Long Half-Life Antiepileptic Drugs Reduce Hospitalization in Uncontrolled Epilepsy

The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.

PHILADELPHIA — The risk of hospitalization among those with uncontrolled epilepsy is significantly reduced with the use of a long half-life antiepileptic drug instead of a short half-life antiepileptic drug, according to research presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, 2019, in Philadelphia, Pennsylvania.

This longitudinal, retrospective cohort study included 6158 individuals with uncontrolled epilepsy from the Symphony Health Solution Patient Integrated Dataverse. All participants were at least 12 years old, had at least 2 medical claims 1 month or more apart, and were initiated on an adjunctive antiepileptic drug in which the prescription date was also the index date.

The study took place between August 2012 and July 2017. Categorization was performed on the basis of index antiepileptic drug half-life, with participants stratified into <20-hour (short half-life, n=2279) or >20-hour (long half-life, n=2705) groups. To calculate relative risk for all-cause hospitalization, Poisson regressions were utilized with strong error variances.

Those in the long half-life cohort had a significantly lower relative risk for hospitalization compared with those in the short half-life cohort at the one-year post-index date (0.81 [95% CI, 0.73-0.89]; P <.001). Those in the long half-life cohort were significantly younger than those in the short half-life cohort, with a mean age of 43.9±18.5 vs 49.2±17.2 years, respectively (P <.001). They also had fewer comorbidities than the short half-life cohort, with a respective Charlson Comorbidity Index of 1.2±1.8 vs 1.8±2.2 (P <.001).

The study researchers conclude that “[in] patients with uncontrolled epilepsy who were initiated on an adjunctive [antiepileptic drug], the choice of a [long half-life] vs [short half-life antiepileptic drug] was associated with a significantly lower risk of hospitalization.”

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Reference

Cramer J, Yan J, Tieu R, et al. Risk of hospitalization in patients with uncontrolled epilepsy treated with a long versus short half-life adjunctive antiepileptic medication. Presented at: 2019 American Academy of Neurology Annual Meeting; May 4-10, 2019; Philadelphia, PA.