Abstracts

Rationale: The FDA approved the use of Epidiolex® for use in Lennox-Gastaut (LGS) and Dravet syndromes (DS) in 2018. Since then, numerous patients have started treatment with the drug, with mostly positive experiences. As a newly approved drug, quality control studies are warranted to assess Epidiolex®’s efficacy and potential roadblocks to its use. Herein, we explore the attitudes and experiences of a small sample of health care providers regarding the use of Epidiolex® in clinical practice.

Methods: At MUSC Epilepsy Clinic, 96 patients were prescribed Epidiolex® by 14 prescribers. Of these providers, 11 (84.62%) participated in our 36 question-based survey regarding their experiences with Epidiolex®. These professionals had different levels of training and experience in the prescription of the drug, including adult and pediatric physician assistants, nurse practitioners, epilepsy fellows, epilepsy attendings and child neurology attendings with a subspecialty in epilepsy.

Results: All prescribers reported that their patients had decreased seizures following Epidiolex® use, with a mean reduction of 43.64% (SD 19.62). The greatest decrease in seizures was seen in those with bilateral motor tonic-clonic (n=6, 46.2%) and generalized motor atonic (n=3, 23-1%) types. Five prescribers (38.5%) said they had at least one patient who attained seizure freedom after Epidiolex® use. Epidiolex® was discontinued in a mean 2.09 patients per prescriber. Some improvement in depressive (n=1, 7.7%), anxiety (n=4, 30.8%), conduct (n=3, 23.1%), neurocognitive (n=2, 15.4%) and sleep-wake (n=1, 7.7%) symptoms were noted. Providers claimed that a considerably longer time for approval was expected when prescribing Epidiolex® compared to other medications, and a significant number (n=4, 36,4%) avoided prescribing it due to this delay. Most (n=10, 91%) believed an expansion in the FDA approved diagnoses should be made for Epidiolex®, namely for other focal and generalized drug-resistant epilepsies. Most of our prescribers had a positive (53-90%) impression of Epidiolex®, all things considered.

Conclusions: To our knowledge, this is the first study of prescriber experiences and attitudes towards the newly approved Epidiolex® medication; it offers unique insight into the current strengths and weaknesses of a novel drug in clinical practice. Regardless of the limitation of being low-powered study (n=11), based on qualitative and potentially biased survey responses, it highlights current strengths of Epidiolex® and areas for improvement to enhance its value.

Funding: Please list any funding that was received in support of this abstract.: No funding was received in support of this abstract.