Effectiveness and safety of adjunctive cenobamate in people with focal-onset epilepsy: Interim results after 24-week observational period from the BLESS study.
Simona Lattanzi, Fedele Dono, Giuseppe d'Orsi, Alfredo D'Aniello, Mariangela Panebianco, Paolo Bonanni, Carlo Di Bonaventura, Elisa Montalenti, Antonio Gambardella, Federica Ranzato, Giada Pauletto, Elena Tartara, Angela La Neve, Francesca Bisulli, Giampaolo Vatti, Patrizia Pulitano, Claudio Liguori, Giovanni Assenza, Alfonso Giordano, Pietro Pignatta, Vincenzo Belcastro, Michela Cecconi, Simone Beretta, Chiara Pizzanelli, Marianna Pezzella, Massimo Gangitano, Maurizio Elia, Rosaria Renna, Catello Vollono, Angelo Pascarella, Luciana Tramacere, Giovanni De Maria, Daniela Audenino, Maria Pia Pasolini, Loretta Giuliano, Rosita Galli, Gionata Strigaro, Monica Puligheddu, Angelo Labate, Pietro Penza, Stefano Quadri, David Stokelj, Giovanni Boero, Elisa Fallica, Monica Santo Sabato, Giovanni Falcicchio, Nicoletta Foschi, Michela Procaccini, Valentina Villano, Gabriele Camattari, Fabiano Mele, Barbara Roncari, Giancarlo Di Gennaro
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Abstract
Objective: Cenobamate is an antiseizure medication (ASM) with a dual mechanism of action that was recently approved for the treatment of focal seizures in adults. This analysis aimed to describe the outcomes at 12 and 24 weeks after starting cenobamate therapy in a real-world setting.
Methods: BLESS [NCT05859854] is an ongoing, observational, retrospective and prospective cohort study to evaluate the real-world effectiveness and safety of adjunctive cenobamate in adults with uncontrolled focal epilepsy. Subgroup analysis was performed in subjects with 2 to 3 previous ASMs (early users) and those with >3 previous ASMs (late users).
Results: The second interim analysis of the BLESS study included 388 participants with a median (interquartile range) age of 43.0 (31.0-54.0) years. They had a median of 6.0 (4.0-9.0) prior ASMs and a median of 7.2 (3.0-20.6) monthly seizures at baseline. The median monthly seizure frequency was reduced by 59.9% (19.2%-87.3%) from baseline to 24 weeks; 229 (59.0%) subjects had a ≥50% seizure frequency reduction, and 44 (11.3%) showed sustained seizure freedom. The proportion of participants taking ≤2 concomitant ASMs increased from 217 (56.5%) at baseline to 239 (65.7%) at 24 weeks. Among the early users (n = 76, 19.6%), the median reduction in monthly seizure frequency at 24 weeks was 78.0% (50.0-97.1%), and 76.3% of subjects had a ≥50% response rate. The frequency of adverse drug reactions (ADRs) was 5.3% and 23.4% in early and late users. The most frequent ADRs were somnolence, dizziness, and balance disorder; after the occurrence of ADRs, 63.5% of participants maintained the prescribed dose, and 5.2% permanently discontinued treatment.
Significance: Cenobamate was effective in reducing seizure frequency in a real-world setting and showed a manageable safety profile. The treatment with cenobamate also reduced the burden of concomitant ASMs in both early and late users.
期刊介绍：
Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
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