Purpose: Cenobamate is a drug approved by the European Medicines Agency in 2021 as adjunctive therapy for seizures in adults with drug-resistant epilepsy inadequately controlled by at least two antiepileptic drugs. Its exact mechanism of action remains unclear. Cenobamate is prescribed in a titrated dosage, starting at 12.5mg/day and increasing up to 400mg/day. This study aims to evaluate drug utilization, therapeutic adherence, and quality of life (QoL) improvements in patients who received cenobamate from an Italian pharmacy, following prescription appropriateness assessments. Methods: Cenobamate disbursements from September 2022 to May 2024 were analyzed to evaluate therapeutic adherence and QoL, using an anonymous questionnaire based on the Morisky scale. Data collected included patient demographics(age, gender, epilepsy type, polytherapy with other antiseizure drugs),compliance, and adherence. Results: The study included 34 patients with focal structural, drug-resistant epilepsy, including one off-label prescription for early childhood epileptic encephalopathy.Of the cohort, 56% were female and 44% male, with a mean age of 38.5 years. Age distribution was as follows:59% were aged 30–50 years, 20%(18–30 years), 18% aged >50 years, and 3%(0–18 years), all with childhood-onset conditions. To date, 28 patients remained adherent to therapy; two discontinued due to comorbidities (chemotherapy, kidney problems), three due to ineffectiveness or adverse reactions, and one never initiated treatment. Questionnaire analysis showed that 20 patients had high adherence, 6 intermediate, and 1 low. Polypharmacy data revealed that 9 patients combined one additional antiseizure drug, 12 combined two, 4 combined three, and 2 combined four drugs. Most patients were not autonomous in daily activities.71.4% reported QoL improvements, including reduced seizure frequency.Conversely, 25% of adherent patients reported no QoL improvement despite treatment. Conclusion: This study highlights the efficacy and safety of cenobamate, supporting its value as a new therapeutic option for drug-resistant epilepsy. The high prescription appropriateness underscores the critical role of pharmacists in monitoring and optimizing emerging therapies.
Cenobamate treatment for drug-resistant epilepsy: a quality of life and drug utilization study from an italian pharmacy
Giorgia Dinoi;Paola Imbrici;Antonella Liantonio;Domenico Tricarico;
2025-01-01
Abstract
Purpose: Cenobamate is a drug approved by the European Medicines Agency in 2021 as adjunctive therapy for seizures in adults with drug-resistant epilepsy inadequately controlled by at least two antiepileptic drugs. Its exact mechanism of action remains unclear. Cenobamate is prescribed in a titrated dosage, starting at 12.5mg/day and increasing up to 400mg/day. This study aims to evaluate drug utilization, therapeutic adherence, and quality of life (QoL) improvements in patients who received cenobamate from an Italian pharmacy, following prescription appropriateness assessments. Methods: Cenobamate disbursements from September 2022 to May 2024 were analyzed to evaluate therapeutic adherence and QoL, using an anonymous questionnaire based on the Morisky scale. Data collected included patient demographics(age, gender, epilepsy type, polytherapy with other antiseizure drugs),compliance, and adherence. Results: The study included 34 patients with focal structural, drug-resistant epilepsy, including one off-label prescription for early childhood epileptic encephalopathy.Of the cohort, 56% were female and 44% male, with a mean age of 38.5 years. Age distribution was as follows:59% were aged 30–50 years, 20%(18–30 years), 18% aged >50 years, and 3%(0–18 years), all with childhood-onset conditions. To date, 28 patients remained adherent to therapy; two discontinued due to comorbidities (chemotherapy, kidney problems), three due to ineffectiveness or adverse reactions, and one never initiated treatment. Questionnaire analysis showed that 20 patients had high adherence, 6 intermediate, and 1 low. Polypharmacy data revealed that 9 patients combined one additional antiseizure drug, 12 combined two, 4 combined three, and 2 combined four drugs. Most patients were not autonomous in daily activities.71.4% reported QoL improvements, including reduced seizure frequency.Conversely, 25% of adherent patients reported no QoL improvement despite treatment. Conclusion: This study highlights the efficacy and safety of cenobamate, supporting its value as a new therapeutic option for drug-resistant epilepsy. The high prescription appropriateness underscores the critical role of pharmacists in monitoring and optimizing emerging therapies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
