Association between antiseizure medications and quality of life in epilepsy: A mediation analysis

Wang, Meng; Perera, Kevin; Josephson, Colin B.; Lamidi, Mubasiru; Lawal, Oluwaseyi; Awosoga, Olu; Roach, Pamela; Patten, Scott B.; Wiebe, Samuel; Sajobi, Tolulope T.

doi:10.1111/epi.17153

Cited by 23 publications

(9 citation statements)

References 35 publications

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“…Anxiety and depression are substantially more common in epilepsy patients than in the healthy population, which shows that patients exhibiting symptoms of anxiety and/or depression are not receiving substandard care in the epilepsy management [ 12 , 13 ]. In terms of ASMs, it has also been demonstrated that initial prescription of monotherapy and further addition of newer regimens was more effective in controlling seizures and reduced the seizure frequency significantly in PWE [ 14 , 15 , 16 ]. However, the use of these bi or polyherapy ASMs has been found to cause drug resistance and showed adverse effects in PWE.…”

Section: Introductionmentioning

confidence: 99%

Anti-seizure medications and quality of life in person with epilepsy

Dwivedi

Tiwari²,

Tripathi³

2022

Heliyon

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Section: Introductionmentioning

confidence: 99%

Anti-seizure medications and quality of life in person with epilepsy

Dwivedi

Tiwari²,

Tripathi³

2022

Heliyon

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“…[1][2][3] Nonetheless, many patients with drug-resistant epilepsy have polytherapy with ASMs, often in high doses, which increases toxicity and negatively affects quality of life. [20][21][22] From this perspective, application of cenobamate, which allows tapering of a patient's comedication, can be potentially beneficial. Although there is no marketing authorization for monotherapy with cenobamate, it will be interesting to see in clinical practice whether cenobamate alone also leads to good seizure control in individual patients.…”

Section: Discussionmentioning

confidence: 99%

“…The probability of improved seizure control is known to decrease with each subsequently added ASM 1–3 . Nonetheless, many patients with drug‐resistant epilepsy have polytherapy with ASMs, often in high doses, which increases toxicity and negatively affects quality of life 20–22 . From this perspective, application of cenobamate, which allows tapering of a patient's comedication, can be potentially beneficial.…”

Section: Discussionmentioning

confidence: 99%

Add‐on treatment with cenobamate is already effective at low doses in refractory focal epilepsy: A prospective observational study

Novitskaya,

Schütz,

Metternich

et al. 2024

Epilepsia

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Abstract:ObjectiveCenobamate, a novel ASM with a dual mechanism of action, has been shown in pivotal trials to significantly improve seizure control in treatment‐resistant focal epilepsy. We aimed to evaluate whether these promising results could be confirmed in a real‐world setting with a follow‐up period of up to 12 months.MethodsPatients from a tertiary epilepsy centre who received cenobamate add‐on between June 2021 to October 2023 were followed up prospectively at 3, 6 and 12 months after treatment initiation for assessment of seizure outcomes and treatment‐related adverse events.ResultsThe clinical cohort included 112 adult patients with 30% non‐lesional cases and a wide spectrum of epileptogenic lesions underlying refractory focal epilepsy. We observed a significant reduction in monthly seizure frequency of all seizure types already after 3 months of treatment at a median cenobamate dose of 100 mg/day. 46% of patients were responders with a ≥ 50% seizure reduction, 26% had a ≥ 75% seizure reduction, and 9% became seizure free. Among the 74 patients with available follow‐up of 12 months, the responder rates reached 55%, 35% and 19% for ≥ 50%, ≥ 75% and 100% of seizure reduction, respectively.After 3 months of treatment, 38% of patients reported adverse effects, mainly (84%) mild to moderate in intensity. Adjustment of comedication allowed successful management of adverse effects in 32% of patients. At a group level, there was no correlation between the cenobamate daily dose and the incidence of adverse effects.SignificanceWe found a clinically relevant response to cenobamate already at a low daily dose of 100 mg also in a patient cohort with a higher degree of drug resistance than in pivotal trials. Our prospectively collected data provide real‐world evidence for high efficacy and good tolerability of the drug although no standardized treatment protocol or comparison with a control group was applied.

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“…Ney et al evaluated RRLM-EEG cost-benefits in the hospital and found that each use of RRLM-EEG as a Rapid-EEG system saved between $3971 and $17,290 [ 25 •]. These cost-benefits result from reduced hospitalizations and unnecessary use of antiseizure medications in those with suspected NCSE [ 26 – 28 ]. Specifically, the deployment of this rapid tool reduced hospital length of stay by 1.2 days and length of stay in the intensive care unit by 0.4 days.…”

Section: Cost and Accessibilitymentioning

confidence: 99%

Rapid Response EEG: Current State and Future Directions

Davey

Gupta

et al. 2022

Curr Neurol Neurosci Rep

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Purpose of Review To critically appraise the literature on the application, methods, and advances in emergency electroencephalography (EEG). Recent Findings The development of rapid EEG (rEEG) technologies and other reduced montage approaches, along with advances in machine learning over the past decade, has increased the rate and access to EEG acquisition. These achievements have made EEG in the emergency setting a practical diagnostic technique for detecting seizures, suspected nonconvulsive status epilepticus (NCSE), altered mental status, stroke, and in the setting of sedation. Summary Growing evidence supports using EEG to expedite medical decision-making in the setting of suspected acute neurological injury. This review covers approaches to acquiring EEG in the emergency setting in the adult and pediatric populations. We also cover the clinical impact of this data, the time associated with emergency EEG, and the costs of acquiring EEG in these settings. Finally, we discuss the advances in artificial intelligence for rapid electrophysiological interpretation.

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Association between antiseizure medications and quality of life in epilepsy: A mediation analysis

Cited by 23 publications

References 35 publications

Anti-seizure medications and quality of life in person with epilepsy

Anti-seizure medications and quality of life in person with epilepsy

Add‐on treatment with cenobamate is already effective at low doses in refractory focal epilepsy: A prospective observational study

Rapid Response EEG: Current State and Future Directions

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