Efficacy and Safety of Eslicarbazepine Acetate as First and Second-Line Monotherapy in Adult Patients with Focal Epilepsy: a Real-life Study in a Spanish Epilepsy Unit
Abstract number :
2.228
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2021
Submission ID :
1826074
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Elena Fonseca, MD, PhD - Vall d'Hebron University Hospital; Laura Abraira - Epilepsy Unit. Neurology Department - Vall d'Hebron University Hospital; Thomas Medina - Facultad de Medicina - Universidad de los Andes; Manuel Quintana - Epilepsy Unit. Neurology Department - Vall d'Hebron University Hospital; Estevo Santamarina - Epilepsy Unit. Neurology Department - Vall d'Hebron University Hospital; Manuel Toledo - Epilepsy Unit. Neurology Department - Vall d'Hebron University Hospital
Rationale: Eslicarbazepine acetate (ESL) monotherapy has shown to be an effective treatment of epilepsy with focal-onset seizures. We aimed to evaluate its efficacy and safety in routine clinical practice in adult patients in a specialized epilepsy unit.
Methods: We performed a retrospective longitudinal study including adult patients with a confirmed focal epilepsy diagnosis in which ESL monotherapy was started from March 2014 to May 2019. All patients completed a follow-up period (FUP) of at least 6 months. Seizure frequency during the 6-month period before and after treatment initiation was obtained from medical records. Retention and responder rates (considered as a seizure frequency reduction of ≥50%), and emergent adverse events (AE) at FUP were analyzed as outcome measures.
Results: Fifty patients were included in the study (mean age 53.3±18.7 years; 64% men), 2 lost to follow-up. The most frequent epilepsy type was temporal lobe epilepsy (50%), followed by frontal lobe epilepsy (22%). The most frequent etiologies were: unknown (46%), vascular (18%), tumor-related (12%) and hippocampal sclerosis (6%). ESL was started as first-line monotherapy in 26% of patients, and as second-line monotherapy in 74% (due to inefficacy, AE or poor compliance of previous antiseizure drugs in 22.2%, 72.2% and 5.6% respectively). Mean baseline seizure frequency was 1.11±2.73 seizures/month). At FUP, retention rate was 81.3% and 82.5% patients were considered responders (70% were seizure-free). No clinical factors predicted better retention or responder rates. Mild AE were reported by 53.2% patients and no severe AE were reported. Treatment discontinuation occurred in 9 patients (18.8%), due to inefficacy (22.2%) or AE (77.8%). Patients who presented AE were older than those who did not (mean age 58.3 vs 46.1 years; p=0.023).
Conclusions: ESL monotherapy is an effective and overall well tolerated first and second-line treatment for adult patients with focal epilepsy in real-life clinical practice.
Funding: Please list any funding that was received in support of this abstract.: Travel support from Bial Pharmaceutical.
Anti-seizure Medications