Rapid Termination of Seizures in a Cluster: Minute-by-Minute Subgroup Analysis of Prompt Treatment With Diazepam Nasal Spray
Abstract number :
2.336
Submission category :
7. Anti-seizure Medications / 7B. Clinical Trials
Year :
2025
Submission ID :
920
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Michael Chez, MD – Sutter Neuroscience Institute
Danielle Becker, MD, MS – The Ohio State University Wexner Medical Center
Jurriaan Peters, MD PhD – Boston Children's Hospital
Jesus Pina-Garza, MD – TriStar Centennial Children’s Hospital
Pavel Klein, MD, M.B., B.Chir. – Mid-Atlantic Epilepsy and Sleep Center
Charles Davis, PhD – CSD Biostatistics, Inc.
Leock Ngo, PhD – Neurelis, Inc.
Miguel Lopez-Toledano, PhD – Neurelis, Inc.
Enrique Carrazana, MD – Neurelis, Inc., John A. Burns School of Medicine; University of Hawaii, Honolulu, HI
Adrian Rabinowicz, MD – Neurelis, Inc., Center for Molecular Biology and Biotechnology (CMBB) in the Charles E. Schmidt Collage of Science at Florida Atlantic University
Rationale: Prompt treatment of seizure urgencies with rapid and early seizure termination (REST) medications is feasible by nonmedical caregivers in the community setting and is supported by an expert group’s recent recommendations. Diazepam nasal spray is approved by the US Food and Drug Administration for acute treatment of seizure clusters (SCs) in patients with epilepsy aged ≥2 years. Reducing time to administration of diazepam nasal spray has been shown to lead to faster seizure termination. Among seizures within an SC treated with diazepam nasal spray < 5 min after seizure onset, the median time to seizure termination was 2 min after administration. In light of recent expert consensus recommendations for early use of REST medications, an analysis was undertaken to more closely examine the minute-by-minute association between time from seizure onset to administration and time of seizure termination. We also assessed the generalizability of these findings in multiple subgroups.
Methods: This was a post hoc analysis of data from the long-term safety study of diazepam nasal spray for the treatment of SCs, which may last ≥24 h. A total of 163 patients aged 6-65 years were administered a total of 4390 doses to treat 3853 SCs. Time from seizure onset to administration of diazepam nasal spray and to termination of seizures within an SC was investigated using time to administration cutoffs of 0 to < 1, 1 to < 2, 2 to < 3, 3 to < 4, and 4 to < 5 min for the overall population and by epilepsy type and age subgroups.
Anti-seizure Medications