Abstract Details

Title Effectiveness of Cenobamate in Postsurgical Patients: A Retrospective Claims-based Analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P8 - Poster Session 8 (5:30 PM-6:30 PM)

Poster/Presentation
Number 1-004

Objective

To compare healthcare utilization outcomes for patients adding cenobamate or 7 other newer antiseizure medications (ASMs) to existing therapy regimens following surgical or neurostimulation therapy for seizure disorders.

Background

Patients undergoing surgical treatment for epilepsy may continue to experience focal seizures.

Design/Methods Patients with epilepsy (ICD-10-CM G40*) 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 ≥12 months of enrollment were included. Mixed-effect regressions estimated the association between ASM-specific line of therapy (LOT; defined as the retail pharmacy dispensing of an ASM after ≥30 days without a previous fill) and epilepsy-related inpatient and emergency room (ER) visits in patients with prior evidence of epilepsy-related surgical resection or implantation of a vagus nerve stimulator or a responsive neurostimulation device. We compared LOT adding cenobamate with those adding brivaracetam, clobazam, eslicarbazepine, lacosamide, lamotrigine, levetiracetam, or perampanel.

Results 7835 patients (52.4% female, mean age=39.3 years) were exposed to 11,771 LOT. Over 14,874.6 person-years (>5.4 million days of therapy), patients experienced 202.7 inpatient days and 47.3 ER visits per 100 person-years. Compared with cenobamate, all 7 other ASMs demonstrated higher ER rates. Six ASMs demonstrated higher inpatient day rates than cenobamate (all P≤0.001); eslicarbazepine demonstrated lower inpatient day rates (P<0.001). Relative to cenobamate, adjusted mean increases in ER visits per patient year ranged from 3.4 (brivaracetam) to 9.2 (levetiracetam) per 100 patient-years. Adjusted mean increases in inpatient days ranged from 0.004 (lamotrigine) to 10.3 (lacosamide) per 100 patient-years, with an adjusted mean decrease of 0.3 inpatient days per 100 patient-years for eslicarbazepine.

Conclusions Following surgery, cenobamate was associated with lower ER rates than 7 leading ASMs, and with lower inpatient days than all comparators except eslicarbazepine, suggesting that improved seizure control with cenobamate may provide significant cost savings and reductions in seizure-related morbidity and mortality.

Authors/Disclosures
Jacob Pellinen, MD (University of Colorado) PRESENTER	The institution of Dr. Pellinen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SK Life Science. The institution of Dr. Pellinen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals.
Clarence Wade (SK life science)	Clarence Wade has nothing to disclose.
Sean Stern (SK life science)	Mr. Stern has received personal compensation for serving as an employee of SK Life Science.
Vernon Schabert (Epilogix LLC)	No disclosure on file
Christopher Elder, MD	Dr. Elder has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SK Life Science Inc.. Dr. Elder has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Science Inc.. Dr. Elder has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Neurology and Neuroscience Reports.

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