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A comparison of cenobamate with other newer antiseizure medications for adjunctive treatment of focal-onset seizures: A systematic review and network meta-analysis.
Mulheron, Stuart; Leahy, Thomas P; McStravick, Megan; Doran, Rachael; Delanty, Norman.
Affiliation
  • Mulheron S; Angelini Pharma UK-I, Napier House, 24 High Holborn, London WC1V 6AZ, UK. Electronic address: stuart.mulheron@angelinipharma.com.
  • Leahy TP; Putnam Associates, LLC., Toronto, Canada.
  • McStravick M; Putnam Associates, LLC., Newcastle, UK.
  • Doran R; Putnam Associates, LLC., Newcastle, UK.
  • Delanty N; Beaumont Hospital, Dublin, Ireland.
Seizure ; 118: 80-90, 2024 May.
Article in En | MEDLINE | ID: mdl-38643679
ABSTRACT

PURPOSE:

To compare the efficacy, safety, and tolerability of cenobamate with other newer anti-seizure medications (ASMs) including brivaracetam, eslicarbazepine, lacosamide, perampanel, and zonisamide, approved for adjunctive treatment of drug-resistant focal-onset seizures (FOS) in adults with epilepsy.

METHODS:

A systematic literature review (SLR) was conducted to obtain relevant efficacy, safety, and tolerability data for ASMs for the treatment of drug-resistant FOS. All studies were thoroughly assessed for potential sources of heterogeneity and analysed via Bayesian network meta-analyses (NMAs). Efficacy outcomes were ≥50 % responder rate and seizure freedom during the maintenance period, which were modelled simultaneously using a multinomial Bayesian NMA. Safety and tolerability outcomes were the proportion of patients who experienced at least one treatment-emergent adverse event (TEAE) and the proportion who experienced at least one TEAE leading to discontinuation.

RESULTS:

The SLR identified 76 studies, of which 23 were included in the Bayesian NMAs. Cenobamate was associated with statistically significant higher rates for the ≥50 % responder rate and seizure freedom outcomes compared with all ASMs analysed. The point estimates indicated that cenobamate was associated with higher rates of experiencing at least one TEAE and at least one TEAE leading to discontinuation compared with brivaracetam, lacosamide, and zonisamide; however, no results were statistically significant.

CONCLUSION:

Cenobamate was associated with increased efficacy compared with all ASMs analysed. There were no statistically significant differences in the safety and tolerability outcomes. The results presented corroborate the conclusions drawn from previous published NMAs, which also highlight the notable efficacy of cenobamate in comparison with other ASMs.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Network Meta-Analysis / Anticonvulsants Limits: Humans Language: En Journal: Seizure Journal subject: NEUROLOGIA Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Network Meta-Analysis / Anticonvulsants Limits: Humans Language: En Journal: Seizure Journal subject: NEUROLOGIA Year: 2024 Document type: Article