Conflicting Views Between Epileptologists and General Neurologists Hinder Adoption of New Refractory Epilepsy Treatments


New brands aiming to enter the refractory epilepsy market may face challenges achieving desired penetration without improved general neurologist education efforts, according to Spherix Global Insights.

EXTON, PA, July 08, 2024 (GLOBE NEWSWIRE) — Chronic epilepsy is often well managed by neurologists, but a sizable proportion of adults with epilepsy continue to experience seizures at varying frequencies despite using typically-effective pharmacological interventions. Every seizure is one too many, and experts recognize that if seizures are not fully controlled after a patient tries their third medication, the risk of developing recurrent epilepsy increases dramatically.1

In Market Dynamix™: Adult Refractory Epilepsy (US), Spherix Global Insights dives into the variations in patient management and beliefs between epileptologists and general neurologists, who often manage epilepsy patients. Findings indicate that one-quarter of epilepsy patients seen by general neurologists have developed refractory epilepsy. Thus, a sizable portion of the refractory epilepsy patient population remains under the care of general neurologists.


The study reveals that while general neurologists and epileptologists typically choose the same drug classes for patients with new-onset seizures, differences between the two subspecialties emerge when the initial treatment fails to adequately control seizures. Epileptologists prefer to maximize the dose of the first medication through meticulous dose titrations, while general neurologists are more inclined to introduce a second medication. These differences become more pronounced as their patients progress toward refractory epilepsy status.

When determining the next course of action for patients whose seizures are not quickly controlled, over half of general neurologists delay referring patients to an epileptologist until seizures are ‘clearly’ uncontrolled. None of the general neurologists surveyed said they would refer to an epileptologist after the first medication failed to stop seizures, despite literature suggesting that achieving seizure control with the second medication is more likely than with the third or later medication.1 Even after referral to epilepsy centers, differences between subspecialties persist: Epileptologists report that approximately two-thirds of refractory patients referred for seizure management remain indefinitely under their care, whereas general neurologists indicate that only one-third of their patients receive ongoing management at comprehensive epilepsy centers.

Typically, general neurologists are less informed than epileptologists about the latest therapies and those in development for refractory partial and generalized epilepsy. Therefore, Spherix’s findings indicate that epileptologists give higher favorability ratings to newer therapies, such as SK Life Science’s Xcopri, compared to general neurologists. Epileptologists also show greater enthusiasm for pipeline assets Staccato® alprazolam, XEN1101, and bexicaserin (LP352) being developed respectively by UCB, Xenon and Longboard.

Spherix Global Insights will continue to monitor these trends and provide valuable insights to improve patient outcomes through our Market Dynamix™ services.

1 Kwan, P & Brodie, M. (2000). Early Identification of Refractory Epilepsy, NEJM, 342:314-319

Market Dynamix™ is an independent service providing analysis of markets anticipated to experience a paradigm shift within the next three to five years. Insights highlight market size, current treatment approaches, unmet needs, and expert opinions on the likely disruption introduced by pipeline agents. 

About Spherix Global Insights 

Spherix is a leading independent market intelligence and advisory firm that delivers commercial value to the global life sciences industry, across the brand lifecycle.

The seasoned team of Spherix experts provides an unbiased and holistic view of the landscape within rapidly evolving specialty markets, including dermatology, gastroenterology, rheumatology, nephrology, neurology, ophthalmology, and hematology. Spherix clients stay ahead of the curve with the perspective of the extensive Spherix Physician Community.

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NOTICE: All company, brand or product names in this press release are trademarks of their respective holders. The findings and opinions expressed within are based on Spherix Global Insight’s analysis and do not imply a relationship with or endorsement.

CONTACT: Blaine Cloud, Ph.D., Neurology Franchise Head Spherix Global Insights (484) 879-4284 [email protected] 

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