We aim to assess efficacy, safety and tolerability of eslicarbazepine acetate (ESL) in post-stroke epilepsy (PSE) patients from Euro-Esli study.

Stroke is a common aetiology of epilepsy in elderly population, accounting for 55% of newly diagnosed seizures among older people.

Antiepileptic drug selection is of a major importance for patients with PSE. Nevertheless, there is limited data on safety and efficacy on this subject.

Euro-Esli study was an exploratory, pooled analysis of data from 14 European clinical practice studies, that included 2079 patients. Efficacy (responder rate; seizure freedom rate) and safety (adverse events; adverse events leading to discontinuation) parameters were assessed. Subgroup analyses were conducted for patients who had vascular vs. non-vascular aetiology of epilepsy.

This subanalysis included 1656 patients, of whom 76 (4.6%) had post-stroke epilepsy. Patients with PSE were older (60.4 vs. 42.9 years; p<0.001), had higher age at epilepsy onset (50.9 vs. 23.7 years; p<0.001), shorter duration of epilepsy (9.6 vs. 19.4 years; p<0.001) and lower mean seizure baseline frequency (4.3 vs. 13.8 seizures/month; p<0.001) than patients without post-stroke epilepsy.

In patients with post-stroke epilepsy, responder rate (RR) and seizure freedom (SF) at last visit was higher (72.9% vs. 60.6%, p=0.040; 48.6% vs. 31.7%, p=0.003; respectively) than in patients without post-stroke epilepsy. In patients not treated with sodium channel blockers, PSE patients had higher RR and SF (83.3% vs. 67.6%, p=0.034; 57.1% vs. 40.6%, p=0.036; respectively). In patients with psychiatric comorbidity, PSE patients had higher RR and SF (100.0% vs. 61.4%, p=0.015; 80.0% vs. 33.2%, p=0.004; respectively).

There were no statistical significant differences between both populations regarding tolerability parameters. The most common AEs were somnolence, dizziness, instability/ataxia and fatigue.

In this post-hoc analysis in real-world clinical setting in Europe, ESL was shown to be effective and well tolerated in a small subgroup of PSE patients.