Clobazam as Add-on Therapy for Patients with Epilepsy: Results from an Epilepsy Center
Abstract number :
3.215
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2021
Submission ID :
1826066
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Sidra Saleem, MD - University of Toledo COM LS; Sihyeong Park, MD - PGY3 Neurology Resident, Neurology, University of Toledo COM LS; Hira Pervez, MD - PGY1 Neurology Resident, Neurology, University of Toledo COM LS; Anum Riaz - Assistant Professor, Neurology, University of Toledo COM LS; Imran Ali, MD - Professor and Chair, Neurology, University of Toledo COM; Ajaz Sheikh, MD - Assistant Professor, Neurology, University of Toledo COM LS
Rationale: The objective of this study was to investigate the role of Clobazam in controlling seizures when added as the last agent in anti-seizure medication regimen.
Methods: This is a retrospective study of an Epilepsy Database utilizing information collected between 2015-2020. A total of 3159 patients were identified in REDCap database, and 119 patients received CLB as the last add-on therapy. These patient were segregated, and data was stratified based on demographic, type of epilepsy, adjunction of CLB with other ASMs, seizure-free rates and reported side effects. Data was analyzed using SPSS-21.
Results: A total of 119/3159 (3.76%) patients had CLB as the last medication added to their ASM regimen. Mean age of patients was 38.8±17.1 years. Mean age at onset of seizure was 17.1±16.4 years. The mean duration of epilepsy was 17.7 years. Majority of these patients were men (58.8% vs 41.17% women). 68.06% of the study population had focal epilepsy, 17.64% were diagnosed with generalized epilepsy, and 12.6% were diagnosed with both. The type of epilepsy was unknown in 1.68% patients. In our study group, CLB was added to first and second generation ASMs to improve efficacy. It was added to 1 ASM in 15.96% (19), to 2 ASMs in 49.57% (59), with 3 ASMs in 31.19% (38) and with 4 ASMs in 2.52% (3) patients (Figure-1). Dosage of CLB used is provided in Figure-2. Proportion of patients who remained seizure-free for 6-months was 28.57% (34) of the study population, whereas 2.52% (3) of the patients achieved seizure freedom according to the ILAE definition. Intractable epilepsy was diagnosed in 71.42% (85) patients. Somnolence, weight gain, and cognitive deficit were reported in 4.2%, 3.6%, and 4.2% of patients, respectively.
Conclusions: Clobazam is an effective ASM in patients with refractory focal and generalized epilepsy with tolerable side effects. It is currently used as a late add on therapy and, in our study, approximately a third of the patients were seizure free for at least 6 months. This indicates potential benefits to utilizing this drug earlier in treatment of refractory epilepsy.
Funding: Please list any funding that was received in support of this abstract.: NA.
Clinical Epilepsy