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Sangare M, Doumbia F, Sidibe O, Oumar AA, Bah S, Kouyate M, Diakite SS, Traore K, Karembe A, Haidara MS, Coulibaly SP, Coulibaly S, Togora A, Dolo H, Traore D, Doumbia S, Diakite M, Maiga Y, Diawara A, Kuate C, Kim HG, Awandare GA. Epilepsy Research in Mali: A Pilot Pharmacokinetics Study on First-Line Antiepileptic Drug Treatment. J Epilepsy Res 2020; 10:31-39. [PMID: 32983953 PMCID: PMC7494886 DOI: 10.14581/jer.20006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/09/2020] [Accepted: 05/04/2020] [Indexed: 02/05/2023] Open
Abstract
Background and Purpose The indication and benefit of plasma level of antiepileptic (AEDs) has been debating in the monitoring of people living with epilepsy and the epilepsy treatment gap has largely been documented in developed countries. This study was aimed to highlight the epilepsy treatment gap between rural and urban Mali. Methods We conducted a pilot study on AEDs treatment from September 2016 to May 2019. For 6 months, 120 children and young adults living with epilepsy (rural site, 90; urban site, 30) received phenobarbital, valproic acid and/or carbamazepine. At our rural study site, we determined the AED plasma levels, monitored the frequency, severity and the duration of seizure, and administered monthly the McGill quality of life questionnaire. At our urban study site, each patient underwent an electroencephalogram and brain computed tomography scan without close monitoring. Results At the rural study site, patients were mostly on monotherapy; AED levels at 1 month (M1) (n=90) and at 3 months (M3) (n=27) after inclusion were normal in 50% at M1 versus 55.6% at M3, low in 42.2% at M1 versus 33.3% at M3 and high in 7.8% at M1 versus 11.1% at M3. AED levels at M1 and at M3 were significantly different p<0.0001. By M3, seizures (n=90) were <1/month in 26.7%, and lasted less than 1 minute in 16.7%. After a yearlong follow up, all 90 patients reported a good or excellent quality of life. At our urban study site, patients (n=30) were on carbamazepine and valproid acid in 66.67% and monotherapy (carbamazepine) in 33.33%. By November 2018, only six out 30 patients (on bi-therapy) were still taking their medications. Conclusions Epilepsy diagnostic and treatment are a real concern in Mali. Our data showed appropriate AED treatment with close follow up resulted in a better quality of life of patients in rural Mali. We will promote the approach of personalized medicine in AED treatment in Mali.
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Affiliation(s)
- Modibo Sangare
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar.,West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana, State of Qatar
| | - Fatoumata Doumbia
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Oumar Sidibe
- Faculty of Pharmacy, University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, State of Qatar
| | - Aboucacar Alassane Oumar
- Faculty of Pharmacy, University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, State of Qatar
| | - Sekou Bah
- Faculty of Pharmacy, University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, State of Qatar
| | - Modibo Kouyate
- African Center of Excellence in Bio-informatics (ACE), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamakom, State of Qatar
| | - Seidina S Diakite
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar.,Faculty of Pharmacy, University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, State of Qatar
| | - Karim Traore
- Faculty of Pharmacy, University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, State of Qatar
| | - Adama Karembe
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Mohamed S Haidara
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Souleymane P Coulibaly
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Souleymane Coulibaly
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Arouna Togora
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Housseini Dolo
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Drissa Traore
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Seydou Doumbia
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Mahamadou Diakite
- Faculty of Pharmacy, University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, State of Qatar
| | - Youssoufa Maiga
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali, State of Qatar
| | - Amadou Diawara
- Algi Biomedical Analysis Lab, Bamako, Mali, State of Qatar
| | - Callixte Kuate
- Central Neurology Hospital, Yaounde, Cameroun, State of Qatar
| | - Hyung-Goo Kim
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Doha, State of Qatar
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana, State of Qatar
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Al-Eitan LN, Al-Dalalah IM, Aljamal HA. Effects of GRM4, SCN2A and SCN3B polymorphisms on antiepileptic drugs responsiveness and epilepsy susceptibility. Saudi Pharm J 2019; 27:731-737. [PMID: 31297029 PMCID: PMC6598501 DOI: 10.1016/j.jsps.2019.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/19/2019] [Indexed: 12/19/2022] Open
Abstract
