Patient and Caregiver Preferences for Acute Seizure Medications: A Quantitative Survey
Cedric Laloyaux1, Tommi Tervonen2, Vicente Villanueva3, Joseph Sirven4, Alison Kukla5, Cecilia Jimenez-Moreno2, Kerrie-Anne Ho6
1UCB, Brussels, Belgium, 2Kielo Research, Zug, Switzerland, 3Universitario y Politecnico La Fe, Valencia, Spain, member of ERN EpiCARE, 4Mayo Clinic, Jacksonville, FL, USA, 5Partners Against Mortality in Epilepsy, Chicago, IL, USA, 6UCB, Slough, UK
Objective:
To explore the preferences of people with epilepsy/an epilepsy syndrome (PwE) and caregivers (CGs) for attributes of acute (on-demand) seizure medications.
Background:
Rapid and Early Seizure Termination (REST) medications prevent seizures from becoming prolonged/progressing in severity, while rescue medications treat seizures that have already prolonged/progressed.
Design/Methods:
Survey of PwE aged ≥18 years who had experienced ≥1 prolonged seizure (PS) of ≥2 minutes in the past 12 months and CGs (aged ≥18 years) of PwE aged ≥12 years from France/Italy/Poland/Spain/UK/US. A discrete choice experiment (DCE) was used to elicit treatment preferences (analyzed using multinomial logit models) and a willingness-to-wait exercise for administration of acute seizure medication.
Results:
135 adult PwE, 120 CGs of adults, 119 CGs of adolescents participated (N=374): median (Q1-Q3) age 45 (35-54) years, 242 (65%) female. Of 239 CGs, 133 (56%) were parents of PwE. Overall, 173 (46%) participants reported generalized or bilateral/tonic-clonic as their most common seizure type; 193 (52%) reported 3-5 seizures/month on average; and 214 (57%) reported an average duration of 1-4 minutes for the most common seizure type over past 12 months. 212 (57%) participants reported using oral acute medication for PS. In DCE, all attributes significantly influenced treatment preferences (p<0.05); most important was time to seizure cessation (relative attribute importance [RAI]=32.4%) and mode of administration (RAI=26.6%): nasal spray and single-use inhaler were most preferred; rectal was least preferred. Participants preferred treating early in the seizure and faster-acting medications. Willingness-to-wait exercise showed that 328 (88%) participants would be willing to wait 30 seconds (the minimum time proposed) to administer acute seizure medication.
Conclusions:
Adult PwE and CGs of adult and adolescent PwE value fast-acting acute seizure medications with non-rectal administration (nasal spray and single-use inhaler preferred), and would administer these early in the seizure. Results from the DCE suggest an unmet need with current acute treatments for PS.
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