Nicotine patch treatment for Sleep-related Hypermotor Epilepsy

£30,000 pilot grant over 24 months awarded to Prof Deb Pal at King’s College London

Scientific title: Feasibility/Pilot study for Precision Medicine Transdermal Nicotine in Sleep-related Hypermotor Epilepsy Randomised Controlled Trial

“What could be easier than wearing a skin patch to treat epilepsy? Some people with a certain rare genetic epilepsy, sleep-related hypermotor epilepsy (SHE) can be effectively treated with the same nicotine patch that smokers use to help quit their habit. We’d like to find anyone with SHE in the UK and ask whether they would like to try this treatment. It might turn out to be life-changing”

Background

People with sleep-related hypermotor epilepsy (SHE) experience seizures and sleep disturbance that seriously impact many aspects of their quality of life. Almost 80% never achieve relief from symptoms using conventional treatments. However, nicotine patches have been effective in studies around the world.

The Study

In order to trial this treatment in the UK, researchers need to find out how many people might benefit and how they feel about the design of a future trial. Prof Pal and his colleagues are trying to answer a number of research questions: How many people in the UK have this condition? How many of those people have variations in specific genes (known as CHRNA4 and CHRNB2), making make them eligible for nicotine patch treatment? Can their medical history predict these gene changes? And finally, what are their thoughts on nicotine patch treatment, a clinical trial, and on what the most important outcome measures are?

Significance

SHE was the first type of genetic epilepsy, discovered in 1995. However, despite this there have not been any precision medicine treatments to date. This study attempts to remedy this situation and prepare the ground for the next stage of research: a randomised controlled trial to evaluate evidence of effectiveness and acceptability of nicotine patch treatment for SHE. The results of this study will inform researchers as to which people with SHE have the specific gene mutations, whether genetic testing is necessary, and how feasible a precision medicine approach is to treating SHE. Results will be available within 2 years and may inform future research into treatment.

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