Authors :
Presenting Author: Stern Sean, MS – SK Life Science, Inc.
Arkady Nisman, PharmD – SK Life Science, Inc.
Louis Ferrari, RPh – SK Life Science, Paramus, New Jersey, USA
Rationale:
Patients with uncontrolled seizures are burdened by decreased overall health and quality of life and utilize more healthcare resources. Cenobamate is an antiseizure medicine (ASM) approved in the US, Canada, and Europe for treatment of focal seizures in adults. The aim of the current study was to evaluate the impact of 90-day and 360-day zero-seizure intervals on healthcare resource utilization (inpatient [IP] and emergency room [ER] encounters) in the subsequent 360-day period.Methods:
A retrospective observational study using de-identified electronic health records (EHR) from a subset of 28 health care organizations representing ambulatory centers, hospitals, imaging centers, clinics, and medical offices (Truveta database) identified adults (≥18 years) who initiated cenobamate between 1/1/2020-4/12/2025. Seizure data were extracted from clinical notes using Truveta Language Model (TLM), a mixture of large language models that extracts structured information from unstructured clinical notes. Clinical concepts and their interrelations within clinical notes were also identified, annotated, and reviewed by internal clinical experts. Patients were included if they had any encounter (office visit, IP, ER; including non-epilepsy related) ≥180 days before initiation of cenobamate and had any type of medication dispensed or requested in the ≥360 days before initiation. Depending on the zero-seizure interval that was measured, patients were required to have at least one seizure observation-related encounter at least 90- or 360-days post-completion of a 90-day enrollment period. Zero seizures status was calculated by taking the difference in time between the last available encounter date (regardless of ongoing cenobamate use) where seizures were measured (seizures could be ≥0) and the last date of an observed seizure (seizures must be >0). If those time differences were ≥90 days or ≥360 days, this was then transformed into a binary variable. Healthcare resource utilization (frequency of all-cause and epilepsy-related IP and ER encounters) for the subsequent follow-up period, up to 360 days, were summed and transformed into annual rates. For each of the 90-day and 360-day zero seizures cohorts, four negative binomial regression analyses were conducted utilizing baseline demographic, clinical, and utilization characteristics. Results:
A total of 669 patients (324 men [48%]; mean (SD) age, 42.5 (14.7) years) were included in the 90-day zero seizures analysis and 361 patients (166 men [46%]; mean (SD) age, 41.5 (14.0) years) were included in the 360-day zero seizures analysis. All subsequent all-cause and epilepsy-related IP and ER rates were significantly reduced for patients with 90-day and 360-day zero-seizure intervals vs those without a 90- or 360- day zero-seizure interval (Table 1).Conclusions:
These data suggest a potential healthcare resource utilization benefit during the subsequent 360-day period after achieving zero seizures for 90 days or 360 days. Future research should investigate this impact for a broader set of epilepsy patients beyond just those initiating cenobamate.Funding:
Funded by SK Life Science, Inc.