Abstract Details

Title Cenobamate for Uncontrolled Focal Seizures in Patients With Previous Epilepsy-Related Surgery: A Post-hoc Analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-003

Background

Cenobamate is approved in the US for treatment of focal seizures in adults.

Objective To report cenobamate efficacy in patients with uncontrolled focal seizures and previous epilepsy-related surgery (resection/corpus callosotomy/tumor removal/ablation/vagus nerve stimulation [VNS]/responsive neurostimulation [RNS]) in a post-hoc analysis of 10 US study sites from a global open-label phase 3 study.

Design/Methods Adults 18-70 years old with uncontrolled focal seizures on stable doses of 1-3 antiseizure medications (ASMs) received increasing doses of cenobamate (12.5, 25, 50, 100, 150, 200 mg/day) biweekly. Further increases up to 400 mg/day by 50-mg/day increments biweekly were permitted. Efficacy was examined as the percentage of patients achieving seizure freedom (SF) ≥12 months at last clinic visit, at any interval (ie, does not have to include the last visit), and at the data cut-off visit in patients still receiving cenobamate.

Results Of the 240 patients, 85 (35.4%) had prior epilepsy-related surgery (n=40, ≥1 procedure that were not VNS/RNS; n=31, VNS/RNS only; n=14, both VNS and resection/ablation/disconnection). In these patients, 23.5% (20/85) had SF ≥12 months at the last clinic visit and 30.6% (26/85) had SF ≥12 months at any interval versus 27.1% (42/155) and 39.4% (61/155) of nonsurgical patients, respectively. Of the 177 patients still receiving cenobamate at data cut-off (mean duration of time on-study=33.6 months), 65 had prior epilepsy-related surgery and 29.2% (19/65) had SF ≥12 months at data cut-off (mean duration=23.5 months) versus 36.6% (41/112) of nonsurgical patients. Across surgical procedures, SF ≥12 months with cenobamate treatment ranged from 20%-35.7% of patients.

Conclusions High rates of sustained seizure freedom (≥12 months) were achieved with cenobamate in adult patients with uncontrolled focal seizures despite prior epilepsy-related surgery. These findings suggest cenobamate could be considered early in the treatment regimen, including prior to surgery.

Authors/Disclosures
Bassel W. Abou-Khalil, MD, FAAN (Vanderbilt University) PRESENTER	The institution of Dr. Abou-Khalil has received research support from Cerevel. The institution of Dr. Abou-Khalil has received research support from Xenon. The institution of Dr. Abou-Khalil has received research support from Otsuka. The institution of Dr. Abou-Khalil has received research support from UCB. The institution of Dr. Abou-Khalil has received research support from SK LIfe Science. The institution of Dr. Abou-Khalil has received research support from Neuroelectrics.
Sami M. Aboumatar, MD (Austin Epilepsy Care Center)	Dr. Aboumatar has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Aboumatar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Aboumatar has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sunovion.
Pavel Klein, MD, FAAN (Mid-atlantic Epilepsy and Sleep Center)	The institution of Dr. Klein has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Aquestive. The institution of Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurelis. The institution of Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB Pharma. The institution of Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Life Sience. The institution of Dr. Klein has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eisai. The institution of Dr. Klein has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alliance. The institution of Dr. Klein has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arvelle Therapeutics. Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Aquestive. Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai. Dr. Klein has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for UCB Pharma. Dr. Klein has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for SK Life Sciences. Dr. Klein has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sunovion. Dr. Klein has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for PrevEp. Dr. Klein has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Fenwick . Dr. Klein has received research support from DOD/CURE.
Gregory Krauss, MD (Johns Hopkins University)	Dr. Krauss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arvelle. Dr. Krauss has received stock or an ownership interest from EpiWatch.
Michael R. Sperling, MD, FAAN (Thomas Jefferson University)	Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. The institution of Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Pharma. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for International Medical Press. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Projects for Knowledge. The institution of Dr. Sperling has received research support from SK Life Science. The institution of Dr. Sperling has received research support from UCB Pharma . The institution of Dr. Sperling has received research support from Takeda. The institution of Dr. Sperling has received research support from Neurelis. The institution of Dr. Sperling has received research support from Engage Therapeutics . The institution of Dr. Sperling has received research support from Medtronic. The institution of Dr. Sperling has received research support from Cavion. The institution of Dr. Sperling has received research support from Xenon Pharma. The institution of Dr. Sperling has received research support from Cerevel. The institution of Dr. Sperling has received research support from National Institutes of Health . The institution of Dr. Sperling has received research support from DARPA. Dr. Sperling has received publishing royalties from a publication relating to health care. Dr. Sperling has received publishing royalties from a publication relating to health care. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving as a Vice President with Epilepsy Consortium .
William E. Rosenfeld, MD, FAAN (Comprehensive Epilepsy Care Center for Children and Adults)	The institution of Dr. Rosenfeld has received personal compensation in the range of $500,000-$999,999 for serving as a Consultant for SK Life Science. Dr. Rosenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for SK Life Science.