Work

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

Year: 2025

Type: article

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.

Source: Epilepsy Research

DOI: 10.1016/j.eplepsyres.2025.107717