Abstracts

Rationale: Eslicarbazepine acetate is a single daily dose voltage-gated sodium channel blocker approved as add-on-therapy therapy in adults with partial onset seizures, with or without secondary generalization. It has demonstrated efficacy in patients with refractory focal epilepsy in randomized control trials in doses of 800 mg and 1200 mg. However, experience in clinical practice often varies from the results of regulatory trials, and observational outcome data in the real life setting, over longer periods of time, can help inform clinical practice. We conducted a retrospective study to determine the clinical efficacy and tolerability of eslicarbazepine over a 12-month period in patients with refractory focal epilepsy attending a regional neuroscience centre and a community epilepsy clinic. Methods: 43 adult patients (27 female) on eslicarbazepine were identified from the clinical database at the Greater Manchester Neurosciences Centre and Breightmet Health Centre in the UK. Demographic and epilepsy details as well as clinical outcomes at 3, 6 and 12 months after initiation of eslicarbazepine was collected using a structured proforma by case note review. Results: 42 patients had focal epilepsy, and 1 patient had unclassified epilepsy. 31 (72.09%) had received treatment with 5 or more AEDs in the past. Of the 43 patients starting on eslicarbazepine, 31 (72.09%) took the drug for a minimum period of 12 months. Those discontinuing eslicarbazepine (12, 27.91%) did so within 3 months of initiation. 6 (50%) patients discontinued eslicarbazepine because of lack of efficacy / worsening or seizures, and the rest due to adverse effects. Adverse effects leading to withdrawal were tiredness, feeling drunk, unsteadiness and double vision. Significant hyponatraemia was not observed in any patient in this study. Of the 31 patients continuing eslicarbazepine, 19 (61.29%) experienced at least 50% reduction in seizure frequency: 4 (12.90%) were seizure free. 11 (35.48%) found no significant change in seizure frequency. Seizure outcome was not known for one patient. 3 of the 31 patients who continued eslicarbazepine for 12 months were on 400mg/day, 19 (44.19%) were on 800 mg/day and 18 (41.86%) were on 1200mg. 3 (6.98%) took 1600 mg/day. Eslicarbazepine was most frequently used in conjunction with levetiracetam (n=11) and lamotrigine (n=10). Conclusions: Our data confirms the efficacy of eslicarbazepine in patients with refractory focal epilepsy in the ‘real-world' setting. The majority of patients tolerated the drug well, with over 70% retention rate at 12 months. Of those continuing on the drug, 61% were responders, and 12.9% were seizure free in a population of patients with refractory epilepsy.