Assessment of efficacy and safety of eslicarbazepine acetate for the treatment of trigeminal neuralgia

Sánchez-Larsen, Álvaro; Sopelana, D.; Díaz-Maroto, Inmaculada; Perona-Moratalla, Ana Belén; Gil, J. Gracia; García-Muñozguren, Susana; Palazón-García, Elena; Segura, Tomás

doi:10.1002/ejp.1192

Cited by 35 publications

(23 citation statements)

References 30 publications

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“…This study supports the hypothesis that ESL is an effective, safe and well-tolerated drug for the treatment of TN (Sanchez-Larsen et al, 2018). We would like to add some considerations that may be useful for the use of ESL in clinical practice off label.…”

supporting

confidence: 82%

Comment on a paper by Sanchez‐Larsen A et al. ‘Assessment of efficacy and safety of eslicarbazepine acetate for the treatment of trigeminal neuralgia’

Montero¹,

Carnerero

2018

European Journal of Pain

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supporting

confidence: 82%

Comment on a paper by Sanchez‐Larsen A et al. ‘Assessment of efficacy and safety of eslicarbazepine acetate for the treatment of trigeminal neuralgia’

Montero¹,

Carnerero

2018

European Journal of Pain

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“…91 Efficacy and safety of eslicarbazepine in TN patients was first assessed in 2018. 183 The results of this open-label study that included 15 patients suggested that eslicarbazepine is an effective, safe, and well-tolerated treatment for TN. It is noteworthy that around 60% of the patients presented adverse events, mainly lightheadedness, severe dizziness, and hyponatremia and 4 of the 15 patients discontinued treatment for this reason.…”

Section: Additional Pharmacological Perspectivesmentioning

confidence: 86%

“…It is noteworthy that around 60% of the patients presented adverse events, mainly lightheadedness, severe dizziness, and hyponatremia and 4 of the 15 patients discontinued treatment for this reason. 183 Although the adverse events induced by eslicarbazepine are similar to CBZ and OXC, they are considered less frequent. 184,185 Eslicarbazepine is contraindicated in patients with hypersensitivity reactions to CBZ (European Medicines Agency, London, UK), but some studies have suggested that severe skin reactions occur less frequently with eslicarbazepine compared to other anticonvulsants, leading to treatment discontinuation in only 0.1% of the cases.…”

Section: Additional Pharmacological Perspectivesmentioning

confidence: 99%

Trigeminal neuralgia: An overview from pathophysiology to pharmacological treatments

2020

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The trigeminal nerve (V) is the fifth and largest of all cranial nerves, and it is responsible for detecting sensory stimuli that arise from the craniofacial area. The nerve is divided into three branches: ophthalmic (V1), maxillary (V2), and mandibular (V3); their cell bodies are located in the trigeminal ganglia and they make connections with second-order neurons in the trigeminal brainstem sensory nuclear complex. Ascending projections via the trigeminothalamic tract transmit information to the thalamus and other brain regions responsible for interpreting sensory information. One of the most common forms of craniofacial pain is trigeminal neuralgia. Trigeminal neuralgia is characterized by sudden, brief, and excruciating facial pain attacks in one or more of the V branches, leading to a severe reduction in the quality of life of affected patients. Trigeminal neuralgia etiology can be classified into idiopathic, classic, and secondary. Classic trigeminal neuralgia is associated with neurovascular compression in the trigeminal root entry zone, which can lead to demyelination and a dysregulation of voltage-gated sodium channel expression in the membrane. These alterations may be responsible for pain attacks in trigeminal neuralgia patients. The antiepileptic drugs carbamazepine and oxcarbazepine are the first-line pharmacological treatment for trigeminal neuralgia. Their mechanism of action is a modulation of voltage-gated sodium channels, leading to a decrease in neuronal activity. Although carbamazepine and oxcarbazepine are the first-line treatment, other drugs may be useful for pain control in trigeminal neuralgia. Among them, the anticonvulsants gabapentin, pregabalin, lamotrigine and phenytoin, baclofen, and botulinum toxin type A can be coadministered with carbamazepine or oxcarbazepine for a synergistic approach. New pharmacological alternatives are being explored such as the active metabolite of oxcarbazepine, eslicarbazepine, and the new Nav1.7 blocker vixotrigine. The pharmacological profiles of these drugs are addressed in this review.

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“…Although TN, a severe facial pain disorder, has been studied for decades, neither medicines nor surgical treatments can reach satisfactory effects 23 . The molecular mechanism of TN remains unclear and needs further investigation.…”

Section: Discussionmentioning

confidence: 99%

Effects of palmatine on BDNF/TrkB-mediated trigeminal neuralgia

Liu

Yin

et al. 2020

Sci Rep

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Trigeminal neuralgia (TN), a sudden, needle-like pain in the distribution area of the trigeminal nerve, can seriously affect the physical and mental health of patients. In chronic pain conditions including TN, increased levels of brain-derived neurotrophic factor (BDNF) may enhance pain transmission. This study compares the effect of palmatine administration on the expression of BDNF and its receptor TrkB (tropomyosin receptor kinase B) in trigeminal ganglion cells of Sprague-Dawley rats in a shamversus TN model group. Within 14 days of surgery, the mechanical allodynia threshold of the TN group was significantly lower than that of the sham group, while the TN + palmatine group had a higher mechanical pain sensitivity threshold than the TN group (p < 0.05). Real-time quantitative PCR, immunohistochemistry, and immunofluorescence showed that BDNF and TrkB expression in the TN group was higher than that in the sham group, while palmatine treatment could reverse these changes. Western blotting showed that palmatine treatment could reduce the elevated phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2) in TN rats. Thus, the BDNF/TrkB pathway may be involved in the pain transmission process of TN, and palmatine treatment may reduce pain transmission by inhibiting the BDNF/TrkB pathway and suppressing ERK1/2 phosphorylation.

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Assessment of efficacy and safety of eslicarbazepine acetate for the treatment of trigeminal neuralgia

Abstract: Eslicarbazepine acetate has shown to be an effective, safe and well-tolerated drug for TN. This is the first study that evaluated the efficacy of this drug on TN in humans.

Cited by 35 publications

References 30 publications

Comment on a paper by Sanchez‐Larsen A et al. ‘Assessment of efficacy and safety of eslicarbazepine acetate for the treatment of trigeminal neuralgia’

Comment on a paper by Sanchez‐Larsen A et al. ‘Assessment of efficacy and safety of eslicarbazepine acetate for the treatment of trigeminal neuralgia’

Trigeminal neuralgia: An overview from pathophysiology to pharmacological treatments

Effects of palmatine on BDNF/TrkB-mediated trigeminal neuralgia

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