title: Stiripentol in Dravet syndrome: results of a retrospective U.S. study.
abstract: OBJECTIVE
  To review the efficacy and tolerability of stiripentol in the treatment of U.S. children with Dravet syndrome.
  
  
  METHODS
  U.S. clinicians who had prescribed stiripentol for two or more children with Dravet syndrome between March 2005 and 2012 were contacted to request participation in this retrospective study. Data collected included overall seizure frequency, frequency of prolonged seizures, and use of rescue medications and emergency room (ER)/hospital visits in the year preceding stiripentol initiation, and with stiripentol therapy. We separately assessed efficacy in the following treatment groups: group A, stiripentol without clobazam or valproate; group B, stiripentol with clobazam but without valproate; group C, stiripentol with valproate but without clobazam; and group D, stiripentol with clobazam and valproate. In addition, adverse effects were recorded.
  
  
  RESULTS
  Thirteen of 16 clinicians contacted for study participated and provided data on 82 children. Stiripentol was initiated a median of 6.0 years after seizure onset and 1.2 years after diagnosis of Dravet syndrome. Compared to baseline, overall seizure frequency was reduced in 2/6 in group A, 28/35 in group B, 8/14 in group C, and 30/48 in group D. All children with prolonged seizure frequency greater than quarterly during the baseline period experienced a reduction in this frequency on the various treatment arms with stiripentol. Similarly, 2/4 patients in group A, 25/25 in group B, 5/10 in group C, and 26/33 in group D experienced reduction in frequency of rescue medication use and 1/1 in group A, 12/12 in group B, 3/5 in group C, and 18/19 in group D had reduction in frequency of ER/hospital visits. Adverse effects were reported in 38, most commonly sedation and reduced appetite. Four patients (5%) discontinued stiripentol for adverse effects and two (2%) for lack of efficacy.
  
  
  CONCLUSIONS
  Stiripentol is an effective and well-tolerated therapy that markedly reduced frequency of prolonged seizures in Dravet syndrome.
authors.affiliation: Divisions of Child and Adolescent Neurology, Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. wirrell.elaine@mayo.edu
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Wirrell
authors.forename: Linda
authors.initials: L
authors.lastname: Laux
authors.forename: David N
authors.initials: DN
authors.lastname: Franz
authors.forename: Joseph
authors.initials: J
authors.lastname: Sullivan
authors.forename: Russell P
authors.initials: RP
authors.lastname: Saneto
authors.forename: Richard P
authors.initials: RP
authors.lastname: Morse
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.forename: Harry
authors.initials: H
authors.lastname: Chugani
authors.forename: Angel
authors.initials: A
authors.lastname: Hernandez
authors.forename: Lorie
authors.initials: L
authors.lastname: Hamiwka
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Mikati
authors.forename: Ignacio
authors.initials: I
authors.lastname: Valencia
authors.forename: Marie-Emmanuelle
authors.initials: ME
authors.lastname: Le Guern
authors.forename: Laurent
authors.initials: L
authors.lastname: Chancharme
authors.forename: Marcio Sotero
authors.initials: MS
authors.lastname: de Menezes
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000078306:Clobazam; D004148:Dioxolanes / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004831:Epilepsies, Myoclonic / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy*; D016896:Treatment Outcome; D014481:United States; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D004148:Dioxolanes; D001569:Benzodiazepines; D000078306:Clobazam; D014635:Valproic Acid; C021092:stiripentol
keywords: Dravet syndrome; Intractable epilepsy; Pediatric epilepsy; Stiripentol