Abstract：
This retrospective chart review examined dose reductions and discontinuations of concomitant antiseizure medications (ASMs) following cenobamate initiation and maintenance in patients with epilepsy treated at MetroHealth (Cleveland, OH) between 9/1/2020-9/26/2022. Concomitant ASM dose adjustments and treatment-emergent adverse events (TEAEs) were assessed. Efficacy (100 % seizure reduction) was examined among patients who received cenobamate for ≥ 3 months at data cutoff (including titration). As of 9/26/2022, 95 patients received cenobamate (mean age, 45.9 years; 48.4 % female, median exposure 7.5 months). Five patients (5.3 %) discontinued (n = 1 withdrawal by patient; n = 1 noncompliance; n = 3 adverse event). Among the 90 patients taking cenobamate at data cutoff, 50 % (45/90) discontinued ≥ 1 concomitant ASM, most commonly clobazam (n = 18), levetiracetam (n = 10), and phenytoin (n = 7); 21 patients (23.3 %) had additional concomitant ASM dose reductions, most commonly phenytoin (n = 6) and clobazam (n = 4). Sixteen patients received cenobamate monotherapy. Among 79 patients who received cenobamate for ≥ 3 months at data cutoff, 51.9 % (41/79) were seizure-free for ≥ 3 months. Of the 41 seizure-free patients, 58.5 % (24/41) were taking 100 mg/day of cenobamate. Sixteen of the 95 cenobamate-treated patients (16.8 %) reported 22 TEAEs. The most common TEAE was fatigue (n = 7). These data suggest that cenobamate therapy may allow reduction or elimination of polytherapy in some patients.
摘要：
这项回顾性图表审查了在MetroHealth治疗的癫痫患者（克利夫兰，OH）在2020年9月1日至2022年9月26日之间。评估伴随的ASM剂量调整和治疗引起的不良事件（TEAE）。在数据截止（包括滴定）时，在接受西诺膦酸治疗≥3个月的患者中检查了疗效（癫痫发作减少100％）。截至2022年9月26日，95例患者接受了西诺本（平均年龄，45.9岁；48.4%为女性，中位暴露7.5个月)。5例患者（5.3%）停药（n=1例患者停药；n=1例不依从；n=3例不良事件）。在90名患者中，在数据截止时服用西诺巴特，50%(45/90)停止≥1次伴随ASM，最常见的是clobazam(n=18)，左乙拉西坦（n=10），和苯妥英（n=7）;21例患者（23.3％）有额外的ASM剂量减少，最常见的是苯妥英（n=6）和氯巴赞（n=4）。16例患者接受西诺本单药治疗。在79名患者中，在数据截止时接受西诺本治疗≥3个月，51.9%(41/79)的患者在≥3个月内无癫痫发作。在41名没有癫痫发作的患者中，58.5％（24/41）服用100mg/天的cenobamate。95例接受西诺本酯治疗的患者中有16例(16.8%)报告了22例TEAE。最常见的TEAE是疲劳（n=7）。这些数据表明，在某些患者中，西诺膦酸盐治疗可能会减少或消除多疗法。
