William Rosenfeld, MD: Reducing Concomitant ASM Dosages for Focal Seizures


The neurologist from the Comprehensive Epilepsy Care Center for Children and Adults, in St. Louis, Missouri, discussed the different medications that cenobamate was used with.

"The key part was that cenobamate appeared to work with whichever antiseizure medication (ASM) the patient was on.... it's the efficacy of cenobamate, the retention, the seizure freedom numbers, and the ability to reduce ASMS that speaks about to the success of cenobamate.”

Cenobamate (Xcopri; SK Life Science) was approved for the treatment of partial-onset seizures in late 2019. Data from a post-hoc analysis of a phase 3 study presented at the American Epilepsy Society (AES) Annual Meeting, December 4–8, 2020 suggested that reducing doses of concomitant ASMs led to fewer patients with focal seizures discontinuing cenobamate.

Presenter William Rosenfeld, MD, neurologist, Comprehensive Epilepsy Care Center and colleagues found that among patients who remained on cenobamate, 91 of the 401 (22.7%) concomitant baseline ASM doses were discontinued completely. Carbamazepine accounted for 28.6% of patients, oxycarbazepine for 25%, lacosamide for 21.5%, eslicarbazepine for 23.1%, clobazam for 22.6%, lamotrigine for 15.4%, and levetiracetam for 14.1%.

NeurologyLive spoke with Rosenfeld to learn more about the concomitant ASMs that were used with cenobamate and how different levels of intractable patients found efficacy with cenobamate. He also discussed how the open-label study was valuable in being able to adjust dosages.

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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