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Abstract Details

Effectiveness of Cenobamate in Reducing Focal Onset Seizure-related Hospitalizations: A Retrospective Claims-based Analysis
Epilepsy/Clinical Neurophysiology (EEG)
S29 - Epilepsy Diagnostics and Therapeutics (1:24 PM-1:36 PM)
Cenobamate is approved in the United States and Europe as a treatment for adults with focal onset seizures.
To compare healthcare utilization outcomes for patients diagnosed with focal epilepsy and having cenobamate or one of 7 other newer antiseizure medications (ASMs) added to their treatment regimen.
Patients with focal epilepsy [ICD-10-CM G40.0*-G40.2*] taking ≥1 ASM between 1/1/2017-12/31/2021 were identified retrospectively from the HealthVerity Marketplace Private Source 20 database. Adjudicated pharmacy claims from patients with at least 12 months of enrollment were included. Mixed-effect regressions estimated the association between ASM-specific new lines of therapy (LOT, defined as the retail pharmacy dispensing of an ASM after ≥30 days without a previous fill) and epilepsy-related inpatient stays and emergency room (ER) visits. We compared LOT adding cenobamate with those adding brivaracetam, clobazam, eslicarbazepine, lacosamide, lamotrigine, levetiracetam, or perampanel. 
58,786 patients (55.7% female, mean age=42.0 years) were exposed to 84,301 LOT. Overall LOT for ASMs ranged from 2069 for cenobamate (2062 patients) to 26,485 for lacosamide (25,889 patients). Over 116,859.2 person years, (>42.6 million total days of therapy), patients experienced 170.6 inpatient days and 41.0 ER visits per 100 patient-years. Compared with cenobamate, all other 7 ASMs demonstrated higher inpatient day rates and higher ER visit rates (all P≤0.001); this finding was consistent across focal epilepsy subgroups and was amplified in patients with prior admits. Relative to cenobamate, adjusted mean increases in inpatient days ranged from 1.7 (lamotrigine) to 6.4 (lacosamide) per 100 patient-years. Adjusted mean increases in ER visits vs cenobamate ranged from 2.0 (brivaracetam) to 8.8 (levetiracetam) per 100 patient-years. 

Cenobamate was associated with lower rates of inpatient days and ER visits than 7 leading ASMs for patients diagnosed with focal epilepsy. Additional comparative research in unplanned healthcare utilization is needed to assess the benefit of ASMs in patients with epilepsy.

Alexandra Urban (University of Pittsburgh School of Medicine)
Dr. Urban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. Dr. Urban has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SK Life Science, Inc.
Sean Stern (SK life science) Mr. Stern has received personal compensation for serving as an employee of SK Life Science.
No disclosure on file
No disclosure on file