Abstract Details

Title Inpatient Hospitalization Rates in Patients Diagnosed with Epilepsy and Treated with Perampanel or Lacosamide

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-018

Objective Inpatient hospitalization rates following initiation of perampanel were compared to those of lacosamide, another branded antiepileptic drug (AED).

Background A previous study of perampanel investigated health care resource utilization as a proxy for clinical effectiveness using real-world data. While the results demonstrated a reduction in resource utilization following initiation of perampanel, an alternative explanation suggested “active management” was at work.

Design/Methods Symphony Health, a nationally representative medical and pharmacy claims database, was used in this study. Patients were identified if they had filled a prescription of either perampanel or lacosamide during the period 07/01/14 to 06/30/16. The index date was the date of the first fill of the medication, and patients were selected if they were at least 12 years of age or older, had continuous observations for the year prior to and following this date, if they had at least two diagnoses of epilepsy or non-febrile convulsions, and if they had at least one additional medication fill following the index date. Subsequent to identification, using propensity scores, perampanel and lacosamide treated patients were matched 1:1 on age, gender, index year, region, Charlson Comorbidity Index (CCI), number of previous AEDs, and evidence of previous hospitalizations.

Results After matching, there were 1,717 patients in each cohort and most of the baseline demographics were balanced. The results showed that initiation on perampanel resulted in a 9.6% reduction in all-cause hospitalizations, compared to a 5.8% reduction for those initiated on lacosamide, p<.05. Epilepsy-related hospitalizations also decreased, 9.9% vs. 8.3% for perampanel and lacosamide, respectively, p<.05.

Conclusions In patients diagnosed with epilepsy, treatment with perampanel, compared to treatment with lacosamide, was associated with a significantly greater reduction in all-cause and epilepsy-related hospitalizations. Even when considering the effects of active management, these results suggest that the choice of adjunctive medication may lead to differences in health care utilization.

Authors/Disclosures
R E. Faught, Jr., MD, FAAN (Emory University) PRESENTER	Dr. Faught has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis. Dr. Faught has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LivaNova. Dr. Faught has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SK Life Science. Dr. Faught has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Gideon, Essary, Tardio and Carter PLC, Nashville TN TN law firm. Dr. Faught has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Friedman Dazio and Zulanas Law Firm Birmingham AL. The institution of Dr. Faught has received research support from UCB Pharma. The institution of Dr. Faught has received research support from Cognizance.
Xuan Li (Eisai)	No disclosure on file
	No disclosure on file
Manoj Malhotra, MD	Dr. Malhotra has received personal compensation for serving as an employee of Eisai.
Russell Knoth	No disclosure on file

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