Abstract Details

Title Increased Incidence of Comorbidities in Patients with Uncontrolled Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-002

Objective To evaluate incident comorbidities in adults with epilepsy taking antiseizure medication (ASM).

Background Medical comorbidities are common in people with epilepsy and can impact their medical care and quality of life.

Design/Methods Adults (≥18 years) with epilepsy (ICD-10-CM G40*) taking ≥1 ASM between 1/1/2015-12/31/2021 were identified from the HealthVerity Marketplace Private Source 20 claims database. Patients had to have 360 days of pharmacy/medical enrollment before and after initiating ASM line of therapy (LOT, defined as dispensing of an ASM for ≥30 days). Uncontrolled epilepsy was defined as ≥1 of the following: seizure-related inpatient or emergency room visit, or new ASM LOT initiation during follow-up. Uncontrolled patients were matched with controlled patients using propensity matching. In each cohort, we compared time-to-first occurrence of new comorbidities after initiating first or third observed LOT up to 720 days after an uncontrolled event. Comorbidities assessed were atrial fibrillation, diabetes, high cholesterol, hypertension, obesity, alcohol/substance abuse disorder, mood disorder, nonepileptic seizures, psychiatric disorders, sleep disorders, brain trauma, dementia/Alzheimer's disease, migraine, status epilepticus, and stroke.

Results 78,714 unique patients received first LOT; 64,031 received third LOT. 57% and 56% of first and third LOT patients, respectively, had uncontrolled epilepsy within the first 360 days after initiating ASM. The incidence of all assessed comorbidities except diabetes, high cholesterol, hypertension, and obesity were increased in the uncontrolled vs controlled cohorts following first LOT (hazard ratios ranging from 1.02 for sleep disorders to 2.92 for non-epileptic seizures). In most cases, hazard ratios increased following third compared to first LOT, and all comorbidities except high cholesterol were increased in uncontrolled vs controlled cohorts following third LOT.

Conclusions Patients with uncontrolled epilepsy had a higher incidence of new comorbidities than patients with controlled epilepsy after starting their first and third observed ASM. Further work is needed to examine the nature of these relationships.

Authors/Disclosures
Emily Klatte, MD (Ohio Health Neurological Physicians) PRESENTER	Dr. Klatte has received personal compensation in the range of $0-$499 for serving as a Consultant for SK Life Science . Dr. Klatte has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurelis, Inc. Dr. Klatte has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurelis.
R E. Faught, Jr., MD, FAAN (Emory University)	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.
Wesley Kerr, MD, PhD (University of Pittsburgh)	Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Lifesciences. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven Pharmaceuticals. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Kerr has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for QurAlis. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven Pharmaceuticals. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. The institution of Dr. Kerr has received research support from NINDS. The institution of Dr. Kerr has received research support from American Epilepsy Society. The institution of Dr. Kerr has received research support from ��ɫ��. The institution of Dr. Kerr has received research support from SK Life Science. The institution of Dr. Kerr has received research support from Biohaven Pharmaceuticals. Dr. Kerr has received publishing royalties from a publication relating to health care.
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.

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