Evidence map›Paper›PMID 41056140›Full record

SynthesisEpilepsia open2025

Using Cenobamate for managing idiopathic generalized epilepsy: A single-center experience and systematic literature review.

Nicole Woodrich, Andreas Alexopoulos, Dileep Nair, Imad M Najm, Vineet Punia

Abstract readSystematic Review
In one paragraph

Synthesis in Epilepsia open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nicole WoodrichEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0009-0004-6374-9542
Andreas AlexopoulosEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0003-0214-3286
Dileep NairEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-9663-7222
Imad M NajmEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-5192-2089
Vineet PuniaEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-0552-6736

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the single-center experience of Cenobamate's (CNB) off-label use in adults with idiopathic generalized epilepsy (IGE).

methodsWe conducted a retrospective review of electronic health records within a large healthcare system to identify IGE patients prescribed CNB. Extensive clinical and medication-related data were extracted, including monthly seizure frequency at baseline, 3, 6, and 12 months, and at last follow-up. We used CNB retention, a marker of its potential effectiveness and tolerability, for 12 months as the primary outcome of interest. Statistical analysis, including Kaplan-Meier survival analysis, was performed to estimate CNB retention over time. We also performed a systematic literature review investigating seizure reduction after CNB use in IGE.

resultsSixteen IGE patients (median age = 36 years; 11 females) treated with CNB were included. Twelve (75%) had JME. Median epilepsy duration was 18 years, and a median of 8 ASMs were tried before CNB use. Among the 14 patients with at least a 12-month follow-up, 8 (57%) achieved the primary outcome. Median CNB retention based on survival analysis was 34 months, and 31% of patients stopped CNB within 3 months. At 3, 6, and 12 months, ≥50% seizure reduction was seen in 75%, 86%, and 63% of patients, respectively. Of 8 patients on CNB at last follow-up (median CNB use of 21 months), 3 (38%) were seizure-free. Median ER visits declined significantly in the 6 months post-CNB (p = 0.028; Cohen's d = 0.66). Fatigue, dizziness, and cognitive symptoms were the most frequently reported adverse effects. Systematic review revealed 3 articles with 4 IGE patients whose seizure outcomes were similar to our findings. SIGNIFICANCE: The study found CNB's use in IGE to be effective, including decreased ER visits. These findings provide preliminary evidence to suggest that off-label use of CNB can be considered in drug-resistant IGE patients. PLAIN LANGUAGE SUMMARY: Cenobamate (CNB), an anti-seizure medicine, was studied for off-label use in 16 adults with drug-resistant idiopathic generalized epilepsy (IGE). Most had juvenile myoclonic epilepsy and long-standing seizures despite many prior treatments. Over half continued CNB for at least 12 months, and around 30% stopped within 3 months. At 3, 6, and 12 months, 63%-86% had at least 50% fewer seizures; three patients became seizure-free. Emergency visits dropped significantly after starting CNB. Common side effects were fatigue, dizziness, and cognitive issues. These findings suggest CNB can help reduce seizures and healthcare use in adults with difficult-to-treat IGE, warranting further study.

Indexed as

AnticonvulsantsCarbamatesEpilepsy, GeneralizedAdultChlorophenolsFemaleHumansMaleMiddle AgedNitrilesOff-Label UseRetrospective StudiesTetrazolesTreatment OutcomeYoung AdultAnticonvulsantsCarbamatesCenobamateChlorophenolsNitrilesTetrazolesantiseizure medicationCenobamategeneralized epilepsyhealthcare utilization

Identifiers

PMID41056140
PMCPMC12716304

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.