TABLE 1.
Patient characteristics
Patient | Age at diagnosis | CDKL5 pathogenic Variant | Prior ASMa | ASM at FFA initiationb | Predominant seizure type, BL (seizure history)c | CGI | QOLCE | PedsQL | ||
---|---|---|---|---|---|---|---|---|---|---|
Post FFA | BL | Post FFA | BL | Post FFA | ||||||
1 | 2 months | p.Glu449LeufsX38 | Levetiracetam, oxcarbazepine, pentobarbital, topiramate | Diazepam, valproate |
TC (AA, MC) |
Much Impr | Fair | Very Good | 200 | 425 |
2 | 3 months | p.Arg550Ter | Ataluren, cannabidiol, clobazam, levetiracetam, lamotrigine, lorcaserin, valproate | Diazepam, midazolam, perampanel, quetiapine, zonisamide |
A (MC, TC) |
Slt Worse |
Very Good | Fair | 500 | 450 |
3 | 6 weeks | p.Glu416ValfsX2 | Clonazepam, levetiracetam, topiramate | Clobazam, diazepam, valproate, vigabatrin |
TC (A, ES) |
Much Impr | Good | Good | 650 | 1100 |
4 | 6 weeks | p.His127Tyr | Acetazolamide, cannabidiol, ezogabine, felbamate, lorcaserin, lacosamide, phenytoin, prednisone, primidone, rufinamide, topiramate, vigabatrin | Clonazepam, diazepam, midazolam, valproate |
T (A, MC, TC, TA) |
Much Impr | Fair | Very Good | 450 | 800 |
5 | 5 weeks | p.Arg558ThrfsTer9 | Clonazepam, lacosamide, levetiracetam, lorazepam, phenobarbital, phenytoin, vigabatrin | Cannabidiol, clobazam, midazolam, perampanel, valproate |
T (A, AA, TA, FWMC, MC, TC) |
Slt Impr | Poor | Fair | NC | NC |
6 | 7 months | Xp22.2p22.13 | Brivaracetam, clobazam, felbamate, lacosamide, levetiracetam, perampanel, prednisone, topiramate, valproate | Lorazepam, cannabidiol, clonazepam, midazolam |
TC (AA) |
Much Impr | Poor | Fair | NC | NC |
Median (range) |
7 (5‐28) |
— |
6.5 (5‐12) |
3.5 (2‐5) |
3 (2‐7) |
— | — | — | — | — |
Seizure types: A, atonic; AA, atypical absence; ES, epileptic spasm; FWMC, focal impaired with motor components; MC, myoclonic; T, tonic; TA, typical absence; TC, tonic‐clonic.
Abbreviations: ASM, antiseizure medication; BL, baseline; CGI, clinical global impression; FFA, fenfluramine; Impr, improved; N/A, not applicable; NC, not calculated (N/A listed too many times); QOLCE, Quality of Life Childhood Epilepsy; Slt, slightly; VNS, vagus nerve stimulation.
Patient 2 was also on ketogenic diet as a prior ASM.
Patient 1 was also on ketogenic diet at FFA initiation; Patient 4 was also on VNS at FFA initiation.
Nonseizure symptoms at baseline in ≥2 patients: constipation (n = 4), hypotonia (n = 3), sleep issues (n = 3), tiredness (n = 3), unsteadiness (n = 3), headaches (n = 2), kidney stones (n = 2), and scoliosis (n = 2).