It is possible that currently available ASMs have disease-modifying effects.2 However, the design of conventional clinical trials (typically randomized controlled trials, followed by open-label extensions) would not have the capacity to demonstrate disease modification.2

References:

1.Perucca E, French JA, Aljandeel G, et al. Which terms should be used to describe medications used in the treatment of seizure disorders? An ILAE position paper. Epilepsia 2024; 65 (3): 533–541.

2.French JA, Bebin M, Dichter MA, et al. Antiepileptogenesis and disease modification: clinical and regulatory issues. Epilepsia Open 2021; 6 (3): 483–492.