Cenobamate as add-on treatment in ultra-refractory focal epilepsy: Real-world results from The Danish Epilepsy Centre, Dianalund, Denmark.
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| Title: | Cenobamate as add-on treatment in ultra-refractory focal epilepsy: Real-world results from The Danish Epilepsy Centre, Dianalund, Denmark. |
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| Authors: | Gjerulfsen, Cathrine E. (AUTHOR), Juhl, Stefan (AUTHOR), Mieszczanek, Katarzyna M. (AUTHOR), Spanilá, Lucie (AUTHOR), Thygesen, Kristin S. (AUTHOR), Pavbro, Agnieszka (AUTHOR), Møller, Rikke S. (AUTHOR), Rubboli, Guido (AUTHOR) |
| Source: | Neurological Sciences. Aug2025, Vol. 46 Issue 8, p3875-3884. 10p. |
| Subjects: | Partial epilepsy, People with epilepsy, Epilepsy surgery, Vagus nerve, Anticonvulsants, Neural stimulation |
| Abstract: | Objectives: At The Danish Epilepsy Centre, Dianalund, Denmark, we aimed to assess the long-term efficacy, tolerability profile, and influence on concomitant antiseizure medications (ASMs) of cenobamate as an add-on treatment in patients with ultra-refractory focal epilepsies. Methods: Adult patients with ultra-refractory epilepsy (defined as focal epilepsies in which ≥ 6 treatments, including ASM trials, epilepsy surgery, and vagus nerve stimulator, failed to achieve seizure control) treated with add-on cenobamate between October 2021 and June 2024 were included in our retrospective, observational study. Data were collected through electronic patient records and seizure-diaries. Results: 32 patients were included. The mean length of treatment was 21 months (range 2–32 months) and the median dose of cenobamate was 250 mg (range 50-400 mg). Fourteen/32 (44%) patients were responders (≥ 50% reduction in seizure frequency) to cenobamate, including five patients who became seizure-free (15.6% of the total cohort). Eleven/32 (34%) discontinued due to adverse effects (AEs) or lack of efficacy. Patients with active focal-to-bilateral-tonic–clonic seizures remaining on treatment decreased by 50%. The ASM most frequently reduced was lacosamide, while the one most often discontinued was lamotrigine. Fifteen/32 (47%) patients reported at least one AE during the treatment period of 32 months. Two-thirds were resolved by dose-reduction of ASMs or cenobamate. AEs most frequently reported were tiredness and dizziness; the lowest incidence of these AE was found when cenobamate was added as the third drug. Significance: Our study underlines the usefulness of cenobamate in treating patients with ultra-refractory epilepsy and indicates its long-term effectiveness in real-world clinical practice. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Objectives: At The Danish Epilepsy Centre, Dianalund, Denmark, we aimed to assess the long-term efficacy, tolerability profile, and influence on concomitant antiseizure medications (ASMs) of cenobamate as an add-on treatment in patients with ultra-refractory focal epilepsies. Methods: Adult patients with ultra-refractory epilepsy (defined as focal epilepsies in which ≥ 6 treatments, including ASM trials, epilepsy surgery, and vagus nerve stimulator, failed to achieve seizure control) treated with add-on cenobamate between October 2021 and June 2024 were included in our retrospective, observational study. Data were collected through electronic patient records and seizure-diaries. Results: 32 patients were included. The mean length of treatment was 21 months (range 2–32 months) and the median dose of cenobamate was 250 mg (range 50-400 mg). Fourteen/32 (44%) patients were responders (≥ 50% reduction in seizure frequency) to cenobamate, including five patients who became seizure-free (15.6% of the total cohort). Eleven/32 (34%) discontinued due to adverse effects (AEs) or lack of efficacy. Patients with active focal-to-bilateral-tonic–clonic seizures remaining on treatment decreased by 50%. The ASM most frequently reduced was lacosamide, while the one most often discontinued was lamotrigine. Fifteen/32 (47%) patients reported at least one AE during the treatment period of 32 months. Two-thirds were resolved by dose-reduction of ASMs or cenobamate. AEs most frequently reported were tiredness and dizziness; the lowest incidence of these AE was found when cenobamate was added as the third drug. Significance: Our study underlines the usefulness of cenobamate in treating patients with ultra-refractory epilepsy and indicates its long-term effectiveness in real-world clinical practice. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 15901874 |
| DOI: | 10.1007/s10072-025-08174-y |
