Title: Beyond Clinical Trials: Cenobamate’s Effectiveness in Diverse Epilepsy Populations (P3-10.007)
Authors: Shenney Lin, Ana Leticia Fornari Caprara, Jamir Pitton Rissardo, April Pivonka, Kaitlyn Piotrowski, Omnea Elgendy, Matthew Petruncio, and Evren Burakgazi-Dalkilic
Conference: 2026 AAN, Chicago, IL
Objective
To evaluate real-world effectiveness of cenobamate in reducing seizure frequency and to characterize the demographic and clinical profiles of treated patients.
Background
Cenobamate is a recently approved anti-seizure medication for focal epilepsy, demonstrating robust efficacy in randomized controlled trials. However, clinical trial populations often exclude patients with multiple comorbidities or complex risk factors, limiting generalizability. Real-world evidence is essential to understand its effectiveness across diverse demographic groups and clinically challenging cases, including those with psychiatric comorbidities and developmental disorders.
Design/Methods
A retrospective cohort study was conducted involving 120 patients with focal epilepsy at a tertiary care center. Demographic data, seizure risk factors, and psychiatric comorbidities were extracted. Seizure frequency was assessed before and after at least one year of cenobamate therapy. Descriptive statistics were calculated, and a Wilcoxon signed-rank test was used to evaluate changes in seizure frequency.
Results
The cohort had a mean age of 39.4 ± 12.3 years, with 53.3% male participants and a diverse ethnic distribution (White 55%, Black 23.3%, Hispanic 11.7%, Asian 2.5%); notable risk factors included intellectual/developmental disability in 48.3%, traumatic brain injury in 19.2%, and a family history of epilepsy in 10.8%, while psychiatric comorbidities—particularly depression and anxiety—were common. Among patients with at least one year of follow-up on cenobamate (n = 57), seizure frequency decreased significantly from 2.5 ± 2.06 seizures per week before treatment to 1.7 ± 1.3 after treatment, representing a statistically significant reduction (Wilcoxon signed-rank test: W = 1.00, p = 0.0312).
Conclusions
Cenobamate significantly reduces seizures in a real-world, diverse patient population. Effective even in patients with psychiatric and developmental comorbidities. Supports broader use beyond clinical trials. Highlights need for prospective studies for long term outcomes and optimized treatment
Citation
Lin S, Caprara AL, Rissardo JP, Pivonka A, Piotrowski K, Elgendy O, Petruncio M, Burakgazi-Dalkilic E. Beyond Clinical Trials: Cenobamate’s Effectiveness in Diverse Epilepsy Populations (P3-10.007). Neurology 2026;106(11_suppl_1):2414. doi: 10.1212/WNL.0000000000215821.
Figure 1. Pie chart showing racial distribution of patients treated with cenobamate, highlighting a majority White cohort with representation across diverse ethnic groups.
Figure 2. Pie chart illustrating prevalence of psychiatric comorbidities, with depression and anxiety most common, followed by combined conditions and none/other.
Figure 3. Pie chart showing clinical risk factors, emphasizing high prevalence of intellectual/developmental disability and notable contributions from traumatic brain injury and family history.