Abstract Details

Title Effectiveness of Cenobamate in Pediatric Patients With Lennox-Gastaut Syndrome: A Retrospective Claims-based Analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 1-001

Objective To compare outcomes in pediatric patients with Lennox-Gastaut syndrome (LGS) taking cenobamate vs their previous antiseizure medications (ASMs) using data from a national claims database.

Background Small case series have reported benefit with off-label cenobamate in patients with drug-resistant pediatric developmental encephalopathies.

Design/Methods Patients ≤17 years old with LGS (ICD-10-CM G40.81*) taking ≥1 ASM between 5/1/2020-12/31/2022 were identified retrospectively from the HealthVerity Marketplace Private Source 20 database. Patients were required to have taken ≥2 prescription fills of cenobamate and have ≥180 days of medical and pharmacy enrollment before and after initiating cenobamate. Patients with a history of Dravet syndrome were excluded (n=1). Data were analyzed by line of therapy (LOT); a new LOT was identified as the dispensing of a new ASM after ≥30 days without a previous fill. Health utilization outcomes (eg, epilepsy-related inpatient days and emergency room [ER] visits) during the patient’s previous therapies were compared to outcomes when on cenobamate.

Results 76 patients (41% female, mean age 13.4 years, age range 2-17 years; mean previous LOT=6.01) with LGS were included. The median line duration was 371.2 days with cenobamate vs 377.2 days on the previous ASM combinations. The rate of inpatient days per year improved from 3.94 to 3.36, and the rate of ER days per year improved from 1.19 to 0.66. Among patients without a previous history of status epilepticus, new status epilepticus occurred in 20% (3/15) during the previous ASM combinations compared to 7.7% (2/26) during cenobamate treatment. 35.5% of patients on cenobamate required a new LOT during follow-up.

Conclusions

Cenobamate was associated with fewer inpatient days and ER visits and lower rates of status epilepticus compared to patients’ previous ASM combinations. Further studies examining the causal nature of these outcomes and studies evaluating cenobamate use in patients with LGS are warranted.

Authors/Disclosures
Karen C. Keough, MD (Child Neurology Consultants of Austin) PRESENTER	Dr. Keough has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with UCB. Dr. Keough has received personal compensation in the range of $50,000-$99,999 for serving as a Speaker with Jazz Pharmaceuticals. Dr. Keough has received personal compensation in the range of $50,000-$99,999 for serving as a Speaker with SKLSI . Dr. Keough has received personal compensation in the range of $10,000-$49,999 for serving as a Speaker with LivaNova.
Sean Stern (SK life science)	Mr. Stern has received personal compensation for serving as an employee of SK Life Science.
Clarence Wade (SK life science)	Clarence Wade has nothing to disclose.
Mindl M. Weingarten, PharmD	Dr. Weingarten has received personal compensation for serving as an employee of SK Life Science.

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