Authors :
Presenting Author: Pyae Aung, MBBS, MRCP – University Hospitals Birmingham
Presenting Author: shanika Samarasekera, – Queen Elizabeth Hospital Birmingham
Shehr Syeda, BSc, MBBS, MRCP – Internal Medicine Trainee (CT1 IMT), Neurology Department, University Hospitals Birmingham; Shanika Samarasekera, FRCP – Consultant Neurologist, Neurology Department, University Hospitals Birmingham
Rationale: Cenobamate was licenced in the UK in December 2021 for the adjunctive treatment of adult focal epilepsy. Although its potential efficacy was clear in initial studies,
1 its potential impact on service use for those with severe refractory epilepsy is less clear. Does Cenobamate reduce seizures in adults who have been considered for epilepsy surgery? Does addition of Cenobamate impact on hospitalisations and contact with epilepsy services?
Methods: A retrospective cohort study was conducted. The records of patients commenced on adjunctive Cenobamate between January and mid-August 2022 were assessed over a six-month period.
Results: Of 61 patients (34 male), 56 (92%) had a seizure duration of over 10 years. A total of 37 (60%) were on the epilepsy surgery pathway and were prescribed at least three concomitant ASMs at baseline. Following addition of Cenobamate, 25 patients (40%) were able to withdraw one concomitant ASM. Three patients were able to withdraw two ASMs.
A total of 50 patients (80%) achieved a reduction in seizure frequency. A total of 26 patients (42%) achieved significant seizure reduction (over 50%), of whom three were seizure free. The maximum dose of Cenobamate used was 200mg/day.
Addition of Cenobamate was associated with reduced hospitalisation in 15 (25%) of patients. Contact with services, via the epilepsy specialist nurses, increased in 37 patients (61%). The most common query was about dose titration.
Conclusions: Adjuvant Cenobamate reduces seizure burden in the majority of patients with severe refractory focal epilepsy, with potentially favourable impact on rates of hospitalisation. Pharmacy support needs to be accessible as service utilisation increases.
Funding: No external funding.