Saouda Christopher, Nofal Omar, Makke Yamane, Eid Alexandra, Vinarsky Victoria, Edelberg Helen, Lee Sean M, Koubeissi Mohamad
George Washington University, Department of Neurology, Washington, DC, USA.
George Washington University, Department of Neurology, Washington, DC, USA.
Epilepsy Res. 2025 Jan;209:107498. doi: 10.1016/j.eplepsyres.2024.107498. Epub 2024 Dec 19.
Medication-resistant epilepsy (MRE) is characterized by the failure of adequate trials of two antiseizure medications (ASMs). Numerous studies have shown that once two ASMs fail to control seizures, the likelihood of subsequent ASM regimens providing seizure control diminishes significantly. Recent clinical data on cenobamate (CNB) suggest it may offer higher rates of seizure freedom in MRE patients. This study aims to report real-world, single-center findings on the effectiveness and tolerability of CNB in treating MRE.
This retrospective study includes adult patients diagnosed with MRE and treated with CNB between 2020 and 2023 at The George Washington University (GWU). Data were collected from electronic medical records. Statistical analyses were conducted to evaluate CNB's impact on seizure control and patient outcomes.
121 patients with medication-resistant epilepsy (MRE) were prescribed cenobamate (CNB). After exclusions, 104 patients were included in the effectiveness analysis and 111 in the tolerability analysis. Results showed that 34.6 % of patients achieved seizure freedom for at least three months, with a mean duration of seizure freedom of 11 ( ± 7.9) months.
CNB use in a large population of more than 100 patients demonstrated impressive anti-seizure activity with a good proportion of patients with MRE achieving seizure freedom despite having failed multiple prior ASMs.
药物难治性癫痫（MRE）的特征是两种抗癫痫药物（ASM）进行了充分试验但仍无效。大量研究表明，一旦两种ASM无法控制癫痫发作，后续ASM方案控制癫痫发作的可能性就会显著降低。最近关于司替戊醇（CNB）的临床数据表明，它可能使MRE患者实现癫痫发作自由的比例更高。本研究旨在报告CNB治疗MRE的真实世界、单中心疗效和耐受性研究结果。
这项回顾性研究纳入了2020年至2023年期间在乔治华盛顿大学（GWU）被诊断为MRE并接受CNB治疗的成年患者。数据从电子病历中收集。进行统计分析以评估CNB对癫痫控制和患者预后的影响。
121例药物难治性癫痫（MRE）患者被处方了司替戊醇（CNB）。排除后，104例患者纳入疗效分析，111例纳入耐受性分析。结果显示，34.6%的患者实现了至少三个月的癫痫发作自由，癫痫发作自由的平均持续时间为11（±7.9）个月。
在100多名患者的大量人群中使用CNB显示出令人印象深刻的抗癫痫活性，尽管之前多种ASM治疗失败，但仍有相当比例的MRE患者实现了癫痫发作自由。
