Adolescent Cenobamate Exposure Aligns With Adults, Nipocalimab Shows Sustained Disease Control, Sex Differences in Women With Parkinson Disease

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Welcome to the Neurology News Network, my name is Louie Pasculli. With the 2026 AAN Annual Meeting now concluded, NeurologyLive was on the ground covering the latest data and speaking with leading experts. Here’s a look at some of the key highlights from our coverage.

Data presented at the 2026 American Academy of Neurology (AAN) Annual Meeting demonstrate that adolescents with focal epilepsy achieve cenobamate exposures comparable to adults, supporting the potential use of similar fixed-dose regimens in younger patients.¹

Cenobamate (XCOPRI), an antiseizure medication that enhances inhibitory signaling through GABAA receptor modulation while inhibiting persistent sodium currents, has become an important option for adults with focal seizures, particularly those with drug-resistant disease.² Its efficacy in reducing seizure frequency, along with emerging real-world and long-term safety data, has prompted increasing interest in extending its use to pediatric populations.

In the current analysis, investigators evaluated pharmacokinetic (PK) data from adolescents aged 12 to younger than 18 years enrolled in 2 open-label pediatric studies (C039 and C040), integrating these findings with adult PK data from prior trials.¹ Using population PK modeling, simulations were conducted to assess steady-state exposure following a 10-week titration and 10-week maintenance period across both weight-based and fixed-dose regimens.

Results showed that cenobamate PK in adolescents was adequately described by a two-compartment model with first-order absorption and elimination. Notably, adolescents receiving 4 mg/kg once daily achieved a mean steady-state exposure (AUC) of 510 µg•h/mL (90% prediction interval [PI], 251–883), while those receiving a fixed 200 mg dose reached 546 µg•h/mL (90% PI, 260–973).¹ These values were comparable to adult exposures at the approved 200 mg dose (434 µg•h/mL; 90% PI, 207–777), indicating pharmacokinetic alignment across age groups.¹

Researchers presented new data of nipocalimab (Imaavy; Johnson & Johnson) from the phase 3 Vivacity-MG3 study (NCT04951622) and its ongoing open-label extension (OLE) at the recently concluded 2026 American Academy of Neurology (AAN) Annual Meeting, held April 18–22 in Chicago, Illinois. Findings showed that treatment with nipocalimab demonstrated sustained disease control, continued symptom improvement, and a consistent safety profile in adults with antibody-positive generalized myasthenia gravis (gMG) over a 2-year period.³

At 96 weeks in the OLE, results revealed that treatment with nipocalimab was associated with sustained improvements in clinical outcomes, including Myasthenia Gravis Activities of Daily Living (MG-ADL) and Quantitative Myasthenia Gravis (QMG) scores, among participants with gMG. Investigators reported that the mean changes from baseline were −6.47 points for MG-ADL (SE, 1.20; P <.001) and −5.97 points for QMG (SE, 1.28; P <.001), consistent with sustained improvement over time.³

“For people living with gMG, consistent and durable symptom control is the central goal of treatment,” ConstantineFarmakidis, MD , associate professor of neurology at the University of Kansas Medical Center, said in a statement.1 “These long-term results, now extending to beyond two years, provide further evidence that disease control, as initially observed in the nipocalimab phase 3 pivotal study, can be sustained, and add to the body of evidence that may help guide clinical decision-making.”³

In recognition of Parkinson’s Disease Awareness Month, held annual in April, growing attention has been placed on understanding sex-specific differences in Parkinson disease (PD), particularly among women. Although studies have shown that PD is more prevalent in men, research describes that women experience distinct clinical patterns, including differences in motor complications, nonmotor symptoms, and quality of life. Evidence suggests that hormonal factors, including the potential neuroprotective effects of estrogen and changes associated with menopause, may also contribute to variations in disease risk, symptom expression, and overall trajectory.

Despite these differences, women remain underrepresented in clinical trials, potentially limiting the evidence base needed to inform sex-specific treatment strategies and counseling. This gap has clinical implications for understanding pharmacologic responses, hormone-related influences, and outcomes that may be particularly meaningful to women living with the movement disorder. Additionally, women with PD can often face unique social challenges, including a disproportionate burden of caregiving responsibilities, which may further affect their experience and management with the condition.

To further explore these considerations, NeurologyLive® spoke with PD experts Sameea Husain, DO, director of movement disorder neurology at Marcus Neuroscience Institute, a part of Baptist Health South Florida, and Sarah Marmol, MD, a neurologist specializing in movement disorders at Miami Neuroscience Institute. In this Q&A, the duo discussed the current understanding of hormonal influences, clinical differences between men and women, and the broader implications of these gaps in research and care. Their clinical perspectives highlight the importance of a more individualized, gender-informed approach to the management of PD.

To read the full piece and to get more direct access to expert insight, head to NeurologyLive.com. Be sure to tune in next week to remain informed on the latest in neurology. I’m Louie Pasculli, thanks for watching Neurology News Network.

REFERENCES
1. Cenobamate in adolescent patients with focal epilepsy: a phase 1 pharmacokinetic study. Presented at: American Academy of Neurology Annual Meeting; April 18–22, 2026; Chicago, IL.
2. XCOPRI® (cenobamate tablets) CV Receives FDA Approval for Alternate Methods of Administration That Include Crushed Tablet in Liquid Suspension Taken Orally or Through a Nasogastric Tube. News Release. SK Life Science. Published April 11, 2024. Accessed April 23, 2026.
3. IMAAVY® (nipocalimab)▼shows over two years of sustained disease control in a broad population with generalised myasthenia gravis (gMG). News release. April 23, 2026. Johnson & Johnson. Accessed April 27, 2026. https://www.jnj.com/innovativemedicine/emea/media-center/press-releases/imaavy-nipocalimab-shows-over-two-years-of-sustained-disease-control-in-a-broad-population-with-generalised-myasthenia-gravis-gmg