Epidiolex In Adult Patients with Lennox-Gastaut Syndrome (LGS): The Pittsburgh Experience
Abstract number :
785
Submission category :
7. Antiepileptic Drugs / 7E. Other
Year :
2020
Submission ID :
2423123
Source :
www.aesnet.org
Presentation date :
12/7/2020 9:07:12 AM
Published date :
Nov 21, 2020, 02:24 AM
Authors :
Bahareh Sianati, Allegheny Health Network; Spurthi Surpur - Allegheny Health Network; James Valeriano - Allegheny Health Network;;
Rationale:
To present interim results of our experience with cannabis-based therapy, Epidiolex, by evaluating changes in frequency of drop seizures and total seizures in adult Lennox-Gastaut (LGS) patients and to document its tolerability as an adjunctive treatment.
Method:
In this open label study, eligible patients with clinical diagnosis of LGS were enrolled in the Allegheny Neurological Association Adult Epilepsy Clinic from June 2018 to May 2020. Data was collected via review of medical records, and seizure calendar reported by caregivers. Patients’ cases were initially reviewed at least 6 months after the initial start date. Patients received highly purified CBD (100 mg/ml) starting from 2.5 mg/kg/d, titrated to the efficacious dose, and continued to receive this dose as maintenance dose. To gauge for safety, clinical lab parameters including currently taken anti-seizure drug levels, and serum hepatic enzymes were measured.
Results:
Interim analysis of the 41 patients with at least 6 months on adjunctive Epidiolex treatment revealed median age of 35 years (19-56), 60% male, and median number of concurrently taken anti-seizure medication 4. Most commonly used anti-seizure medications were Levetiracetam (51%), Clobazam (46%), Lamotrigine (46%), and Rufinamide (39%). Reported decrease in total seizure-frequency by at least 50% in 34 (82%) patients, increase by 50% in 2 (4%), and no change in 5 (12%); median reduction in drop seizure from baseline ranged from 45-48%. Most common adverse effects were diarrhea in 14 (25%), and somnolence in 10 (18%) while on Clobazam. Hepatic enzyme levels increased in 3 (7%) mostly in patients who were receiving Valproic acid.
Conclusion:
Our open label trial demonstrated treatment with add-on Epidiolex is well tolerated and resulted in reduction in the frequency of drop seizures and total seizures in an adult epilepsy clinic treating LGS patients. Most experienced adverse effects were reported to be somnolence and diarrhea especially in patients taking Clobazam.
Funding:
:none
Antiepileptic Drugs