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Abstract Details

Faster Time to Treatment of Seizure Clusters With Diazepam Nasal Spray Is Associated With Faster Cessation of Clusters and a Similar Rate of Second Dose Usage
Epilepsy/Clinical Neurophysiology (EEG)
P9 - Poster Session 9 (5:30 PM-6:30 PM)
9-009
Diazepam nasal spray (Valtoco®) is approved for acute treatment of seizure clusters in patients with epilepsy age ≥6 years. While early intervention for status epilepticus is considered beneficial, the impact of timing of benzodiazepine rescue treatment for seizure clusters remains unknown. 
To understand the temporal patterns of seizure clusters treated with diazepam nasal spray rescue therapy.
Seizure timing data were collected during a phase 3, long-term, open-label, repeat-dose safety study of diazepam nasal spray in patients aged 6–65 years with epilepsy and frequent seizure clusters; safety results were similar to diazepam rectal gel. To characterize temporal patterns, seizure-cluster data from this study were analyzed based on timing of treatment administration after seizure start: 0–5, 5–15, and >15 minutes. Data preparation included deletion of observations with seizure duration >24 hours, seizure stop time preceding start time, invalid dose date/time values, and dose date/time not within seizure start/stop time.  
Among 175 enrolled patients, 163 received ≥1 dose of diazepam nasal spray. From 4466 observations, 3225 were included in this analysis. Median time from seizure start to administration of diazepam nasal spray; from dosing to seizure cessation; and total seizure duration were 1, 2, and 4 minutes, respectively, in the 0–5 minute group. In the 5–15 minute group, median times were 6, 7, and 15 minutes, respectively. For the >15 minute group, median times were, 35, 15, and 70 minutes, respectively. 
In patients treated with diazepam nasal spray, shorter time from seizure-cluster start to treatment with diazepam nasal spray was associated with shorter time to seizure-cluster cessation and overall shorter seizure duration in this post-hoc analysis. This reinforces the value of prompt treatment, which may help minimize risk of injury and additional healthcare utilization.
Authors/Disclosures
Sunita N. Misra, MD (SK Life Science)
PRESENTER
Dr. Misra has received personal compensation for serving as an employee of Neurelis, Inc. An immediate family member of Dr. Misra has received personal compensation for serving as an employee of Neurocrine Biosciences. Dr. Misra has received personal compensation in the range of $500-$4,999 for serving as a Consultant for RubiconMD. Dr. Misra has received intellectual property interests from a discovery or technology relating to health care.
Randa Ghazi Jarrar, MD Dr. Jarrar has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralis.
John M. Stern, MD, FAAN Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB Pharma. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Life Science. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurelis. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz Pharma. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for LivaNova. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for LivaNova. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Jazz. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Sciences. Dr. Stern has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. Dr. Stern has stock in DEARhealth. Dr. Stern has stock in Ceribell. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care.
Danielle Alyse Becker, MD (University of Pennsylvania) Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis, Inc. Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sk life Science. Dr. Becker has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus Pharmaceuticals. Dr. Becker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis, Inc. Dr. Becker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sk Life Science. Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Jazz pharmaceuticals. Dr. Becker has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UBC. Dr. Becker has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for LivaNova. Dr. Becker has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neuropace. Dr. Becker has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus Pharmaceuticals.
Adrian L. Rabinowicz, MD, FAAN (Consulting) Dr. Rabinowicz has received personal compensation for serving as an employee of Neurelis, Inc. Dr. Rabinowicz has stock in Neurelis, Inc.
Enrique Carrazana Enrique Carrazana has received personal compensation for serving as an employee of Neurelis. Enrique Carrazana has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Neurelis, Alexza, Zogenix. Enrique Carrazana has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Hawaii-Biotech, CND Life Sciences. Enrique Carrazana has stock in Neurelis, Marinus, .