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Review
. 2014 May;7(3):169-76.
doi: 10.1177/1756285614521314.

Experience in the use of clobazam in the treatment of Lennox-Gastaut syndrome

Gabriela Purcarin  1 , Yu-Tze Ng  2
Affiliations
Review

Experience in the use of clobazam in the treatment of Lennox-Gastaut syndrome

Gabriela Purcarin et al. Ther Adv Neurol Disord. 2014 May.

Abstract

Clobazam is a 1,5-benzodiazepine used successfully worldwide since the 1970s as an anxiolytic and antiepileptic drug. Since its recent Food and Drug Administration (FDA) approval in the United States in 2011 as adjunctive treatment for Lennox-Gastaut syndrome, it has continued to show sustained efficacy and a better safety and tolerability profile compared with other benzodiazepines. The two randomized, controlled studies that led to the US FDA approval, as well as the follow-up multicenter, open-label study of clobazam, showed ≥50% seizure reduction for more than 50% of Lennox-Gastaut syndrome patients, while none of the other FDA-approved treatments for LGS have demonstrated efficacy rates better than 50%. Clobazam appears to have a safe profile and sustained effectiveness over the first 3 years of use in LGS and other epilepsy syndromes with intractable seizures, which makes it a viable long-term treatment option.

Keywords: Lennox–Gastaut syndrome; benzodiazepine; clobazam; drop seizures; open-label trial; pediatric epilepsy.

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Conflict of interest statement

Conflict of interest statement: Dr Purcarin has nothing to disclose. Dr Ng has served as a consultant, study investigator, and scientific advisory board member for Lundbeck, Inc. and has received consulting fees, travel funding, and speaker honoraria. This study did not receive any funding or manuscript support from any company.

Figures

Figure 1.
Figure 1.
Controlled and open-label study designs. aEnd of previous blinded Lundbeck-sponsored study and the start of the open-label study. b‘Week-1 visit’ only applied to patients who participated in OV-1012 (patients in OV-1002 had passed the week-1 time point prior to the amendment change that added week-1 procedures).
Figure 2.
Figure 2.
Median reduction in total seizure frequency with antiepileptic drugs approved for Lennox–Gastaut syndrome (dark gray columns) compared with placebo (light gray columns) [The Felbamate Study Group in Lennox–Gastaut Syndrome, 1993; Glauser et al. 2008; Jensen, 1994; Sachdeo et al. 1999; Ng et al. 2011].
Figure 3.
Figure 3.
Percentage of patients with more than 50% reduction in drop seizures with antiepileptic drugs approved for Lennox–Gastaut syndrome (dark gray columns) compared with placebo (light gray columns) [VanStraten and Ng, 2012].
See this image and copyright information in PMC

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