Evidence map›Paper›PMID 41774409›Full record

ReviewCNS drugs2026

Seletracetam Revisited: A Missed Opportunity for Effective Epilepsy Therapy.

Wolfgang Löscher, Chris Rundfeldt, Eugen Trinka, Matthias Koepp, Pavel Klein

Erratum issuedAbstract readReview
In one paragraph

Review in CNS drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Wolfgang LöscherTranslational Epilepsy Research Group, NIFE, Department of Experimental Otology of the ENT Clinics, Hannover Medical School, Hannover, Germany. Loescher.Wolfgang@mh-hannover.de.ORCID http://orcid.org/0000-0002-9648-8973
Chris RundfeldtPrevEp Inc., Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-9430-6806
Eugen TrinkaPrevEp Inc., Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-5950-2692
Matthias KoeppPrevEp Inc., Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-4277-8000
Pavel KleinPrevEp Inc., Bethesda, MD, USA.ORCID http://orcid.org/0000-0001-7244-3722

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Seletracetam (SEL) is a second-generation racetam derivative of the benchmark antiseizure medication (ASM) levetiracetam, discovered in a drug discovery program conducted by UCB Pharma in the early 2000s to optimize binding to synaptic vesicle glycoprotein 2A (SV2A), the main target of levetiracetam. SEL (administered orally) reached phase IIa clinical trials, but its further development was stopped, and its patent expired in 2021. In preclinical studies, SEL showed very potent seizure suppression in several acquired and genetic epilepsy models, with high CNS tolerability. Phase I human studies indicated rapid and extensive oral absorption (> 90% bioavailability), linear pharmacokinetics, and an elimination half-life of about 8 h, with mostly mild to moderate CNS adverse events. Several phase IIa trials found SEL to be effective and to have a good safety profile in patients with photosensitive epilepsy and drug-resistant focal epilepsy. A unique aspect of SEL is its high potency and water solubility that-unlike any other non-benzodiazepine (non-BDZ) ASMs-allows it to be formulated at therapeutic doses in a very low liquid volume suitable for intranasal administration and potential use in acute seizure rescue therapy. The US-based company PrevEp, Inc. (Bethesda, MD) filed a new US patent application in 2024, followed by a worldwide Patent Cooperation Treaty (PCT) application in 2025 on intranasal and orobuccal SEL formulations and new medical uses as the first potential non-BDZ rescue treatment of acute repetitive seizures and rapid epileptic seizure termination (REST). The clinical development of this novel formulation is derisked by the favorable oral SEL administration phase I and phase IIa clinical data. SEL offers several important advantages for rescue treatment in comparison with BZDs. It is only moderately sedative even at the highest doses tested orally, does not cause respiratory depression, and has no addictive potential. Thus, SEL has the potential to become the first non-BDZ acute rescue therapy. Because SEL has never been approved for use in humans, it is a new chemical entity (NCE). In this review, we describe the pharmacology of SEL, its clinical profile after oral administration, and the development of the new intranasal formulation, including first-in-human data.

Indexed as

AnticonvulsantsEpilepsyAnimalsHumansAnticonvulsants

Identifiers

PMID41774409
PMCPMC13095982

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.