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Introduction <p>Fenfluramine (FFA) is approved as an adjunctive treatment for epileptic seizures associated with Dravet syndrome (DS) and Lennox–Gastaut syndrome (LGS) in patients aged 2&#xa0;years and older. Owing to its pharmacological characteristics and history of cardiovascular adverse effects, specific cardiological monitoring is required throughout the course of treatment.</p> Methods <p>A set of recommendations for FFA was developed by a multidisciplinary panel comprising specialists in neurology/paediatric neurology, epilepsy, and cardiology (both adult and paediatric). The process involved a literature review, methodological design, working group sessions, and preparation of recommendations structured around three key phases: before treatment, during treatment, and after treatment discontinuation.</p> Results <p>An expert-led algorithm for the use of FFA was developed, helping to establish a common language that promotes a better understanding between cardiologists and neurologists/paediatric neurologists, facilitating the prevention and early management of potential cardiovascular events.</p> Conclusion <p>The management of FFA treatment should be holistic, with coordinated follow-up involving neurologists, paediatric neurologists, and cardiologists. Implementing a structured, expert-based protocol will help enhance treatment safety and optimize clinical outcomes for patients with developmental and epileptic encephalopathies.</p>

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Practical Recommendations for Cardiology Follow-Up in Patients Treated with Fenfluramine Based on Expert Opinion and Clinical Experience

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月11日

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  • Antonio Gil-Nagel,
  • Leopoldo Pérez de la Isla,
  • Elena Sanz Pascual,
  • Enrique J. Balbacid Domingo,
  • Juan J. García Peñas

摘要

Introduction

Fenfluramine (FFA) is approved as an adjunctive treatment for epileptic seizures associated with Dravet syndrome (DS) and Lennox–Gastaut syndrome (LGS) in patients aged 2 years and older. Owing to its pharmacological characteristics and history of cardiovascular adverse effects, specific cardiological monitoring is required throughout the course of treatment.

Methods

A set of recommendations for FFA was developed by a multidisciplinary panel comprising specialists in neurology/paediatric neurology, epilepsy, and cardiology (both adult and paediatric). The process involved a literature review, methodological design, working group sessions, and preparation of recommendations structured around three key phases: before treatment, during treatment, and after treatment discontinuation.

Results

An expert-led algorithm for the use of FFA was developed, helping to establish a common language that promotes a better understanding between cardiologists and neurologists/paediatric neurologists, facilitating the prevention and early management of potential cardiovascular events.

Conclusion

The management of FFA treatment should be holistic, with coordinated follow-up involving neurologists, paediatric neurologists, and cardiologists. Implementing a structured, expert-based protocol will help enhance treatment safety and optimize clinical outcomes for patients with developmental and epileptic encephalopathies.