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oxcarbazepine (SPN604 / SPN 804 / oxcarbazepine ER)

✓ Approved

Aequus Pharmaceuticals, Inc. · SCN1A · 小分子

什么是 oxcarbazepine？

oxcarbazepine 是一种小分子，由Aequus Pharmaceuticals, Inc.研发。该药已获批，用于治疗相关适应症，给药途径：Oral (PO)。

药物档案

商品名SPN604, SPN 804, oxcarbazepine ER
公司Aequus Pharmaceuticals, Inc.
药物类别小分子
分子靶点SCN1A, SCN2A, SCN3A
给药途径Oral (PO)
状态Approved
来源： ClinicalTrials.gov, Aequus Pharmaceuticals, Inc.

作用机制

分子靶点

oxcarbazepine 作用于 3 个分子靶点：

SCN1Asodium voltage-gated channel alpha subunit 1 (DEE6B, FEB3)
SCN2Asodium voltage-gated channel alpha subunit 2 (Na(v)1.2, BFNIS)
SCN3Asodium voltage-gated channel alpha subunit 3 (Nav1.3, NAC3)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

oxcarbazepine 针对 2 个适应症，涉及 2 个治疗领域。

治疗领域疾病/病症分期
Nervous system disordersPartial seizures✓ Approved
Psychiatric disordersBipolar disorderPhase III

相关研究文献

PubMedEpilepsia2026-08-02

Acute effects of anti-seizure medications on network level dynamics: A systematic comparison using multielectrode arrays.

Marku Griselda G, Gschossmann Lena L, Hallmann Kerstin K, Beck Heinz H et al.

A multi-electrode array (MEA) is a powerful extracellular recording technique for long-term monitoring of neuronal network activity. In recent years, MEA-based assays have been applied increasingly to evaluate drug efficacy and neurotoxicity, including the assessment of anti-seizure medications (ASMs). However, systematic comparisons of ASMs with different mechanisms of action under identical experimental conditions remain limited. In this study, we evaluated the effects of 18 ASMs on neuronal network activity using MEA recordings under standardized conditions. Network activity was characterized using four components-spike, burst, network burst, and synchrony-and a total of 44 MEA-derived parameters were analyzed. Dimensionality reduction by t-distributed stochastic neighbor embedding (t-SNE) followed by hierarchical clustering classified the 18 ASMs into four distinct clusters. Cluster 1, including S-licarbazepine, oxcarbazepine, and lamotrigine, exhibited pronounced effects across all four network components. Cluster 2, comprising carbamazepine, eslicarbazepine acetate, phenytoin, phenobarbital, and stiripentol, significantly affected spike and burst duration but showed only limited effects on burst frequency, network burst frequency, or synchrony. Cluster 3 was solely diazepam, for which minimal effects were detected. The remaining ASMs were assigned to Cluster 4 and produced only minimal measurable effects in network activity. Several limitations should be considered, including the use of primary neuron cultures, incomplete maturation of certain drug targets, evaluation of only acute drug effects, and the limited spatial resolution of low-density MEA systems. Nevertheless, our results demonstrate that this MEA-based platform enables systematic evaluation of ASM effects on neuronal networks under identical experimental conditions. Furthermore, multivariate and unsupervised clustering analysis of 44 MEA parameters facilitated classification independent of drug mechanism of action. These findings suggest that MEA, combined with multidimensional data analysis, may provide a useful platform for the direct comparison of ASMs and could contribute to future pharmacological screening and drug discovery efforts.

PMID 42541378
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PubMedEpilepsia open2026-08-02

The gut microbiome and drug-resistant epilepsy: Microbiome-antiseizure medication interactions and implications for pharmacoresistance.

Zammar Khaled K, AbuAlrob Majd A MA, Ali Musab M, Lattanzi Simona S et al.

