New onset of comorbidities in people with epilepsy in a national healthcare claims database

Abstract

Purpose

This study evaluated the rate of new occurrence of select comorbidities in adults after events of uncontrolled epilepsy versus controlled epilepsy.

Methods

The HealthVerity Marketplace Inovalon healthcare claims database was used. Adults (≥18 years) with an epilepsy diagnosis (ICD-10-CM G40*) prescribed at least one antiseizure medication (ASM) between January 1, 2015, and December 31, 2021, were included. Patients were categorized as having either a first-filled or third-filled ASM. The first ASM filled was defined as no ASMs filled for at least 1 year of enrollment. Uncontrolled epilepsy events within 1 year of new ASM initiation were: seizure-related inpatient or emergency room visit or initiation of subsequent ASM. Patients with uncontrolled and controlled epilepsy were propensity score matched. Time to first new comorbidity was measured for cardiac/metabolic, neuropsychiatric, and neurologic disorders.

Results

First-filled ASM start date was identified for 78,714 patients with epilepsy, 64,031 of whom received a third ASM. Most patients had an uncontrolled epilepsy event within the first year after first-filled (57%) ASM initiation and after third-filled (56%) ASM initiation. The rate of most neuropsychiatric and neurologic comorbidities was higher among patients with uncontrolled epilepsy during first-filled and third-filled ASM. The rate of most cardiac/metabolic comorbidities was higher among patients with uncontrolled epilepsy after third-filled ASM initiation; however, these comorbidities were more common in controlled epilepsy during first-filled ASM.

Conclusion

Patients with uncontrolled epilepsy had a higher rate of new-onset comorbidities. These results indicated that seizure control may influence the non-seizure impacts of epilepsy.