How to reduce the treatment gap for people with epilepsy in resource-limited settings by innovative galenic formulations: A review of the current situation, overview of potential techniques, interests and limits.

Jérémy Jost; Pierre-Marie Preux; Michel Druet-Cabanac; Voa Ratsimbazafy

How to reduce the treatment gap for people with epilepsy in resource-limited settings by innovative galenic formulations: A review of the current situation, overview of potential techniques, interests and limits.

Jérémy Jost ¹ Pierre-Marie Preux ^{2, 3, 1} Michel Druet-Cabanac ^{4, 1} Voa Ratsimbazafy ^{5, 6, 1}

1 NET - Neuroépidémiologie Tropicale

2 SIME - Service de l'Information Médicale et de l'Évaluation [CHU Limoges]

3 Laboratoire de Biostatistique et d'Informatique Médicale

4 Service de Santé au Travail [CHU Limoges]

5 Service de Pharmacie Centrale [CHU Limoges]

6 UNILIM - Université de Limoges

Abstract : Epilepsy is a chronic neurological disease affecting more than 69 million people worldwide, nearly 90% of them in low and middle-income countries (LMICs). In those countries, only four major antiepileptic drugs are commonly used: phenobarbital, carbamazepine, sodium valproate and phenytoin. There are also problems with the accessibility, availability and quality of drugs. The main objective was to review the literature concerning "long" sustained-release formulations of AEDs that have the potential to reduce the number of administrations and help overcome problems of compliance, accessibility and the treatment gap. The main endpoint was a releasing of the active ingredient over more than 24h. We also assessed the feasibility and acceptability in resource-limited settings. Two drugs were found in unconventional release formulations: carbamazepine and sodium valproate; but they were not "long" sustained release because they required administration once a day. Several techniques were available, including: esterification, transdermal devices, liposomes and polymeric devices preformed or formed in situ. In situ methods for the preparation of injectable biodegradable microparticles or implants for controlled delivery seemed best suited to the objective. Furthermore, they appear to fulfil the requirements of feasibility and cost. Sodium valproate appeared as well to be a relevant candidate for a "long" sustained release formulation that would improve access to medicines for people with epilepsy in resource-limited settings. .

Type de document :

Article dans une revue

Domaine :

Sciences du Vivant [q-bio] / Santé publique et épidémiologie

Liste complète des métadonnées

https://hal-unilim.archives-ouvertes.fr/hal-01245403
Contributeur : Elisabeth Grelier <>
Soumis le : jeudi 17 décembre 2015 - 10:39:30
Dernière modification le : vendredi 8 juin 2018 - 10:24:02

How to reduce the treatment gap for people with epilepsy in resource-limited settings by innovative galenic formulations: A review of the current situation, overview of potential techniques, interests and limits.

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How to reduce the treatment gap for people with epilepsy in resource-limited settings by innovative galenic formulations: A review of the current situation, overview of potential techniques, interests and limits.

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