Antiseizure Medication Treatment Patterns, Reasons for Disruption & Side Effects For Patients With Dravet Syndrome Or Lennox-Gastaut Syndrome: A Retrospective Analysis Of U.S. Physician Notes 

This poster was originally presented at the American Epilepsy Society (AES) Annual Meeting on December 1-5, 2023, in Orlando, FL.  

Introduction 

Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) are 2 rare epileptic syndromes that manifest with unpredictable, frequent seizures and are associated with a wide range of developmental delays. The objective of this study is to describe real-world treatment patterns for patients with DS or LGS, including antiseizure medication (ASM) use (frequency and reasons for ASM treatment disruptions, side effects, and safety monitoring) and non-ASM use. 

Methods  

• This was a retrospective study using the Amplity AnswerY™ (formerly known as Amplity Insights) unstructured medical transcription records of routine care in the United States from January 2010 to January 2022 

• The database included approximately 55 million records from interactions of approximately 25 million patients with 150,000 multispecialty physicians 

• NLP logic was leveraged to retrospectively analyze the transcription records in the database to identify patients with confirmed DS or LGS, based on symptoms and/or genetic or electroencephalography findings, and treatment with ≥1 ASM 

Results 

• Combination ASM therapy was recorded by 67% of patients with DS and 58% of patients with LGS 

• Side effects or adverse events were reported by 38 (23%) and 246 (23%) patients with DS or LGS, respectively. The most common side effects included drowsiness, somnolence, and sedation

Side Effects In Patients With DS Or LGS Treated With ASM

• Overall, 65 (39%) patients with DS and 302 (28%) patients with LGS had at least 1 ASM treatment disruption. Treatment disruptions were broadly categorized into discontinuation (DS: 48%; LGS: 55%), switching (DS: 57%; LGS: 45%), dose decreasing (DS: 28%; LGS: 38%), and tapering/weaning (DS: 9%; LGS: 13%) 

• Safety and clinical monitoring included blood pressure, blood labs, ASM drug-level checks, weight checks, and genetic testing  

Non-ASM Treatments 

• Dietary therapy was most reported (DS: 23%; LGS: 16%), with frequent use of the keto diet (DS: 20%; LGS: 14%)  

• Other therapies like occupational, physical, or speech to address developmental delays were used by 16% of patients with DS and 14% of patients with LGS  

• Surgical interventions were reported by 1% and 8% of patients with DS or LGS, respectively 

Limitations 

• Due to lack of longitudinal follow-up of the transcription records, there is a possibility of not fully understanding the patient’s evolving treatment pattern and medical conditions related to ASM use  

• Underreporting of ASM/non-ASM and ASM treatment disruptions are possible due to the limited sensitivity of search terms used for NLP queries and/or limited documentation in the transcription notes 

Conclusions  

• Current treatment options for refractory epileptic conditions DS or LGS with broad-spectrum ASMs, adjunct ASMs, dietary therapies, and surgery are limited by inadequate seizure control, tolerability, and safety  

• Based on AnswerY, this real-world study suggests that patients may benefit from more effective and tolerable ASMs  

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