Efficacy and Tolerability of Adjunctive Cenobamate in Pediatric and Adult Patients with Lennox Gastaut Syndrome
Abstract number :
3.412
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2024
Submission ID :
91
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Amanda Pong, MD, MSc – Mid-Atlantic Epilepsy and Sleep Center, Comprehensive Epilepsy Clinics of Bethesda
Ivana Tyrlikova, MD – Mid Atlantic Epilepsy and Sleep Center
Mark Wehland, BS – Mid-Atlantic Epilepsy and Sleep Center, LLC
Pavel Klein, MD – Mid Atlantic Epilepsy and Sleep Center
Rationale: Cenobamate (CNB) is a novel antiseizure medication (ASM) effective against focal epilepsy. Proposed mechanisms of action include inactivation of persistent sodium currents and weak positive allosteric modulation of synaptic (phasic) and extrasynaptic (tonic) GABAA receptors. Anecdotal reports suggest possible efficacy in Lennox Gastaut Syndrome (LGS)[1]. LGS is a childhood-onset epileptic encephalopathy often refractory to current treatments of valproate, clonazepam, topiramate, lamotrigine, felbamate, clobazam, rufinamide, cannabidiol and fenfluramine.
Here we present the efficacy and tolerability results of CNB use in pediatric and adult LGS patients at a single center.
Methods: We conducted systematic chart review of all LGS patients treated with CNB at a single center between 2020-2024. At our center, patients/caregivers keep seizure diaries that are evaluated at every visit and recorded in the chart. Seizure frequency was determined by chart review. Change in seizure frequency from baseline to treatment period was calculated. Responder rates (RR) ≥ 50%, 75%, 90% and 100% (seizure free) were calculated for the whole treatment period (titration and maintenance). Patients who did not reach 50 mg/d were excluded from efficacy analysis. Treatment Emergent Adverse Effects (TEAE), maintenance dose and highest tolerated dose were determined by chart review.
Results: 14 LGS patients received CNB (F=4). Median age was 18y (range 9-38); 7 were <
Anti-seizure Medications