Eslicarbazepine Acetate Well Tolerated, Effective in Post-Stroke Epilepsy
According to the study investigators, cerebrovascular disease may account for approximately 50% of new cases of epilepsy in patients older than age 65.
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Eslicarbazepine acetate (ESL) is well tolerated and possibly effective for treating patients with post-stroke epilepsy, according to research presented at the 2018 American Epilepsy Society meeting held in New Orleans, Louisiana, from November 30 to December 4.
“Cerebrovascular disease may account for almost 50% of new cases of epilepsy in patients older than age 65,” the study investigators reported. “A recent systematic review with network metanalysis of randomized controlled trials of antiepileptic drugs for the treatment of post-stroke epilepsy was inconclusive due to the small number of trials (n=2) included. Our aim was to conduct an exploratory subgroup analysis of data from patients included in Euro-Esli study to evaluate the efficacy, safety, and tolerability of [ESL] in post-stroke epilepsy.”
Data from 14 European clinical practice studies were pooled to analyze the efficacy and tolerability of ESL in 1656 patients with seizures. Of the entire cohort, only 76 patients (4.6%) had post-stroke epilepsy. Researchers evaluated the responder rate (individuals who had a ≥50% reduction in seizure frequency from baseline) and seizure freedom (freedom from seizures since at least previous visit) at 3, 6, and 12 months, and at last visit if follow-up lasted >1 year.
Adverse events (AEs) and AEs that contributed to ESL discontinuation were monitored throughout the study. In addition, the researchers assessed a subgroup of patients with vascular vs nonvascular epilepsy etiology.
Patients with post-stroke epilepsy were significantly older than those without post-stroke epilepsy (60.4 vs 42.9 years; P =.003). A greater proportion of responders were patients with vs without post-stroke epilepsy (72.9% vs 60.6%; P =.04).
There were no significant differences between the 2 groups with regard to rate of AEs (36.0% vs 35.8%; P =.966) or rate of treatment discontinuation because of AEs (6.8% vs 14.5%; P =.063). The proportion of patients who discontinued therapy at 12 months was higher among patients without post-stroke epilepsy vs those with epilepsy with vascular etiology (22.6% vs 12.2%, respectively; P =.035).
“[In] patients treated in [a] real-world clinical setting in Europe, ESL was effective and well tolerated in a small subgroup of patients with post-stroke epilepsy,” concluded the investigators.
Chaves J, Sales F, Villanueva V, McMurray R, Loureiro R, Fernandes H. Efficacy, safety and tolerability of eslicarbazepine acetate in post-stroke epilepsy: real-world evidence from the Euro-Esli study. Presented at: 2018 American Epilepsy Society meeting; November 29-December 4, 2018; New Orleans, LA. Abstract 2.465.