Seizure frequency reduced at 1 year in treatment-resistant focal epilepsy

Key takeaways:

• Researchers analyzed self-reporting seizure data from 154 individuals with treatment-resistant focal epilepsy.
• Seizure reduction was significant and steady after 1 year compared with baseline.

ORLANDO — Individuals with treatment-resistant focal epilepsy that required multiple antiseizure medications saw their seizure frequency significantly reduced after 1 year, according to a poster.

“We were interested in investigating whether, over the course of a patient’s journey, they’re improving over time,” Caitlin L. Grzeskowiak, PhD, vice president of research and innovation at the Epilepsy Foundation, told Healio during a presentation at the American Epilepsy Society annual meeting.

Prior research into open-label long-term extension studies of novel therapeutics suggests that those with treatment-resistant epilepsy improve over time, so Grzeskowiak and colleagues sought to examine the hypothesis through the Human Epilepsy Project 2 (HEP2) clinical trial to identify treatment response.

The prospective, observational, multicenter, U.S.-based study included 154 participants (57.4% female, 71.3% white) diagnosed with focal epilepsy. Included patients experienced at least two seizures per month, were taking at least one antiseizure medication (ASM) and had failed four prior trials with ASMs, at least two of which were due to lack of seizure control. Follow-up continued to 36 months.

Data on seizure frequency for each participant was obtained through daily seizure diaries, monthly check-ins and existing medical records, with comparison between the first and second halves of the follow-up acting as a dropout confounder. To address the disparities in length, time and amount of follow-up, researchers divided the diary entries into three separate time cohorts: fewer than 12 months, 12 to 24 months and more than 24 months.

A total of 128 participants provided full seizure frequency data.

According to results, 55% of the study population added an ASM during the observation period, while 68.2% of participants logged seizure frequency reduction in the second half of their respective follow-up when compared with the first half.

In each of the three time cohorts, data showed negative sloping, which indicated continued improvement over time, with predictive values after 1 year of seizure reduction in Cohort 1 from an average of 14 seizures at baseline to an average of 5.5, in Cohort 2 from 16.5 to 12.6 and in Cohort 3 from 29.5 to 14.4.

“We see that patients are improving over time based on their ongoing active management in a regular clinical setting,” Grzeskowiak told Healio.