Background Pharmacotherapy of epilepsy including antiepileptic drugs (AEDs) is one of the main treatment approaches. As a biological target, sodium channels (Nav channels) and glutamate receptor genes are playing a major role in the etiology and treatment of epilepsy. Objective This study aims to investigate the genetic associations of certain genetic polymorphisms with increased risk of epilepsy susceptibility and variability in response to AEDs treatment in a Jordanian Arab population. Method A pharmacogenetics and case-control study on 296 unrelated epileptic Jordanian patients recruited from the pediatric neurology clinic at the Queen Rania Al-Abdullah Hospital (QRAH) in Amman, Jordan and 299 healthy individuals was conducted. Children up to 15 years old which receiving AEDs for at least three months were scanned for genetic association of 7 single nucleotide polymorphisms (SNPs) within three candidate genes (SCN2A, SCN3B and GRM4) with epilepsy susceptibility. Results SCN2A rs2304016 (P = 0.04) and GRM4 rs2499697 (P = 0.031) were statistically significant with generalized epilepsy. Haplotype of CAACG GRM4 was genetically associated with epilepsy and partial epilepsy (P = 0.036; P = 0.024, respectively). This study also found that TGTAA genetic haplotype formed within GRM4 gene was associated with generalized epilepsy susceptibility (P = 0.006). While, no significant linkage of SCN3B rs3851100 to either disease susceptibility or drug responsiveness was found. Conclusion This study identified no significant associations of allelic or genotypic SNPs with the susceptibility of epilepsy and medication response with an exception of rs2304016 and rs2499697 SNPs that were associated with the generalized type of epilepsy among Jordanian population. Further studies are required in different populations to confirm our results and identify genetic factors that involved in susceptibility and treatment response.
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Affiliation(s)
- Laith N Al-Eitan
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.,Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Islam M Al-Dalalah
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Hanan A Aljamal
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
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Seven M, Batar B, Unal S, Yesil G, Yuksel A, Guven M. The effect of genetic polymorphisms of cytochrome P450 CYP2C9, CYP2C19, and CYP2D6 on drug-resistant epilepsy in Turkish children. Mol Diagn Ther 2014; 18:229-36. [PMID: 24338437 DOI: 10.1007/s40291-013-0078-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite the availability of several antiepileptic drugs, drug resistance remains one of the major challenges in epilepsy therapy. Genetic factors are known to play a significant role in the prognosis and treatment of epilepsy. The aim of this study was to determine the frequencies of alleles for CYP2C9, CYP2C19, and CYP2D6 genes in Turkish children with epilepsy, and to investigate the relationship between the genetic polymorphism of these genes with multiple drug resistance in epilepsy patients. METHODS We genotyped 132 epileptic patients (60 drug resistant and 72 drug responsive) and 55 healthy controls for six single nucleotide polymorphisms (SNPs) in CYP2C9, CYP2C19, and CYP2D6. Genotype, allele, and haplotype frequencies were compared between groups. RESULTS The frequencies of CYP2C9*3/*3 genotype and CYP2C9*3 allele, and the haplotype CCGG (CYP2C9*2 C>T, CYP2C9*3 A>C, and CYP2C19*2 G>A, CYP2C19* G>A) were significantly higher in drug-resistant versus -responsive patients. CONCLUSION Our results demonstrated the important role of the CYP2C9*3 allelic variant in preventing epilepsy patients from developing drug resistance. These data suggest that CYP2C9, CYP2C19, and CYP2D6 SNPs and haplotypes may affect the response to antiepileptic drugs.
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Affiliation(s)
- Mehmet Seven
- Department of Medical Genetics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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SCN1A variations and response to multiple antiepileptic drugs. THE PHARMACOGENOMICS JOURNAL 2013; 14:385-9. [PMID: 24342961 DOI: 10.1038/tpj.2013.43] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/04/2013] [Accepted: 11/06/2013] [Indexed: 11/08/2022]
Abstract
In the current study, we have used the haplotype-tagging single-nucleotide polymorphisms (SNPs) to determine associations between genetic variants in SCN1A and treatment response in 519 Caucasian patients with known response status for epilepsy treated with antiepileptic drugs (AEDs) with sodium channel blocking effects. Nine SNPs within SCN1A were genotyped in this cohort. The only association observed was for rs10188577. A greater proportion of drug-resistant patients were heterozygous compared with drug responsive patients (48.3% vs 35.4%, P=0.014). After correction for potential confounding factors, the association for rs10188577 was only marginally significant (P=0.049). In light of our findings, it seems unlikely that rs10188577 could be a major determinant of response to AEDs. However, looking at the influence of rs10188577 on the expressed quantitative trait association patterns within the immediate vicinity of SCN1A, we found significant associations with neighbouring sodium channel genes, SCN7A and SCN9A (P<0.025), which warrants further studies.
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