Abstracts

Rationale: The prevalence of epilepsy in people with Intellectual Disability (ID) is around 22%. People with ID and epilepsy are twice as likely to be refractory to antiepileptic medications (60%) as compared to the general population (30%). Epilepsy in people with ID is associated with increased psychological and behavioural problems, healthcare costs, morbidity and mortality relative to the non-ID population. There are higher rates of side effects and poly-pharmacy in the ID population. Suitably powered studies to provide evidence for safe prescribing of AEDs to people with ID are rare. The Ep-ID Research Register was constituted in 2015 and has 10 years national UK Ethics and is adopted by the National Institute of Health Research. Presently 20 different NHS sites are registered as data collection centres nationally. The fundamental aim of the Register is to identify differences in effectiveness and side effects between the general and the ID population. It also looks for associations of response based on titration regimes, co-morbidity etc. A set approved protocol is used. The aim is to collect information on all AEDs starting with the newer ones. Studies have been completed on Perampanel, Lacosamide, Eslicarbazepine and Levetiracetam. We report clinically useful information on differences in response to Eslicarbazepine (ESL) between ID and general population from the UK Ep-ID Research Register. Methods: Pooled retrospective case notes data of consented people with epilepsy (PWE) prescribed ESL from 9 UK centres was classified as per WHO guidance into ID and the general population. Demographics, concomitant AEDs, starting and maximum dosage, exposure length, adverse effects, dropout rates, seizure type and frequency were collected. Group differences were reported as odds ratios estimated from logistic regression models. Results: Of the 93 PWE (general 57, ID 36) examined 57% were male (54% in general and 61% in ID group). The ID group were more likely to be younger than the general participants (p=0.01) but no statistically significant group differences were seen in other baseline characteristics including comorbid physical, mental and neurodevelopmental conditions (Table 1).Over 50% seizure improvement was seen in 35% of general population and 56% of those with ID. p=0.17 for association between ID group and efficacy. 39 % were withdrawn of ESL from the general population compared to 33% in the ID population (p =0.53). A higher percentage of physical health side effects was observed in the general group than the ID group but the difference was not statistically significant (46% vs. 28%; p = 0.12). Conclusions: The standardized approach of the Ep-ID register UK used confirms that responses of effectiveness and side effects to ESL by ID groups are similar to the General population. It is well tolerated in the ID population. Funding: No funding