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The Potential of cenobamate ▼ in Uncontrolled Focal Epilepsy

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Pubblished: 04/06/2025

5 minutes

Article

This webpage is intended for UK and Irish healthcare professionals. Prescribing information is available here.

 

ONTOZRY®: shifting the paradigm from “later-line” to early adoption (after 2 ASMs)

Despite over 25 years of advancements in anti-seizure medications (ASMs), over 35% of patients continue to experience uncontrolled seizures1, and the probability of achieving seizure freedom diminishes substantially with each subsequent ASM regimen tried.2 This highlights the need to revitalise the development of ASMs to discover more effective drugs for the treatment of drug-resistant epilepsy.3 

In a study, Winter et al. conducted a single-center observational analysis involving 231 patients with drug-resistant epilepsy (DRE), focusing on the use of CNB▼ as an early adjunctive treatment. The study focused on patients who had failed two or three prior ASMs. Patients were matched (1:2)  by sex, age, and types and frequency of seizures to a comparator group who did not respond to two or three prior ASMs and initiated with any other adjunctive ASM. The comparator group (n=154) included lacosamide (n=40), levetiracetam (n=38), topiramate▼ (n=32), and valproate▼ (n=44).4 

Cenobamate as an early adjunctive add-on therapy vs. other ASMs: data for clinical practice  

Winter's study revealed that the highest 12-month retention rate was observed with CNB▼ (92.0%, n=71/77), compared with all other ASMs, followed by lacosamide (80.0%, n=32/40), levetiracetam (73.3%, n=28/38), sodium valproate▼ (68.2%, n=30/44), and topiramate▼ (62.5%, n=20/32).4 

 

The gold standard in treatment comparison is head-to-head randomised clinical trials. Caution should be exercised when interpreting these observational data.

 

UK: ONTOZRY®▼  is indicated for the adjunctive treatment of focal-onset seizures with or without secondary generalisation in adult patients with epilepsy who have not been adequately controlled, despite treatment with at least 2 anti-epileptic medicinal products5

ROI: ONTOZRY®▼  is indicated for the adjunctive treatment of focal-onset seizures with or without secondary generalisation in adult patients with epilepsy who have not been adequately controlled despite a history of treatment with at least 2 anti-epileptic medicinal products5

 

 

MAT-UKI-0203-P  May 2025

 

  1. Wheless JW. Adjunctive cenobamate for the treatment of focal onset seizures in adults with epilepsy: a critical review. Expert Review of Neurotherapeutics. 2020 Nov 1;20(11):1085-98.
  2. Chen Z, et al. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study. JAMA neurology. 2018 Mar 1;75(3):279-86. 
  3. Schmidt D, Schachter SC. Drug treatment of epilepsy in adults. Bmj. 2014 Feb 28;348.
  4. Winter Y, et al. Cenobamate as an Early Adjunctive Treatment in Drug-Resistant Focal-Onset Seizures: An Observational Cohort Study. CNS Drugs. 2024 Sep;38(9):733-742. 
  5. ONTOZRY® Summary of Product Characteristics. United Kingdom and European Union

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