William Rosenfeld, MD: Decreasing Concomitant ASM Use With Cenobamate for Epilepsy


The neurologist from the Comprehensive Epilepsy Care Center for Children and Adults, in St. Louis, Missouri, discussed how his team saw a roughly 25% decrease in the mean use of concomitant ASMs.

“[Cenobamate]… had some very excellent efficacy. I think our whole paradigm might be shifting because of the numbers that we were seeing in terms of seizure freedom.”

A post-hoc analysis of a phase 3 study investigating cenobamate (Xcopri; SK Life Science) presented at the American Epilepsy Society (AES) Annual Meeting, December 4–8, 2020 found that fewer patients with focal seizures discontinued cenobamate after reducing doses of concomitant antiseizure medications (ASMs). The medication was approved for the treatment of partial-onset seizures in late 2019.

Among the investigators is William Rosenfeld, MD, neurologist, Comprehensive Epilepsy Care Center for Children and Adults, in St. Louis, Missouri. Rosenfeld and colleagues found that patients that decreased their mean concomitant ASM use were more likely to continue using cenobamate as compared to patients that did not decrease mean concomitant ASM use. These decreases were mostly due to adverse events (AEs) that appeared early in the study during titration or early maintenance phases when cenobamate doses were escalated.

NeurologyLive spoke with Rosenfeld to learn more about cenobamate and the sizable decrease in concomitant ASM use that his team saw. He discussed the value in a medication that shows efficacy in refractory epilepsy and that can potentially cut down the amount of ASMs patients use.

For more coverage of AES 2020, click here.

Rosenfeld W, Aboumatar S, Bhatia P, et al. Dose adjustments to concomitant antiseizure medications: post-hoc analysis of a phase 3, open-label study of cenobamate for the treatment of uncontrolled focal seizures. Presented at AES 2020 Annual Meeting; December 4–8, 2020. Abstract 336.
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