Drug-resistant epilepsy (DRE) affects approximately one-third of patients with epilepsy and represents a major unmet clinical need. While traditional hypotheses of pharmacoresistance have focused on alterations in drug targets, efflux transporter overexpression, and intrinsic disease severity, the gut microbiome has recently emerged as a potentially modifiable factor that may function as a systems-level modifier of these established mechanisms rather than a standalone pathway. The gut microbiome harbors a vast repertoire of drug-metabolizing enzymes capable of directly biotransforming orally administered antiseizure medications (ASMs)-including valproic acid, lamotrigine, carbamazepine, and oxcarbazepine-thereby altering their pharmacokinetics, bioavailability, and therapeutic efficacy. Additionally, microbial metabolites modulate host cytochrome P450 enzymes, nuclear receptors, and efflux transporters such as P-glycoprotein, while bacterial β-glucuronidases influence the enterohepatic recirculation of glucuronidated ASMs. Conversely, chronic ASM exposure reshapes the gut microbial ecosystem, creating a self-perpetuating cycle of dysbiosis and pharmacoresistance. This narrative review synthesizes current evidence on microbiome-ASM interactions in DRE, proposes a concrete experimental pipeline for characterizing ASM-specific microbial biotransformation, and outlines a framework for integrating physiologically based pharmacokinetic modeling with microbiome data. We discuss clinical implications for epileptologists-including the role of therapeutic drug monitoring in detecting microbiome-mediated pharmacokinetic variability, the concept of microbiome-neutral ASM selection, and earlier deployment of the ketogenic diet as a microbiome-targeted intervention. We highlight the translational potential of pharmacomicrobiomics-the study of how microbiome variation influences drug disposition and response-and identify critical knowledge gaps that warrant future investigation. PLAIN LANGUAGE SUMMARY: About one in three people with epilepsy continue to have seizures despite treatment. This review summarizes growing evidence that the gut microbiome-the community of bacteria living in the intestines-can influence how seizure medications work by altering their absorption, metabolism, and clearance. The medications themselves can reshape the microbiome in return, creating a cycle that may sustain treatment failure. Understanding this gut-drug relationship may open new paths to personalized epilepsy care through diet, probiotics, and microbiome-guided prescribing.

PMID 42541365
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PubMedEpilepsia open2026-07-29

Response to anti-seizure medications in children carrying novel or previously reported HCN1 gene variants.

Khan Marium N MN, Poolos Nicholas P NP

Variants in the HCN1 gene cause a syndrome of childhood epilepsy and developmental disability with a broad phenotypic range. Many affected children manifest with early infantile epileptic encephalopathy (EIEE) and highly drug-resistant epilepsy. There are anecdotal reports that seizures in this syndrome are exacerbated by some anti-seizure medications (ASMs), including lamotrigine and lacosamide. However, the efficacy of most ASMs in this disorder is unknown. We sought to understand which ASMs were most effective. We compiled a registry of 10 children with HCN1 variants and refractory epilepsy via outreach to parent members of an online social affinity group, and from unsolicited parent outreach to us. Parents filled out an eight-page survey detailing their child's and parents' genetic testing results, child's developmental status, and response to ASMs. Outside medical records were provided that documented genetic testing results. Five of these variants had not been previously reported in the literature. Of these, there was phenotypic variability depending on where the variant mapped on the HCN1 ion channel structure, with variants mapping to an ion channel transmembrane domain causing more severe phenotypes. Subjects given lamotrigine or oxcarbazepine had exacerbated seizure frequency whereas those exposed to valproate or clobazam had improved seizure frequency, with two subjects becoming seizure-free. We report here five novel HCN1 variants. We also provide a novel survey of ASM efficacy. These trends in ASM efficacy are similar to what has been observed in Dravet syndrome, another EIEE, raising questions about potential common pathogenic mechanisms at a cellular level. We surveyed families whose children had been diagnosed with a rare epilepsy syndrome due to mutations in the HCN1 gene. In reviewing their genetic testing results, we discovered five new gene mutations (variants) that had not been previously reported. We also asked which anti-seizure medications had been most effective: they cited valproate and clobazam as most effective, while lamotrigine and oxcarbazepine made seizures worse.

PMID 42524842
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PubMedHealth science reports2026-07-29

Investigation of the Prevalence of the HLA-B*15:02 Allele in the Asian Populations: A Comprehensive Analysis Through Using AFND.

Biswas Mohitosh M, Murad Murshadul Alam MA, Ershadian Maliheh M, Sukasem Chonlaphat C

