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Abstract Details

Demographics and Clinical Factors Associated with Persistence on Cannabidiol in US Patients with Lennox-Gastaut Syndrome (LGS), Dravet Syndrome (DS), Tuberous Sclerosis Complex (TSC), or Other Refractory Epilepsies
Epilepsy/Clinical Neurophysiology (EEG)
P10 - Poster Session 10 (8:00 AM-9:00 AM)
10-004
To evaluate sociodemographic and clinical factors associated with persistence on plant-derived, highly purified CBD (Epidiolex® 100 mg/mL oral solution) among patients with LGS, DS, TSC, or other refractory epilepsies.

CBD is approved in the US for treating seizures associated with LGS, DS, or TSC in patients aged ≥1 year. Real-world studies report long-term CBD persistence in 70–77% of patients, but patient characteristics influencing persistence remain unclear.

This retrospective cohort study used the US Optum® Market Clarity database. Patients with epilepsy and ≥1 CBD prescription between 5/15/2018 and 6/30/2024 were eligible. Baseline period was 12 months before index date (date of first pharmacy claim for CBD after diagnosis). Follow-up period was variable post-index. Patients with missing/invalid demographic data or evidence of baseline CBD use were excluded. Persistence was based on time to discontinuation (>60-day supply gap). Multivariable Cox proportional hazard model(s) identified factors associated with persistence. To account for multiple comparisons across factors, Bonferroni correction was applied as a sensitivity analysis.
The analytical cohort included 7815 patients (LGS, n=4649; DS, n=558; TSC, n=185; other refractory epilepsies, n=2423). Pre-Bonferroni corrections, lower persistence was associated with higher comorbidity burden, epilepsy-related surgeries, and anxiety, and higher persistence with clobazam use, polypharmacy, enrollment in the northeastern/southern US, patient age 3–17 years, and Hispanic ethnicity. Post-Bonferroni corrections, several associations remained significant: baseline anxiety was associated with lower persistence (hazard ratio [HR]=1.14; P=0.039), while clobazam use (HR=0.87; P<0.001), enrollment in the northeast (HR=0.77; P<0.001), and diagnosis of LGS, DS, or TSC vs other refractory epilepsies (HR=0.77, 0.78, 0.67, respectively; all P<0.001) were associated with higher persistence.
Persistence on CBD may vary by diagnosis, comorbidities, concomitant medication use, and region of enrollment. Identification of these factors may support clinicians in recognizing patients at risk for discontinuation and support treatment continuity.
Authors/Disclosures
Mohankumar Kurukumbi, MD
PRESENTER 		Dr. Kurukumbi has nothing to disclose.
Leah Burn, PhD Dr. Burn has nothing to disclose.
Vicki Osborne Dr. Osborne has received personal compensation for serving as an employee of Jazz Pharmaceuticals. Dr. Osborne has stock in Jazz Pharmaceuticals.
Arthur Sillah, PhD Dr. Sillah has nothing to disclose.
Timothy B. Saurer, PhD Dr. Saurer has received personal compensation for serving as an employee of Jazz Pharmaceuticals. Dr. Saurer has stock in Jazz Pharmaceuticals.
Michael Faithe, PharmD Dr. Faithe has received personal compensation for serving as an employee of Jazz Pharmaceuticals. Dr. Faithe has stock in Jazz Pharmaceuticals. Dr. Faithe has stock in Amgen .
Maggie S. McCarter, PhD Dr. McCarter has nothing to disclose.
Sanket Shah, MD, PhD Dr. Shah has received personal compensation for serving as an employee of Jazz Pharmaceuticals. An immediate family member of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Madrigal Pharmaceuticals. The institution of an immediate family member of Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Madrigal Pharmaceuticals. Dr. Shah has stock in Jazz Pharmaceuticals.
NELLIE A. BARNES, MD Dr. BARNES has nothing to disclose.
Arunima Sachdev, MA Miss Sachdev has nothing to disclose.
Anuj Gupta Mr. GUPTA has nothing to disclose.