ABSTRACT
AIM: The aim of the study was to evaluate the effectiveness and tolerability of eslicarbazepine acetate (ESL) when used as monotherapy for 1â¯year or more in routine clinical use in patients with focal seizures in epilepsy clinics in Spain. METHODS: This is a retrospective, observational, noninterventional study. Eligible patients were aged ≥18â¯years, had focal seizures, and started on ESL ≥1â¯year before database closure. Primary endpoint was the following: proportion seizure-free for ≥6â¯months at 1 and 2â¯years. Secondary endpoints included retention on ESL monotherapy at 1 and 2â¯years, seizure frequency change, seizure worsening, and side effects. Other analyses included seizure freedom from baseline to 1 and 2â¯years and outcomes in special populations. RESULTS: Four hundred thirty-five patients were included (127 on first-line monotherapy and 308 converting to ESL monotherapy): median daily dose was 800â¯mg at all time points; 63.2% were seizure-free at 1â¯year, 65.1% at 2â¯years, and 50.3% for the entire follow-up. Mean duration of ESL monotherapy was 66.7â¯months; retention was 88.0% at 1â¯year and 81.9% at 2â¯years. Mean reduction in seizure frequency was 75.5% at last visit. Over the entire follow-up, seizure worsening was seen in 22 patients (5.1%), side effects in 28.0%, considered severe in 1.8%, and leading to discontinuation in 5.7%. Dizziness, hyponatremia (sodium <135â¯mEq/l), and somnolence were the most frequent side effects. Outcomes in special populations (patients aged ≥65â¯years and those with psychiatric history or learning difficulty) were consistent with the overall population. CONCLUSIONS: Patients with focal seizures taking ESL monotherapy had excellent retention, high seizure-free rates, and good tolerability up to 2â¯years.
