Objective:

To evaluate the impact of 90-day and 360-day zero-seizure intervals on inpatient (IP) and emergency room (ER) encounters) retrospectively.

Background:

Patients with uncontrolled seizures are burdened by decreased overall health and quality-of-life and utilize more healthcare resources.

Design/Methods:

De-identified electronic health records from the Truveta database identified adults (≥18 years) who initiated cenobamate between 1/1/2020-4/12/2025. Patients were included if they had any encounter (office visit, IP, ER; including non-epilepsy related) ≥180 days before initiating cenobamate and had any type of medication dispensed or requested in the ≥360 days before initiation. Depending on the zero-seizure interval that was measured, patients were required to have at least one seizure observation-related encounter at least 90 or 360 days post-completion of a 90-day enrollment period. Zero-seizure status was calculated by taking the difference in time between the last available encounter date (regardless of ongoing cenobamate use) where seizures were measured (seizures could be ≥0) and the last date of an observed seizure (seizures must be >0). If those time differences were ≥90 or ≥360 days, this was transformed into a binary variable. The frequency of all-cause and epilepsy-related IP and ER encounters for the subsequent follow-up period, up to 360 days, were summed and transformed into annual rates. 

Results:

669 and 361 patients were included in the 90-day and the 360-day zero seizures analyses, respectively. All subsequent all-cause and epilepsy-related IP and ER rates were significantly reduced for patients with 90-day zero-seizure intervals (ranging from 36% for all-cause ER to 78% for epilepsy-related ER) and 360-day zero-seizure intervals (ranging from 67% for all cause ER to 94% for epilepsy-related IP) vs those without a 90- or 360-day zero-seizure interval.

Conclusions: