MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA; Department of Neurology, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
Epilepsy Res. 2023 Nov;197:107242. doi: 10.1016/j.eplepsyres.2023.107242. Epub 2023 Oct 10.
This retrospective chart review examined dose reductions and discontinuations of concomitant antiseizure medications (ASMs) following cenobamate initiation and maintenance in patients with epilepsy treated at MetroHealth (Cleveland, OH) between 9/1/2020-9/26/2022. Concomitant ASM dose adjustments and treatment-emergent adverse events (TEAEs) were assessed. Efficacy (100 % seizure reduction) was examined among patients who received cenobamate for ≥ 3 months at data cutoff (including titration). As of 9/26/2022, 95 patients received cenobamate (mean age, 45.9 years; 48.4 % female, median exposure 7.5 months). Five patients (5.3 %) discontinued (n = 1 withdrawal by patient; n = 1 noncompliance; n = 3 adverse event). Among the 90 patients taking cenobamate at data cutoff, 50 % (45/90) discontinued ≥ 1 concomitant ASM, most commonly clobazam (n = 18), levetiracetam (n = 10), and phenytoin (n = 7); 21 patients (23.3 %) had additional concomitant ASM dose reductions, most commonly phenytoin (n = 6) and clobazam (n = 4). Sixteen patients received cenobamate monotherapy. Among 79 patients who received cenobamate for ≥ 3 months at data cutoff, 51.9 % (41/79) were seizure-free for ≥ 3 months. Of the 41 seizure-free patients, 58.5 % (24/41) were taking 100 mg/day of cenobamate. Sixteen of the 95 cenobamate-treated patients (16.8 %) reported 22 TEAEs. The most common TEAE was fatigue (n = 7). These data suggest that cenobamate therapy may allow reduction or elimination of polytherapy in some patients.
本回顾性图表研究检查了在 2020 年 9 月 1 日至 2022 年 9 月 26 日期间在 MetroHealth（克利夫兰，俄亥俄州）接受治疗的癫痫患者在开始使用cenobamate 后和维持治疗期间减少和停用伴随抗癫痫药物（ASM）的情况。评估了伴随 ASM 剂量调整和治疗中出现的不良事件（TEAE）。在截止日期（包括滴定期）接受cenobamate 治疗≥3 个月的患者中检查了疗效（100%的癫痫发作减少）。截至 2022 年 9 月 26 日，95 名患者接受了 cenobamate 治疗（平均年龄 45.9 岁；48.4%为女性，中位暴露时间为 7.5 个月）。有 5 名患者（5.3%）停药（n=1 例患者停药；n=1 例不依从；n=3 例不良事件）。在截止日期接受 cenobamate 治疗的 90 名患者中，50%（45/90）停用了≥1 种伴随 ASM，最常见的是氯巴占（n=18）、左乙拉西坦（n=10）和苯妥英（n=7）；21 名患者（23.3%）有其他伴随 ASM 剂量减少，最常见的是苯妥英（n=6）和氯巴占（n=4）。16 名患者接受 cenobamate 单药治疗。在截止日期接受 cenobamate 治疗≥3 个月的 79 名患者中，51.9%（41/79）有≥3 个月的无癫痫发作。在 41 名无癫痫发作的患者中，58.5%（24/41）服用 100mg/天的 cenobamate。在 95 名接受 cenobamate 治疗的患者中，有 16 名（16.8%）报告了 22 例 TEAEs。最常见的 TEAEs 是疲劳（n=7）。这些数据表明，cenobamate 治疗可能允许一些患者减少或消除多药治疗。
