Evaluating the impact of cenobamate in the management in patients with drug resistant focal epilepsy – A retrospective real world observational study of patients attending NHS Greater Glasgow and Clyde

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Epilepsy Research Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI:10.1016/j.eplepsyres.2025.107717

M. Taha , L. Stephen , S. Nichol , S. Yule , S. MacBride-Stewart , AD Marshall , CA Heath

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引用次数: 0

Abstract

Introduction

Cenobamate (CNB) is the latest ASM to be licensed in the UK as an adjunctive treatment for adults with focal epilepsy. Early clinical trials have been encouraging with up to 50.4 % of patients showing a 50 % improvement at 12 weeks and 71 % were still receiving Cenobamate at 48 months. Regulatory studies of this nature provide useful information, but real-world data is often more informative.

Since Scottish Medicine Consortium approval in 2022, we have been collecting audit data on outcomes from patients receiving cenobamate.

Methods

Adult patients were included if they received at least one prescription for cenobamate between March 2022 and April 2024 and had at least 12 months of data available before their first prescription.

Patients dispensed cenobamate were identified from the national Prescribing Information System (PIS) to ensure complete patient capture.

A manual review of electronic patient records was undertaken. The primary outcome of interest was change in seizure frequency on a stable dose. Secondary outcomes included epilepsy-related admissions, changes in ASMs and healthcare resource utilisation costs.

Results

145 patients received at least 1 CNB prescription, 144 of whom had reached an endpoint. 94/144 (65.2 %) had a favourable response. The median length of treatment was 655 days (range 180–922 days), with a median dose of 150 mg/d (range 25–400 mg/d). The median number of previous ASM was 5 (1−13).

48/145 (33.1 %) discontinued CNB – 35 due to adverse effects, 6 due to lack of efficacy. 2 patients died.

Early analysis suggest a reduction in Health care resource use although long term follow up is required.

Conclusion

These results offer insights for clinicians regarding the real-world effectiveness, retention rates, and healthcare cost implications of CNB therapy in a cohort consisting largely of patients with severe drug resistant epilepsy. Further studies are ongoing to assess the efficacy of CNB when used earlier and also to provide a comprehensive assessment of health care resource use in this real world settings.

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评价cenobamate对耐药局灶性癫痫患者管理的影响——一项对大格拉斯哥和克莱德NHS患者的回顾性观察性研究

cenobamate （CNB）是最新在英国获得许可的ASM，作为成人局灶性癫痫的辅助治疗。早期临床试验结果令人鼓舞，在12周时，50.4% %的患者表现出50% %的改善，而在48个月时，仍有71% %的患者在服用Cenobamate。这种性质的监管研究提供了有用的信息，但真实世界的数据往往更有用。自苏格兰医学联盟于2022年批准以来，我们一直在收集接受cenobamate的患者的结果审计数据。方法纳入在2022年3月至2024年4月期间至少服用过一次cenobamate处方的成年患者，并且在首次处方前至少有12个月的数据。从国家处方信息系统（PIS）中识别分配了cenobamate的患者，以确保完整的患者捕获。对电子病历进行了人工审查。研究的主要结果是在稳定剂量下癫痫发作频率的变化。次要结局包括癫痫相关入院、asm变化和医疗资源利用成本。结果145例患者接受了至少1个CNB处方，其中144例达到终点。94/144（65.2 %）表示赞成。中位治疗时间为655天（180-922天），中位剂量为150 mg/d（25-400 mg/d）。既往ASM中位数为5（1 ~ 13）。48/145（33.1% %）因不良反应停用CNB - 35, 6因缺乏疗效。2例死亡。早期分析表明，尽管需要长期随访，但卫生保健资源的使用有所减少。这些结果为临床医生提供了关于CNB治疗在现实世界中的有效性、保留率和医疗成本影响的见解，这些队列主要由严重耐药癫痫患者组成。目前正在进行进一步的研究，以评估早期使用CNB的效果，并对现实世界环境中卫生保健资源的使用情况进行全面评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsy Research 医学-临床神经学

CiteScore

0.10

自引率

4.50%

发文量

143

审稿时长

62 days

期刊介绍： Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.