Cenobamate is an investigational antiepileptic drug with a unique dual mechanism of action. Evaluations of cenobamate in two major randomized controlled trials (NCT01397968; NCT01866111) demonstrated its unmatched efficacy in patients with uncontrolled focal epilepsy, with more than 20% of patients achieving seizure freedom. Bernhard Steinhoff, MD, PhD, Kork Epilepsy Center, Kehl-Kork, Germany, explains how cenobamate works via reduction of persistent currents though voltage-gated sodium channels and positive allosteric modulation of GABAA receptors at the non-benzodiazepine binding site. Investigations into this therapy are ongoing. This interview took place during the European Academy of Neurology 2021 congress.
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What is behind cenobamate’s remarkable efficacy against focal-onset seizures?
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