Healthcare Resource Utilization and Antiseizure Medication Claims in Patients With Lennox-Gastaut Syndrome Receiving Fenfluramine in the United States
Abstract number :
2.431
Submission category :
7. Anti-seizure Medications / 7E. Other
Year :
2025
Submission ID :
1343
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Adam Strzelczyk, MD, MHBA, FEAN – Goethe University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, University Medicine Frankfurt
Jaya Khushalani, MD, PhD – UCB
Heidi Henninger, MD – UCB
Patrik Ohagen, BS – UCB
Renjie Li, MS – Ambit Inc.
Nakul Yadav, PhD – Ambit Inc.
Wesley Kerr, MD, PhD – University of Pittsburgh Neurology
Rationale: There is limited real-world evidence on the impact of fenfluramine (FFA) in patients with Lennox-Gastaut syndrome (LGS), in addition to its influence on seizure control. Here, we examined healthcare resource utilization (HCRU) and antiseizure medication (ASM) claims for patients with LGS before and after FFA initiation using a large US healthcare database.
Methods: This was a retrospective study of patients with LGS (ICD-10, G40.81) from 1/1/2022–12/31/2024 using the Komodo US healthcare claims database. Eligible patients were required to have ≥1 FFA prescription claim, ≥2 LGS claims (≥1 month apart), 12 months of claims data before and after FFA initiation (first FFA prescription claim), and received FFA for 12 months with no gaps >14 days. The primary endpoints were to evaluate differences in HCRU (including inpatient hospitalizations, emergency room [ER] visits, office visits, and ambulance use) and number of unique ASMs and average ASM claims (excluding FFA) between the pre- and post-FFA initiation periods. Change in the average number of HCRU and ASM claims in the pre- and post-index periods were evaluated using paired t-tests. Interrupted time series (ITS) analyses using a generalized estimating equation were conducted to control for time trends in the data. Propensity score-matched cohort difference-in-difference (DiD) regression analyses were used to determine robustness of the results when compared with a matched control group (patients with ≥1 LGS claim and no FFA prescription claims).
Results: The analysis identified 148 patients with LGS who fit the inclusion criteria. There were significant reductions in all-cause inpatient hospitalizations (−23.4%, P=0.04), seizure-related inpatient hospitalizations (−23.6%, P=0.04), all-cause ER visits (−42.4%, P< 0.01), seizure-related ER visits (−46.4%, P< 0.01), ambulance use (−61.8%, P< 0.01), all ASM claims (-9.3%, P< 0.01), and average number of unique ASMs (-12.2%, P< 0.01) from pre- to post-FFA initiation periods (Table). ITS analyses illustrated immediate reductions of claims at FFA initiation, and continual improvement for 12 months post-index for all-cause and seizure-related ER visits and ambulance use claims (Figure). DiD regression analyses confirmed that these reductions were significant when compared with those in the matched control group.
Conclusions: FFA use in patients with LGS was associated with reductions in ER visits (all-cause and seizure-related), inpatient hospitalizations (all-cause and seizure-related), and ambulance use. The results for ER visits and ambulance use remain robust, following more rigorous analytical approaches. The average number of all ASM claims and unique ASM claims per patient decreased following FFA initiation, suggesting that treatment with FFA reduces the total ASM drug load in patients with LGS. These results indicate that FFA is associated with significant improvements in real-world non-seizure outcomes such as HCRU burden and ASM drug load. Reduced HCRU and ASM burden is known to be associated with better quality of care and lower economic burden, which may be of interest to patients, caregivers, HCPs and payers.
Funding: UCB.
Anti-seizure Medications