Abstracts

Rationale: Eslicarbazepine acetate (ESL), a member of the dibenzazepine family, is a new antiepileptic drug (AED). Once daily dosing, a lack of major enzyme inducing activity, and a reported decreased side effect profile make ESL an interesting alternative AED for treating partial epilepsy. Although recent clinical trials have confirmed the efficacy and tolerability of ESL, more research is needed to translate those results into clinical practice. In this study, we aimed to assess the safety, efficacy, and retention of ESL in adults with refractory epilepsy at two large tertiary epilepsy centers. Methods: We retrospectively reviewed 51 outpatients prescribed ESL as part of their antiepileptic drug regimen at Yale or Columbia Comprehensive Epilepsy Center from January 2014 until March 2016. Detailed collection of demographic and clinical data including seizure types, treatment regimens, efficacy, six- and twelve-month retention rates and adverse effects were performed. Results: 41.2% patients were male and 58.8% were female with a mean age of 42.7 16.3. The mean age at seizure onset was 17.1 18. The majority of patients had focal epilepsy (92.2%). Patients had attempted a mean of 6.2 3.1 AEDs before being started on ESL. Mean duration of ESL therapy was 6 5.15 months with an average dose of 1002 mg /daily while on a stable drug regimen. During ESL treatment, patients were concurrently on an average of 3 1 other AEDs. 8 patients used ESL as monotherapy. 6- and 12-month retention rate were 57.6% (19/33) and 54.5% (6/11), respectively. 2 patients reached 6-month seizure freedom, while 2 others remained seizure free but have not been on ESL for 6 months. 1 patient reached 12-months seizure freedom. 43.1% of patients had an adverse effect attributed specifically to ESL with dizziness (17.6%), ataxia (11.8%) and GI symptoms (11.8%) being the most common; in 37.3% of patients the side effects led to dose reduction, and to cessation of ESL in 27.5%. Hyponatremia ( < 135) was seen in two patients. No patients experienced a rash or behavioral changes while 2 patients suffered from cognitive adverse effects. Conclusions: Our study demonstrated good retention rates with half of the patients staying on ESL for at least one year. Adverse events were not uncommon, but rash and behavioral changes were not seen. More investigation is needed to assess the role of ESL in monotherapy and to determine predictors of adverse effects, including use of particular drug combinations. Funding: Eisai Pharmaceuticals, Sunovion Pharmaceuticals