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AAN 2022 | Early and sustained responses to cenobamate across focal seizure subtypes

Cenobamate, an antiepileptic drug with a unique dual mechanism of action, has been subject to investigation in several major clinical trials, leading to its approval in the US for the treatment of adult patients with uncontrolled focal epilepsy. William E. Rosenfeld, MD, FAAN, The Comprehensive Epilepsy Care Center for Children and Adults, St Louis, MO, discusses the results of a post-hoc analysis of one of these trials (C021; NCT02535091), assessing the efficacy of cenobamate by focal seizure subtype. The retrospective analysis included 240 patients with focal aware motor (FAM), focal impaired awareness (FIA), and focal to bilateral tonic-clonic (FBTC) seizures. It was shown that during months 1-3, reduction in median percent seizure frequency was the greatest for FBTC (94.1% vs 55.0% and 52.4% for FAM and FIA, respectively). Assessing months 24-27, seizure reduction was seen in close to 100% across all subtypes. These data support the long-term efficacy of cenobamate for patients with focal seizures, highlighting the early onset of responses in FBTC seizures. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.