Seizure Medication Reduced Optic Neuritis In Multiple Sclerosis Interview with:
Dr. Raj Kapoor
National Hospital for Neurology and Neurosurgery
University College London Hospitals NHS Foundation Trust

Medical Research: What is the background for this study?

Dr. Kapoor: Current treatments for Multiple Sclerosis do not prevent disability which accumulates from relapses, or which progresses between relapses. Experimental work suggests that the neurodegeneration which underlies disability could be prevented using agents which block voltage gated sodium channels. We have tested this possibility using treatment with the sodium channel blocker phenytoin in patients with acute optic neuritis. We tested whether phenytoin could prevent the degeneration seen in the retinal nerve fiber layer and macula after an attack of optic neuritis.

Medical Research: What are the main findings?

Dr. Kapoor: The main findings are that the group of patients treated with phenytoin had less degeneration in the retinal nerve fiber layer (rnfl) and in the macula (mv) in the eye affected by optic neuritis than the group treated with placebo. Phenytoin treatment reduced the degeneration by 30 % (rnfl) – 34% (mv).

Medical Research: What should clinicians and patients take away from your report?

Dr. Kapoor: This is a study designed to test the concept of neuroprotection, and it appears that the treatment was successful. Phenytoin did not lead to better vision after optic neuritis, but our trial was too small to determine whether phenytoin could achieve this. By providing proof of concept for the treatment target, however, and by demonstrating neuroprotection so robustly, we hope to open a door to even better treatments to prevent disability in Multiple Sclerosis.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Kapoor: The trial suggests that proof of neuroprotection using different treatment targets could be sought in similar trials in optic neuritis. Better treatment effects could be achieved by refining the trial design, for example by looking for drugs with more potent effects on the relevant sodium channels, by treating even earlier from the onset of optic neuritis, and by combining such neuroprotection with other treatments to promote remyelination and to suppress inflammation in Multiple Sclerosis.


2015 AAN abstract :

Phenytoin is Neuroprotective in Acute Optic Neuritis: Results of a Phase 2 Randomized Controlled Trial

[wysija_form id=”1″] Interview with: Dr. Raj Kapoor (2015). Seizure Medication Reduced Optic Neuritis In Multiple Sclerosis