlike traditional 1,4 BDZ
 Selectively binds between α2 and 2 subunits
 Greater selectivity for α2 subunits over α1.
 - Less Sedation
 - Less efficacy tolerance.

21. LONG TERM EXPERIENCE WITH
CLOBAZAM

26. AN IDEAL ADD-ON

39. NEWER FACETS IN USE

51. THANKYOU