R. Edward Hogan, MD

“It’s important for clinicians to understand that some patients just don’t respond to the basic, standard antiepileptic drugs. They have runs of seizures. If you sit with patients and you talk with them, a lot of times that’s a little in-road you can make—find a time where they’re more likely to have seizures and give this little extra boost of medicine.”

2019 American Academy of Neurology Annual Meeting in Philadelphia, Pennsylvania

, suggested that over the long-term, intranasal diazepam (Valtoco, Neurelis) is both safe and well-tolerated, with fewer than 20% of patients administered a range of doses up to 20 mg experiencing a treatment-related adverse event.

While this formulation of diazepam is much more convenient to patients compared to its rectal counterpart, R. Edward Hogan, MD, director, adult epilepsy center, and professor of neurology, Washington University in St. Louis, told 

 that it offers advantages to clinicians as well. When patients experience cluster seizures—series of seizures which start and stop, experienced as a group&mdash;this intranasal form allows for a “boost,” according to Hogan, which can help address these runs.

Hogan offered insight into the takeaways for the physician community who may see intranasal diazepam as a possible rescue option for their patients with refractory epilepsy, as well as which situations the treatment offers the most advantages.

Sperling M, Hogan RE, Biton V, et al. A 12-month, open-label, repeat-dose safety study of Valtoco ™ (NRL-1, diazepam nasal spray) in patients with epilepsy: Interim report. Presented at: American Academy of Neurology Annual Meeting; May 4-9, 2019; Philadelphia, PA. Poster P1.5-028.

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The director of the adult epilepsy center at Washington University in St. Louis discussed the takeaways for clinicians regarding the use of intranasal diazepam as a treatment for runs of seizures in patients with refractory epilepsy.

R. Edward Hogan, MD: Clinician Takeaways for Using Diazepam Nasal Spray

“This medication has been shown to be efficacious [in epilepsy], but the route of administration isn’t ideal, and so the idea to have this as a nasal spray is a real help.”

Recent interim analysis of a long-term safety study of intranasal diazepam (Valtoco, Neurelis) in more than 100 patients with epilepsy showed that the therapy was safe and well-tolerated in those with frequent breakthrough seizures. In total, only 17.4% (n = 19) of patients administered at least one 5-, 10-, 15-, or 20-mg dose experienced an adverse event (AE) deemed related to the study drug.

The most frequent AEs related to the therapy were nasal discomfort (6.4%; n = 7), and epistaxis, headache (8.2%; n = 4). In total, 67 patients reported an AE, and 18 patients had 30 serious AEs, none of which were treatment-related. The data were presented at the 

. Additionally, a single dose of medication was determined to be adequate for seizure control in 1457 of 1585 seizure episodes (92%).

R. Edward Hogan, MD, director, adult epilepsy center, and professor of neurology, Washington University in St. Louis, told 

 that the therapy has shown great success thus far in well-conducted clinical trials and that its intranasal formulation offers a great advantage over the traditional rectal administration. To find out more about diazepam and what it offers patients and physicians, 

The director of the adult epilepsy center at Washington University in St. Louis spoke about the use of diazepam nasal spray in patients with epilepsy &shy;and detailed the advantages it offers these patients and their physicians.

R. Edward Hogan, MD

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R. Edward Hogan, MD: Clinician Takeaways for Using Diazepam Nasal Spray

R. Edward Hogan, MD: Diazepam Nasal Spray Offers Benefits and Long-Term Safety