Cenobamate in real world : a single center study
Abstract number :
3.372
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2025
Submission ID :
402
Source :
www.aesnet.org
Presentation date :
12/8/2025 12:00:00 AM
Published date :
Authors :
Louise Adams, Pharmacy student – Université Libre de Buxelles
Charlotte Damien, MD – HUBruxelles-Hôpital Erasme
Charlotte De Maeseneire, MD – HUBruxelles-Hôpital Erasme
Chantal Depondt, MD, PhD – HUBruxelles-Hôpital Erasme
Nicolas Gaspard, MD, PhD – Hôpital Universitaire de Bruxelles
Estelle rikir, MD, PhD – HUBruxelles-Hôpital Erasme
Presenting Author: Benjamin Legros, MD – HUBruxelles-Hôpital Erasme
Rationale: Cenobamate is a new antiseizure medication (ASM), available in Belgium since the end of the year 2022. It is indicated as add-on treatment in patients with focal epilepsy. We conducted a retrospective study to evaluate the efficacy and tolerability of cenobamate in a real world setting.
Methods: The charts of all adult patients treated with cenobamate (CNB) for refractory focal epilepsy between November 2022 and December 2024 in the Neurology Department of HUBruxelles-Hôpital Erasme, Brussels, were retrospectively reviewed. We collected demographic data, epilepsy history, previous epilepsy treatments, cenobamate dose, cenobamate efficacy and toxicity data, as well as modifications of dosage of concomitant ASM. The study was approved by the local ethical committee.
Results: 114 patients were included (55 females). Mean age at initiation of the CNB was 40 (range 18-74). 72 patients had a structural focal epilepsy. They tried a median number of 5 previous ASMs (range 1-11) and the median number of concomitant ASMs was 3 (range 0-5). We have follow up data for 102 patients. 24 patients stopped the treatment, 29 were non responders, 36 (32%) were 50% responders and 13 (11%) were seizure-free at last follow up. The median CNB dose was 200 mg (range 12.5-400). 50 patients had at least 12-month follow up. The median CNB dose was 250 mg (range 100-400). At last follow up, 2 patients stopped the treatment, 18 were non responders, 18 (36%) were responders and 8 (16%) were seizure-free. 68 patients had a proactive decrease in one or several concomitant ASM dosage, mainly lacosamide (N=25), perampanel (N=14), clobazam (N=12). 51 patients needed a further decrease in other ASM dosage (mainly brivaracetam and lacosamide), and 52 patients could stop at least one concomitant ASM (mainly lacosamide and perampanel). 72 patients described at least one side effect. The most frequent were somnolence/fatigue (N=38), ataxia (N=28), diplopia/blurred vision (N=15), nervosism (N=15). The most common side effects associated with discontinuation of CNB were ataxia and somnolence. We found no serious cutaneous problem.
Conclusions: Efficacy of CNB is confirmed in this real world series of patients. After one year of follow up, the efficacy is maintained with 52% of the patients being either seizure free or responders. Side effects are common and in line with those found in regulatory studies.
Funding: None
Anti-seizure Medications