Polymorphisms Affecting the Response to Novel Antiepileptic Drugs. 2023

Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy.

Epilepsy is one of the most frequent chronic neurologic disorders that affects nearly 1% of the population worldwide, especially in developing countries. Currently, several antiepileptic drugs (AEDs) are available for its therapy, and although the prognosis is good for most patients, 20%-30% amongst them do not reach seizure freedom. Numerous factors may explain AED-resistance such as sex, age, ethnicity, type of seizure, early epilepsy onset, suboptimal dosing, poor drug compliance, alcohol abuse, and in particular, genetic factors. Specifically, the interindividual differences in drug response can be caused by single nucleotide polymorphisms (SNPs) in genes encoding for drug efflux transporters, for the brain targets of AEDs, and for enzymes involved in drug metabolism. In this review, we used the PubMed database to retrieve studies that assessed the influence of SNPs on the pharmacokinetic (PK), pharmacodynamic (PD), and efficacy of new antiepileptic drugs. Our results showed that polymorphisms in the ABCB1, ABCC2, UGT1A4, UGT2B7, UGT2B15, CYP2C9, and CYP2C19 genes have an influence on the PK and efficacy of AEDs, suggesting that a genetic pre-evaluation of epileptic patients could help clinicians in prescribing a personalized treatment to improve the efficacy and the safety of the therapy.

UI MeSH Term Description Entries
D010597 Pharmacogenetics A branch of genetics which deals with the genetic variability in individual responses to drugs and drug metabolism (BIOTRANSFORMATION). Pharmacogenomics
D004351 Drug Resistance Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from DRUG TOLERANCE which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. Resistance, Drug
D004827 Epilepsy A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313) Aura,Awakening Epilepsy,Seizure Disorder,Epilepsy, Cryptogenic,Auras,Cryptogenic Epilepsies,Cryptogenic Epilepsy,Epilepsies,Epilepsies, Cryptogenic,Epilepsy, Awakening,Seizure Disorders
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000927 Anticonvulsants Drugs used to prevent SEIZURES or reduce their severity. Anticonvulsant,Anticonvulsant Drug,Anticonvulsive Agent,Anticonvulsive Drug,Antiepileptic,Antiepileptic Agent,Antiepileptic Agents,Antiepileptic Drug,Anticonvulsant Drugs,Anticonvulsive Agents,Anticonvulsive Drugs,Antiepileptic Drugs,Antiepileptics,Agent, Anticonvulsive,Agent, Antiepileptic,Agents, Anticonvulsive,Agents, Antiepileptic,Drug, Anticonvulsant,Drug, Anticonvulsive,Drug, Antiepileptic,Drugs, Anticonvulsant,Drugs, Anticonvulsive,Drugs, Antiepileptic
D020641 Polymorphism, Single Nucleotide A single nucleotide variation in a genetic sequence that occurs at appreciable frequency in the population. SNPs,Single Nucleotide Polymorphism,Nucleotide Polymorphism, Single,Nucleotide Polymorphisms, Single,Polymorphisms, Single Nucleotide,Single Nucleotide Polymorphisms

Related Publications

Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
June 2006, Pharmacogenomics,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
September 2021, Neurological research,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
May 2005, The Lancet. Neurology,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
July 2003, Current opinion in investigational drugs (London, England : 2000),
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
December 1993, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
August 2018, The International journal of neuroscience,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
August 2014, The pharmacogenomics journal,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
April 2012, Pharmacogenomics,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
January 1995, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists,
Valentina Urzì Brancati, and Tiziana Pinto Vraca, and Letteria Minutoli, and Giovanni Pallio
May 2013, Epilepsia,
Copied contents to your clipboard!