What is the role of ezogabine (Potiga) in the treatment of epilepsy?

Updated: Jan 28, 2020
  • Author: Juan G Ochoa, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Answer

Ezogabine (Potiga), known as retigabine internationally, has a novel mechanism of action as a potassium channel opener. Ezogabine was approved by the US Food and Drug Administration (FDA) in June 2011. The FDA approved ezogabine as adjunctive therapy in partial-onset seizures uncontrolled by current medications.

A multicenter, randomized, double-blind, placebo-controlled trial evaluated the safety and efficacy of this agent. The study design was that of a typical adjunctive AED trial with a very refractory population of patients with localization-related epilepsy. [99]

In terms of both efficacy measures and tolerability, ezogabine appears comparable to prior second-generation AEDs, most recently lacosamide. However, because of its unique mechanism of action, it also comes with a different set of adverse effects. For example, potassium channels are expressed in smooth muscles, including the bladder and heart.

Ezogabine may be an option for patients whose condition is not controlled on their current medications; however, it remains to be determined how this agent will work with other medications. Like prior newer AEDs, ezogabine will not change the landscape of epilepsy or the fact that approximately 30% of patients with seizures are medically intractable. Clinicians should be open to trying new medications, and they should act on the recently updated definition of refractory epilepsy formulated by the International League Against Epilepsy (ILAE).


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