Cenobamate's Efficacy in Drug-Resistant Epilepsy: Jacob Pellinen, MD

WATCH TIME: 3 minutes

“Even in patients with very difficult to control seizures and drug resistance, cenobamate can be an incredibly effective tool in our arsenal to prevent seizures. Knowing that it is effective enough to reduce the number of inpatient stays and the number of emergency room visits is huge, and I believe a game changer when it comes to controlling drug resistant seizures.”

Recent research shows that approximately 42% to 63% of patients with drug-resistant epilepsy who undergo surgery still have seizures in 1 year after surgery although surgery for this patient population has shown to be superior to medical management.¹ Cenobamate (Xcopri; SK Life Science), an FDA-approved antiseizure medication (ASM), is a highly effective treatment in managing focal onset seizures. According to a recent review published in Medicina, findings show that more than 20% of patients with drug-resistant epilepsy achieve seizure freedom with cenobamate.²

Findings from a new analysis showed an association between lower emergency room (ER) rates and added cenobamate to existing therapy regimens following surgery compared with 7 leading ASMs in patient with seizure disorders.³ Investigators compared line of therapy with added cenobamate and other added newer ASMS which included brivaracetam, clobazam, eslicarbazepine, lacosamide, lamotrigine, levetiracetam, or perampanel. These results were presented at the 2024 American Academy of Neurology (AAN) Annual Meeting, held April 13-18, in Denver, Colorado, by lead author Jacob Pellinen, MD, and colleagues.

Pellinen, assistant professor of neurology at University of Colorado School of Medicine, sat down with NeurologyLive^® at the meeting to provide a summary of the findings from the presentation. He further discussed how cenobamate, compared with other medications, reduced ER visits and hospital stays among patients with drug-resistant epilepsy. He also talked about the challenges that patients with drug-resistant epilepsy face when taking medications, including cenobamate. Additionally, Pellinen explained from his clinical viewpoint the reason why cenobamate might be considered a "game changer" in the treatment of drug-resistant seizures.

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REFERENCES
1. Andrews JP, Gummadavelli A, Farooque P, et al. Association of Seizure Spread With Surgical Failure in Epilepsy. JAMA Neurol. 2019;76(4):462-469. doi:10.1001/jamaneurol.2018.4316
2. Rissardo JP, Fornari Caprara AL. Cenobamate (YKP3089) and Drug-Resistant Epilepsy: A Review of the Literature. Medicina (Kaunas). 2023;59(8):1389. Published 2023 Jul 28. doi:10.3390/medicina59081389
3. Jacob Pellinen, Clarence Wade, Sean Stern, Vernon Schabert, Christopher Elder. Effectiveness of Cenobamate in Postsurgical Patients: A Retrospective Claims-based Analysis. Presented at: 2024 AAN Annual Meeting; April 13-18; Denver, CO.