Abstract Details

Title Cenobamate Effectiveness in Real-world Focal Epilepsy: Clinical Outcomes from a Large Single-center Cohort in the USA

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 10-001

Objective

To evaluate the clinical effectiveness and safety profile of CBM in adults with treatment-resistant focal epilepsy (TRFE) followed in a level IV Epilepsy Center in the USA.

Background

Focal epilepsy remains challenging to manage, with many patients continuing to experience disabling seizures despite polytherapy. Cenobamate (CBM), a novel antiseizure medication (ASM) with dual mechanism of action, has demonstrated higher rates of seizure freedom than other ASMs. However, there is a limited real-world data on its effectiveness and tolerability.

Design/Methods

We conducted a retrospective cohort study at our center on all adult patients with TRFE who were prescribed CBM and had at least one follow-up visit for > 6 months, till February 2025. The data collected included demographic characteristics, baseline and follow-up seizure frequency, dose and length of CBM prescribed, adverse effects, and seizure freedom.

Results A total of 204 patients (98 females; median age 38 [29-43]) were included in this study. Mean and median baseline seizure frequency were 15.6 / month; 4 (1.5 - 12), respectively. Target dose of 200mg/day was achieved in 153 (75.4%) patients, and the mean time on CBM was 22.9 months. A significant reduction in seizure frequency was achieved with CBM (p < 0.0001), with a drop of mean and median seizure frequencies of 8.2/month and 1 (0-4), respectively. Seizure freedom, defined as being seizure-free for > 6 months, was achieved in 50 (24.6%) of patients. A responder rate of 64.9% (50% reduction in seizure frequency from baseline) was achieved in 131 patients. Discontinuation of CBM occurred in 54 (26.6%) patients, 10 (4.9%) because of lack of efficacy and 39 (19.2%) because of adverse events.

Conclusions In this cohort of patients with TRFE, CBM yielded a robust seizure reduction and higher seizure-free rates than those reported in other ASMs.

Authors/Disclosures
Venkata Sai Manikant Sanikommu PRESENTER	Venkata Sai Manikant Sanikommu has received personal compensation for serving as an employee of University Of Miami.
Yensea M. Costas Encarnacion, MD	Dr. Costas Encarnacion has nothing to disclose.
Tiffany A. Eatz, MD (University of Miami Miller School of Medicine)	Dr. Eatz has nothing to disclose.
CARLOS MAURICIO M. MILLAN, MD	Dr. Millan has nothing to disclose.
Andres M. Kanner, MD, FAAN (University of Miami, Miller School of Medicine, Department of Neurology)	Dr. Kanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Kanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. Dr. Kanner has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsy Foundation of America. Dr. Kanner has received personal compensation in the range of $500-$4,999 for serving as a Lecture at International meeting with Eisai.

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