An Update on Stiripentol Mechanisms of Action : A Narrative Review

© 2024. The Author(s)..

Stiripentol (Diacomit®) (STP) is an orally active antiseizure medication (ASM) indicated as adjunctive therapy, for the treatment of seizures associated with Dravet syndrome (DS), a severe form of childhood epilepsy, in conjunction with clobazam and, in some regions valproic acid. Since the discovery of STP, several mechanisms of action (MoA) have been described that may explain its specific effect on seizures associated with DS. STP is mainly considered as a potentiator of gamma-aminobutyric acid (GABA) neurotransmission: (i) via uptake blockade, (ii) inhibition of degradation, but also (iii) as a positive allosteric modulator of GABAA receptors, especially those containing α3 and δ subunits. Blockade of voltage-gated sodium and T-type calcium channels, which is classically associated with anticonvulsant and neuroprotective properties, has also been demonstrated for STP. Finally, several studies indicate that STP could regulate glucose energy metabolism and inhibit lactate dehydrogenase. STP is also an inhibitor of several cytochrome P450 enzymes involved in the metabolism of other ASMs, contributing to boost their anticonvulsant efficacy as add-on therapy. These different MoAs involved in treatment of DS and recent data suggest a potential for STP to treat other neurological or non-neurological diseases.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:41

Enthalten in:

Advances in therapy - 41(2024), 4 vom: 05. März, Seite 1351-1371

Sprache:

Englisch

Beteiligte Personen:

Bacq, Alexandre [VerfasserIn]
Depaulis, Antoine [VerfasserIn]
Castagné, Vincent [VerfasserIn]
Le Guern, Marie-Emmanuelle [VerfasserIn]
Wirrell, Elaine C [VerfasserIn]
Verleye, Marc [VerfasserIn]

Links:

Volltext

Themen:

56-12-2
Anticonvulsants
Cytochrome P450s
Dioxolanes
Epilepsy
GABA
Gamma-Aminobutyric Acid
Ion channels
Journal Article
Lactate dehydrogenase
Metabolism
R02XOT8V8I
Review
Stiripentol

Anmerkungen:

Date Completed 25.03.2024

Date Revised 26.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s12325-024-02813-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369334779