James Wheless, MD

“That ability to interact with an expert who’s actually used [a new medicine] and can say, ‘when you  start, this is how you use it’ or ‘make sure you’re aware of this and that’ or ‘this is how I did my first few patients’…it’s really hard to replace that.”

As a number of medical meetings have been shifted to a virtual format in parallel to a large amount of medical care, the field has gained a new perspective and tested new abilities in sharing information and providing care. The majority of this has led to positives, most notably what appears to be a push forward in the quest to bring telemedicine to a more regular role.

Although, as with many aspects of this adjustment, there is some downside. For physicians like James Wheless, MD, professor and chief, Pediatric Neurology, University of Tennessee Health Science Center, and director, Neuroscience Institute and Le Bonheur Comprehensive Epilepsy Program, Le Bonheur Children's Hospital, the inability to network at medical meetings has had a bit of a negative effect.

, Wheless shared his insight into the nuance of being able to pick an expert’s brain on the use of an investigational medicine or build on research opportunities while attending societal meetings. He also spoke to how this has affected the research he is currently involved in.

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The chief of pediatric neurology at the University of Tennessee Health Science Center, and director of the Comprehensive Epilepsy Program at Le Bonheur Children's Hospital spoke to the difficulty in connecting with colleagues with virtual meetings.

James Wheless, MD: Consequences of Virtual Societal Meetings

“That’s a small subset of patients, but at least it gets us into the concept of thinking ‘OK, we’re not just treating a symptom over here of the epilepsy,’ [and] we’re going to, ‘OK, it started here with this genetic cause, let’s treat that.’ That’s a real different mind-shift from what we’ve done.”

Despite the lack of in-person medical society meetings to share the information widely, a number of advances and steps have been made in recent months in the care of patients with epilepsy. And as the American Epilepsy Society’s annual meeting was able to occur in early December 2019, some of that science was on display just a few short months ago.

James Wheless, MD, professor and chief, Pediatric Neurology, University of Tennessee Health Science Center, and director, Neuroscience Institute and Le Bonheur Comprehensive Epilepsy Program, Le Bonheur Children's Hospital, told 

 have been a bright light in this time. Additionally, he discussed the importance of the ongoing and upcoming trials for an AAV gene therapy for 

In this interview, Wheless shared his insight into what is going on in the epilepsy pipeline, as well as what concerns his patients have had and how they feel they may be risk amid the ongoing pandemic. Specifically, he noted how quelling their anxieties has been the biggest task.

The chief of pediatric neurology at the University of Tennessee Health Science Center, and director of the Comprehensive Epilepsy Program at Le Bonheur Children's Hospital discussed the current state of research in epilepsy care.

James Wheless, MD: Treatment Development in Epilepsy

“As doctors, many times were asking about seizure numbers or side effects, and we’re maybe not getting all the other aspects of the disease.”

 annual meeting of the American Epilepsy Society (AES), investigators presented additional data on perampanel (Fycompa; Eisai), an antiepileptic drug that has shown favorable retention rates and sustained efficacy for adolescents with partial-onset seizures during routine care. The 

 was conducted over a 24-month period, with more than 50% of enrolled patients seeing improvements in seizure freedom.

James Wheless, MD, professor of pediatric neurology, chief of pediatric neurology, and director of the comprehensive epilepsy program and Neuroscience Institute at Le Bonheur Children’s Hospital, was among the study investigators. He observed firsthand not only the long-term effects of perampanel on seizure freedom, but other improvements in real-world factors such as rates of hospitalization and non-seizure related problems.

 at AES 2019 to discuss the real-world results, and why perampanel may be a good first line therapy going forward.

The professor and chief of pediatric neurology, and director of the comprehensive epilepsy program and neuroscience institute at Le Bonheur Children’s Hospital, detailed his experience with patients treated with perampanel.

James Wheless, MD: Perampanel Shows Sustained Real-World Efficacy  

“We’ve always known that we needed a treatment for seizure clusters at home and the key was trying to develop a product that would do what we wanted it to do—that it was safe, but would also interrupt the seizure cluster&mdash;and was one that the patient could use at home. Nayzilam represents an option that fills all of those criteria.”

 the first nasal spray for the treatment of intermittent, stereotypic episodes of frequent seizure activity that are distinct from usual seizure patterns in patients with epilepsy 12 years of age and older. Its regulatory go-ahead marked an important moment for this patient population, whose prior options were drastically limited. It became 

The benzodiazepine, which may be administered in the outpatient setting by a non-healthcare professional in patients actively seizing and where a seizure cluster occurs, is supplied as 2 single-use nasal spray units, each containing a 5 mg dose of midazolam in 0.1 mL solution. Its effectiveness of midazolam was established in a phase 3 randomized, double-blind, placebo-controlled trial (NCT01390220) that was conducted in 2 phases: an open-label test dose phase followed by a comparative phase.

 annual meeting of the American Epilepsy Society (AES)

, December 6-10, 2019, in Baltimore, Maryland, 

 sat down with James Wheless, MD, professor and chief, pediatric neurology, and director, comprehensive epilepsy program and neuroscience institute, Le Bonheur Children’s Hospital, to discuss the therapy and its potential impact further. He offered insight into his experience with midazolam in clinical trials, as well as the debilitating nature of seizure clusters and the critical need which this product has the opportunity to fill.

The professor and chief of pediatric neurology, and director of the comprehensive epilepsy program and neuroscience institute at Le Bonheur Children’s Hospital offered insight into his experience with midazolam and its potential to play a vital role in treating seizure clusters.

James Wheless, MD

Articles

James Wheless, MD: Consequences of Virtual Societal Meetings

James Wheless, MD: Treatment Development in Epilepsy

James Wheless, MD: Perampanel Shows Sustained Real-World Efficacy

James Wheless, MD: Treating Seizure Clusters With Midazolam