Consensus panel recommendations for the optimization of EPIDIOLEX® treatment for seizures associated with Lennox–Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex

作者：Robert T. Wechsler, David E. Burdette, Barry E. Gidal, Ann E. Hyslop, Patricia Engel McGoldrick, Elizabeth Anne Thiele, James P. Valeriano · 发表于：Epilepsia Open · 年份：2024 · DOI：10.1002/epi4.12956 · 被引用次数：29 · 研究领域：Epilepsy research and treatment、Tuberous Sclerosis Complex Research、Hemoglobinopathies and Related Disorders

Following the approval of Epidiolex® (cannabidiol; CBD) for the treatment of seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome (DS), and tuberous sclerosis complex (TSC), healthcare professionals (HCPs) have had substantial experience in treating patients with Epidiolex. However, confusion still remains among HCPs, caregivers, and patients regarding dosing, drug interactions, safety monitoring, and differentiation between Epidiolex and nonapproved CBD products. To establish consensus recommendations for Epidiolex treatment optimization in LGS, DS, and TSC, a panel of seven HCPs with expertise in epilepsy was convened. Panelists participated in a premeeting survey based on a literature review of Epidiolex for the treatment of LGS, DS, and TSC, and survey responses were compiled for discussion. A modified Delphi method was used to assess agreement among panelists regarding recommendation statements following two rounds of discussion. Panelists identified two broad themes - overcoming barriers to initiation and optimization of treatment for seizures associated with LGS, DS, and TSC - for consensus guidelines. Accurate identification of patients with these rare epilepsies is critical for optimization of Epidiolex treatment. Providers should differentiate Epidiolex from nonapproved CBD products and set expectations for the therapeutic effect and safety/tolerability of Epidiolex. Initial target dose and titration rate should be individualized by baseline varia...