Authors :
Presenting Author: NIcola Specchio, MD, PhD, FRCP – Bambino Gesu' Children's Hospital
Nicola Pietrafusa, MD – Bambino Gesu' Children's Hospital
Marina Trivisano, MD, PhD – Bambino Gesu' Children's Hospital
Susanna Casellato, MD – Child Neuropsychiatry Unit, AOU Sassari
Cinzia Correale, MSN – Bambino Gesu' Children's Hospital
Simona Cappelletti, BS – Bambino Gesu' Children's Hospital
Paola De Liso, MD, PhD – Bambino Gesu' Children's Hospital
Ilaria Onida, MD – Child Neuropsychiatry Unit, AOU Sassari
Ambra Butera, MD – "Gaetano Barresi" University
Federico Vigevano, MD – San Raffaele Institute
Rationale: Dravet syndrome (DS) is a rare developmental and epileptic encephalopathy. Infants with DS are especially vulnerable to the detrimental effects of prolonged and frequent seizures on development. Fenfluramine (FFA) is approved for the treatment of DS in patients aged 2 years and older. This study aims to evaluate the safety and efficacy of FFA in patients with DS younger than 2 years.
Methods: We analyzed safety, tolerability, seizure, and neuropsychological outcome in a real-world setting. Developmental profile was investigated using Griffiths Mental Development Scales (GMDS).
Results: Five patients received FFA at a mean age of 14.9 months (9.6-18.6). Median follow-up was 19 months (interquartile range [IQR] = 18.9-30.4). All patients showed good tolerance to FFA. No significant variation of body mass index or echocardiographic issue was observed. Monthly median convulsive seizure frequency (MCSF) was 1.71 (IQR = 1.56-3.27) at the 6-month baseline period and 0.94 (IQR = 0.41-1.37) at the 18-month follow-up, with a median 53.93 (IQR = 41.95-58.22) percentage reduction in MCSF. Two of five patients had a performance improvement on GMDS subscales.
Conclusions:
Overall, the use of FFA below the age of 2 years in our small sample of patients was safe and represents a promising opportunity for seizure control and for protection of the neurodevelopmental outcome.
Funding: No Fundings.