Pharmacology

Original Paper

A Pharmacokinetic Study and Correlation with Clinical Response of Rufinamide in Infants with Epileptic Encephalopathies

la Marca G.a · Rosati A.b · Falchi M.b · Malvagia S.a · Della Bona M.L.a · Pellacani S.b · Guerrini R.b, c

Author affiliations

aNewborn Screening, Clinical Chemistry and Pharmacology Laboratory and bPediatric Neurology Unit, A. Meyer Children's Hospital, Florence, and cIRCCS Stella Maris, Pisa, Italy

Related Articles for ""

Pharmacology 2013;91:275-280

Log in to MyKarger to check if you already have access to this content.


Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select
* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 11, 2013
Accepted: March 03, 2013
Published online: May 24, 2013
Issue release date: July 2013

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0031-7012 (Print)
eISSN: 1423-0313 (Online)

For additional information: https://www.karger.com/PHA

Abstract

Aim: To evaluate the relationship between the pharmacokinetic (PK) parameters and therapeutic and adverse effects of rufinamide (RUF) in children with epileptic encephalopathies (EE) aged <4 years. Methods: PK analysis was conducted at the steady state using a previously validated liquid chromatography tandem-mass spectrometric method in 15 children aged 6-42 months treated with RUF in add-on. Responders were defined as patients who achieved >50% decrease of seizures. Tolerability was evaluated by analysis of a parental report of adverse effects, a clinical examination and laboratory tests. Results: Maximum plasma concentration (47.40 ± 35.36 mg/l), average plasma concentration (39.94 ± 24.53 mg/l) and half-life (13.66 ± 4.43 h) were extremely variable and considerably higher than those reported in older children treated with the same dose regimen. At the last evaluation, 9 patients (60%) were responders. Conclusion: RUF is efficacious and is well tolerated in children with EE. Nonetheless, a correlation between dose, serum concentration and efficacy could not be demonstrated. The variability in measured concentrations may be related to polytherapy that is necessary for controlling seizures in this very severe form of epilepsy, in which the off-label use of RUF is justified.

© 2013 S. Karger AG, Basel




Related Articles:


References

  1. Arroyo S: Rufinamide. Neurotherapeutics 2007;4:155-162.
  2. Wheless JW, Vazquez B: Rufinamide: a novel broad-spectrum antiepileptic drug. Epilepsy Curr 2010;10:1-6.
  3. Perucca E, Cloyd J, Critchley D, Fuseau E: Rufinamide: Clinical pharmacokinetics and concentration-response relationships in patients with epilepsy. Epilepsia 2008;49:1123-1141.
  4. Marchand M, Fuseau E, Critchley DJ: Supporting the recommended paediatric dosing regimen for rufinamide in Lennox-Gastaut syndrome using clinical trial simulation. J Pharmacokinet Pharmacodyn 2010;37:99-118.
  5. May TW, Boor R, Rambeck B, Jurgens U, Korn-Merker E, Brandt C: Serum concentrations of rufinamide in children and adults with epilepsy: the influence of dose, age, and comedication. Ther Drug Monit 2011;33:214-221.
    External Resources
  6. Wisniewski CS: Rufinamide: a new antiepileptic medication for the treatment of seizures associated with Lennox-Gastaut syndrome. Ann Pharmacother 2010;44:658-667.
  7. Guthrie R, Susi A: A simple phenylalanine method for detecting phenylketonuria in large populations of newborn infants. Pediatrics 1963;32:338-343.
    External Resources
  8. Millington DS, Kodo N, Norwood DL, Roe CR: Tandem mass spectrometry: a new method for acylcarnitine profiling with potential for neonatal screening for inborn errors of metabolism. J Inherit Metab Dis 1990;13:321-324.
  9. Mei JV, Alexander JR, Adam BW, Hannon WH: Use of filter paper for the collection and analysis of human whole blood specimens. J Nutr 2001;131:1631S-1636S.
    External Resources
  10. Li W, Tse FL: Dried blood spot sampling in combination with LC-MS/MS for quantitative analysis of small molecules. Biomed Chromatogr 2010;24:49-65.
  11. Filippi L, Cavallaro G, Fiorini P, Daniotti M, Benedetti V, Cristofori G, Araimo G, Ramenghi L, La Torre A, Fortunato P, Pollazzi L, la Marca G, Malvagia S, Bagnoli P, Ristori C, Dal Monte M, Bilia AR, Isacchi B, Furlanetto S, Tinelli F, Cioni G, Donzelli G, Osnaghi S, Mosca F: Study protocol: safety and efficacy of propranolol in newborns with retinopathy of prematurity (PROP-ROP). BMC Pediatr 2010;10:83.
  12. la Marca G, Malvagia S, Filippi L, Innocenti M, Rosati A, Falchi M, Pellacani S, Moneti G, Guerrini R: Rapid assay of rufinamide in dried blood spots by a new liquid chromatography-tandem mass spectrometric method. J Pharm Biomed Anal 2011;54:192-197.
  13. Filippi L, la Marca G, Fiorini P, Favelli F, Malvagia S, Donzelli G, Guerrini R: Phenobarbital for neonatal seizures in hypoxic ischemic encephalopathy: a pharmacokinetic study during whole body hypothermia. Epilepsia 2011;52:794-801.
  14. Edelbroek PM, van der Heijden J, Stolk LM: Dried blood spot methods in therapeutic drug monitoring: methods, assays, and pitfalls. Ther Drug Monit 2009;31:327-336.
  15. Spooner N, Lad R, Barfield M: Dried blood spots as a sample collection technique for the determination of pharmacokinetics in clinical studies: considerations for the validation of a quantitative bioanalytical method. Anal Chem 2009;81:1557-1563.
  16. Engel J Jr: A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia 2001;42:796-803.
  17. Glauser T, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo S: Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome. Neurology 2008;70:1950-1958.
  18. Kluger G, Kurlemann G, Haberlandt E, Ernst JP, Runge U, Schneider F, Makiwski C, Boor R, Bast T: Effectiveness and tolerability of rufinamide in children and adults with refractory epilepsy: first European experience. Epilepsy Behav 2009;14:491-495.
  19. Vendrame M, Loddenkemper T, Gooty VD, Takeoka M, Rotenberg A, Bergin AM, Eksioglu YZ, Poduri A, Duffy FH, Libenson M, Bourgeois BF, Kathora SV: Experience with rufinamide in a pediatric population: a single center's experience. Pediatr Neurol 2010;43:155-158.
  20. Häusler M, Kluger G, Nikanorova M: Epilepsy with myoclonic absences - favourable response to add-on rufinamide treatment in 3 cases. Neuropediatrics 2011;42:28-29.
  21. Mueller A, Boor R, Coppola G, Striano P, Dahlin M, von Stuelpnagel C, Lotte J, Staudt M, Kluger G: Low long-term efficacy and tolerability of add-on rufinamide in patients with Dravet syndrome. Epilepsy Behav 2011;21:282-284.
  22. Wheless JW, Conry J, Krauss G, Mann A, LoPresti A, Narurkar M: Safety and tolerability of rufinamide in children with epilepsy: a pooled analysis of 7 clinical studies. J Child Neurol 2009;24:1520-1525.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 11, 2013
Accepted: March 03, 2013
Published online: May 24, 2013
Issue release date: July 2013

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0031-7012 (Print)
eISSN: 1423-0313 (Online)

For additional information: https://www.karger.com/PHA


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
TOP