Abstracts

Rationale: Clobazam (CLB) has proven efficacy against multiple seizure types. Although available in many countries, it is not approved by the U.S. F.D.A.. The objective of this study was to evaluate the usage patterns, efficacy, tolerability and one-year retention of CLB in patients with refractory epilepsy seen at a tertiary US epilepsy center. Methods: We retrospectively reviewed the use of CLB, one measure of efficacy (6 month seizure-freedom), one-year retention and tolerability in patients with epilepsy who were prescribed CLB as part of their antiepileptic drug regimen at the Columbia Comprehensive Epilepsy Center over a 5 year period. Data were analyzed with chi-square or Fisher exact tests, with significance set at p<0.05. We also tested for potential predictors of 6-month seizure-freedom using binary logistic regression analysis. Results: 251 patients were prescribed CLB, of which 62 were newly started on CLB at our center during this time period (29 men, 33 women; mean age 44.years, range 8 to 88). Clobazam dose ranged from 5 to 60 mg/day (mean = 24 mg/day). Mean serum level was 220.6. The mean number of prior AED trials per patient was 8. Of the 62 patients newly started on CLB, 7 (11.3%) patients became seizure-free for at least 6 months after introduction of CLB. Binary logistic regression was unable to identify any significant predictors of seizure-freedom. Four patients remained seizure free on CLB for >