The Scottish Medicines Consortium has endorsed the use of UCB’s epilepsy drug Vimpat (lacosamide) on the National Health Service for use as an add-on therapy in adult patients with partial onset seizures.

According to the firm, Vimpat’s unique mode of action sets it aside from all the other antiepileptics on the market, and offers patients a new hope for improved seizure control.

Although the exact mechanism by which Vimpat induces its antiepileptic effect in humans is yet to be explained, preclinical studies have shown that the drug regulates sodium channel activity – which plays a crucial role in producing seizures - differently to other medicines on the market acting on the same pathway.

In addition, preclinical studies suggest that the drug is the only antiepileptic to bind to the collapsin response mediator protein-2, an important target that affects nerve differentiation and growth. However, again the precise nature of the interaction between Vimpat and this protein, as well as the relationship between this protein and seizure control, is as yet unknown.

Nevertheless, the drug was issued a green light by European regulators in September last year on the back of data from three Phase III, multi-centre, clinical studies and pooled analysis showing that treatment with Vimpat 200mg/day and 400mg/day cut seizures by half in 34% and 40% of patients, respectively, compared with 23% in the placebo group.

Need for better control
The SMC’s approval of its addition to the treatment menu is good news for patients in the country. An estimated 20,000-40,000 adults in Scotland have epilepsy, and around a third of patients throughout the UK are thought to experience seizures despite taking medication, highlighting the urgent need for better seizure control.

“This acceptance by the SMC means that specialists have another therapeutic choice to offer those patients in Scotland not achieving adequate seizure control,” commented Dr John Paul Leach, Southern General Hospital, Glasgow.