Six-month efficacy data for Cenobamate in refractory focal epilepsy – a viable alternative to VNS?

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 94; no. Suppl 1; pp. A14 - A15
• Main Authors: Pyae, Aung, Tom, Hayton, Barbara, Wysota, Salini, Sumangala, Shanika, Samarasekera
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 23-11-2023; BMJ Publishing Group LTD
• Subjects: Association of British Neurologists: Annual Meeting Abstracts 2023; Convulsions & seizures; Epilepsy
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/JNNP-2023-ABN.43

ObjectiveTo assess the efficacy of adjuvant Cenobamate in adults with refractory focal epilepsy.MethodologyA retrospective cohort study was conducted. Patients were commenced on adjuvant Cenobamate between January and June 2022; reduction in seizure frequency and change in concom- itant antiseizure medications (ASMs) was assessed over a six-month period.ResultsOf 43 patients (23 male), 40 had a seizure duration of over 10 years. 18 patients (41%) had intel- lectual disability. 35 patients were on the surgical pathway, over 50% having undergone or awaiting VNS. 71% of patients were prescribed at least three concomitant ASMS at baseline.38 patients tolerated Cenobamate for six months. Of these, 36 achieved a reduction in seizure frequency with a dose of Cenobamate of 50-200mg/day. 19 patients (50%) achieved significant seizure reduction (over 50%), of whom 3 were seizure free.16 patients (42%) were able to withdraw one concomitant ASM. 2 patients were able to withdraw two ASMs.ConclusionThus far, adjuvant Cenobamate reduces seizure burden in the majority of patients with severe refractory focal epilepsy. It may be a viable alternative to VNS in those patients who have limited options accessing a surgical pathway.