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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.
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]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Cenobamate as add-on treatment in ultra-refractory focal epilepsy: Real-world results from The Danish Epilepsy Centre, Dianalund, Denmark.
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Aug2025, Vol. 46 Issue 8, p3875-3884. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Partial+epilepsy%22">Partial epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22People+with+epilepsy%22">People with epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Vagus+nerve%22">Vagus nerve</searchLink><br /><searchLink fieldCode="DE" term="%22Anticonvulsants%22">Anticonvulsants</searchLink><br /><searchLink fieldCode="DE" term="%22Neural+stimulation%22">Neural stimulation</searchLink>
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  Data: 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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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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