Efficacy and safety of cenobamate-based combination therapy in drug-resistant epilepsy: Secondary analysis by mechanisms of action of concomitant antiseizure medications - PubMed
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- #cenobamate
- #antiseizure medications
- #drug-resistant epilepsy
- Secondary analysis of 475 adults with drug-resistant epilepsy treated with adjunctive cenobamate.
- Concomitant antiseizure medications grouped by mechanisms: sodium channel blockers (SCBs), SV2A ligands, valproate, carbonic anhydrase inhibitors, or GABA analogs.
- Valproate use associated with higher odds of ≥50% seizure reduction and seizure freedom.
- SCB co-therapy linked to lower odds of seizure freedom initially, but modestly favored ≥50% response at follow-up.
- SCB co-medication decreased risk of somnolence; SV2A ligands, valproate, or carbonic anhydrase inhibitors correlated with lower discontinuation rates.
- Cenobamate dose showed no significant association with efficacy or adverse events.
- Optimal efficacy when cenobamate combined with valproate and broad-spectrum agents; suboptimal with SCB.
- Substantial seizure improvements achieved at moderate cenobamate doses, highlighting individualized titration importance.