VANCOUVER, BC—A network meta-analysis of 6 historical control studies found that eslicarbazepine acetate had the lowest odds of study discontinuation among evaluated anti-epileptic drug (AED) monotherapies, researchers presented at the 68th Annual AAN Meeting.
Study authors set out to compare study exit rates and all-cause discontinuations among antiepileptic monotherapies for refractory partial-onset seizures (POS) by conducting a Cochrane systematic review and a Bayesian network meta-analysis. A total of 13 studies were identified, 6 of which were historically controlled and 7 of which were pseudo-placebo controlled. Primary outcomes for the analysis were exit rate at end of study and total withdrawals, specified as discontinuation due to any reason from conversion phase onwards or all-cause discontinuation.
Each monotherapy displayed a statistically significant reduction in likelihood of study exit during maintenance phase compared to historical-controls: eslicarbazepine acetate 1200mg/day (odds ratio [OR] 0.05, 95% CI: 0.02–0.17), lamotrigine XR 300mg/day (OR 0.07, 95% CI: 0.02– 0.26); lacosamide 400mg/day (OR 0.08, 95% CI: 0.02–0.27); pregabalin 600mg/day (OR 0.09, 95% CI: 0.02–0.34); levetiracetam XR 2000mg/day (OR 0.11, 95%CI: 0.03–0.36).
“Similar results were obtained for discontinuations in the double-blind phase, except for pregabalin which showed higher likelihood of discontinuation conversion phase onward (OR 0.47, 95% CI: 0.1–2.15) and in all-cause discontinuation (OR 0.48, 95% CI: 0.1–2.26),” explained lead author, Fulton Velez, Director of Health Economics & Outcomes Research, Sunovion Pharmaceuticals, Marlborough, MA,
Eslicarbazepine acetate (Aptiom; Sunovion) tablets are currently approved by the Food and Drug Administration (FDA) for the once-daily treatment of POS as monotherapy or adjunctive therapy. Velez and coauthors were able to conclude that “eslicarbazepine acetate showed the lowest odds of study exit associated with worsening of seizure control, and the lowest odds of study discontinuation for all other reasons, compared to all evaluated comparators.”