The HLA-B*15:02 allele is related to a high risk of severe cutaneous adverse drug reactions (SCARs) in patients taking certain antiepileptic drugs. However, its prevalence in the Asian population and the number of drugs linked to SCARs due to the carriage of this variant are relatively underexplored. This study sought to address these knowledge gaps. The prevalence of the HLA-B*15:02 allele in Asian populations was estimated by using the data from the Allele Frequency Net Database. Weighted means, standard deviations, and 95% Confidence Interval (CI) were estimated for the study populations, and the chi-square test was used to assess the statistical significance of variability in allele frequencies across populations. Drugs associated with SCARs due to HLA-B*15:02 were identified from the clinical guidelines of the international pharmacogenomics (PGx) working groups. HLA-B*15:02 was most prevalent in South-East Asia (5.6% ± 3.1), followed by South Asia (2.1% ± 1.5), North-East Asia (0.6% ± 0.9), and West Asia (0.01% ± 0.05). This distribution was statistically significant (χ2 = 9712.5, df = 3, p < 0.001; χ 2 test). Country-wise, prevalence was the highest in the Philippines (22%; 95% CI, 11.53-35.96%), followed by Vietnam (13.5%; 95% CI, 8.77-19.61%), Indonesia (11.9% ± 1.5), Malaysia (10% ± 4.3), Hong Kong (9.3% ± 0.2), Thailand (8.4% ± 0.1), Singapore (8.1% ± 3.7), China (5.4% ± 5.4), Taiwan (4.4% ± 0.7), Sri Lanka (2.5%, single study), India (2.1% ± 1.5) and South Korea (1.5% ± 0.9). PharmGKB clinical annotations identified four drugs (carbamazepine, oxcarbazepine, lamotrigine, phenytoin) with strong evidence (Level 1 A) for HLA-B*15:02-related SCARs, though the majority of the evidence for lamotrigine came from the Han Chinese Population. International PGx working groups require or recommend preemptive HLA-B*15:02 genotyping for at least three drugs, i.e., carbamazepine, oxcarbazepine, and phenytoin. Considering the high prevalence of the HLA-B*15:02 in the Southeast and South Asians, and its association with drug-induced SCARs, pre-emptive HLA-B*15:02 testing may reduce SCARs substantially in this region.

PMID 42524381
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PubMedInternational medical case reports journal2026-07-28

Arachnoid Cyst in the Posterior Fossa and Its Contested Association with Mania and Psychotic Symptoms in a Prepubertal Child: A Case Report.

Al Lihabi Abeer Ayad AA

Bipolar affective disorder presenting as a primary diagnosis in prepubescent children remains a contentious issue. Studies examining how common it is have yielded mixed, sometimes contradictory findings. One might argue that many of the rare cases described could actually be secondary to underlying neurological problems. In this report, we describe a 10-year-old girl with a posterior fossa arachnoid cyst who displayed a cluster of manic and psychotic symptoms. The clinical picture was marked by a sudden onset of irritability and hyperactivity, along with paranoid delusions. Of particular interest was a relapse after stopping medication. An initial EEG raised the possibility of epileptiform activity, but thorough follow-up testing failed to confirm this. Treatment with olanzapine and oxcarbazepine brought about some improvement, though not complete remission. Surgery was ultimately not pursued, as the cyst was deemed incidental. This case really discusses the difficulty in differentiating primary psychiatric illness from neuroimaging findings that may or may not be relevant. We propose that this might be a rare example of very early-onset mania, with the arachnoid cyst merely an incidental finding. It is worth noting that while there is some literature hinting at links between posterior fossa abnormalities and psychopathology, the evidence remains inconclusive. For a fuller picture, we include a one-year follow-up to shed light on the course of this complex presentation.

PMID 42518745
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PubMedEpilepsy & behavior : E&B2026-07-24

Infertility treatment in women with epilepsy: A systematic review.

Alshaqi Ola O, Maisenbacher Mathias M, Nofal Yazan Y, Sane Caroline C et al.

The impact of assisted reproductive technologies (ART) on seizure control in women with epilepsy remains incompletely understood. A systematic review was conducted according to PRISMA guidelines. EMBASE, MEDLINE, CINAHL, Scopus, and the Cochrane Library were searched from inception to March 2025. Eligible studies included observational studies and case-based reports involving women undergoing infertility treatment. A total of 1216 publications were identified, of which four studies met the inclusion criteria, including case reports, a case series, and a cohort study. These studies included 16 women aged 25-46 years undergoing infertility treatment, all but one of whom had epilepsy. Interventions involved in vitro fertilization (IVF), ovulation induction, and hormonal therapies. Patients were treated with a range of antiseizure medications (ASMs), including carbamazepine, clobazam, lamotrigine, levetiracetam, oxcarbazepine, valproate, and zonisamide, either as monotherapy or in combination. Seizure frequency was generally stable, with most patients maintaining baseline seizure control. Seizure exacerbations were uncommon and primarily associated with hormonal therapy and reduced ASM levels, particularly reduced lamotrigine levels. Reported events included breakthrough seizures in the setting of decreased lamotrigine concentrations, seizure clusters associated with follitropin beta, and a new-onset seizure following dehydroepiandrosterone exposure. Across studies, multiple ART attempts resulted in live births with different ASM regimens, as well as in patients not receiving ASMs. Available evidence suggests that ART is feasible in women with epilepsy, with most patients maintaining stable seizure control. Hormonal therapy may affect ASM pharmacokinetics and seizure threshold, thereby warranting close monitoring. Larger prospective studies are needed to better define ASM-specific effects and optimize care.

PMID 42492305
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