Healthcare resource utilization in adults with focal onset seizures before and after initiating cenobamate: A US...

Antiseizure medications (ASMs) are the mainstay of treatment for patients with epilepsy, though over one third remain uncontrolled after treatment with at least two ASMs. Cenobamate is an ASM indicated for the treatment of adults with focal onset seizures (FOS) in the United States. In Europe cenobamate is approved for the adjunctive treatment of FOS in adult patients with epilepsy who have not been adequately controlled despite at least 2 previous ASMs. Real-world data helps to better describe the impact of cenobamate long-term effectiveness and tolerability/safety balance. Evidence reflecting a reduction of the impact of epilepsy on the daily lives of patients would be important when assessing and eventually predicting the benefit of treatments.

A retrospective observational study was conducted using the IQVIA PharMetrics Plus database among adult patients with both a claim for cenobamate between April 1, 2020, to April 30, 2023, and a diagnosis of FOS prior to the first cenobamate dispensing date (identified in the baseline period). Demographic characteristics were captured on the index date and clinical characteristics were captured in the 6 months baseline period; treatment patterns and healthcare resource utilization (HCRU) were assessed across 3 epochs forming 3 non-mutually exclusive cohorts: Cohort A, 6 months follow-up; Cohort B, 12 months follow-up; Cohort C, 18 months follow-up. Designated treatment regimen was defined by recorded ASMs prescribed in the 90 days following cenobamate dispensing (treatment regimen evaluation window), and patients were classified as 'monotherapy', 'stable polytherapy', or 'changing treatment regimen'.

Among the 1132 patients included in Cohort A, approximately half (45.1 %) had stable polytherapy, 1.5 % had monotherapy, and 53.5 % had a changing treatment regimen following initiation of cenobamate. Similar distribution of designation was present among the 800 patients in Cohort B and 554 patients in Cohort C. A lower proportion of patients required hospitalization and emergency department visits in the 6 months after cenobamate initiation compared to the 6-month pre-index period (Cohort A: 15.4 % vs. 21.9 % and 24.9 % vs. 30.9 % respectively). Lower HCRU reduction rates (%) per patient per month were found at 6, 12 and 18 months of follow-up.

Epilepsy-related hospitalizations and Emergency Room visits (indicators of seizures) were reduced in adult FOS patients with epilepsy 6, 12 and 18 months after initiating cenobamate as monotherapy or stable polytherapy, leading to reduced HCRUs and epilepsy costs.