Tim Wehner1, Suganthi Chinnasami2, Jan Novy3, Gail S Bell4, John S Duncan5, Josemir W Sander6. 1. NIHR University College London Hospitals Biomedical Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom; Epilepsy Society, Chalfont St Peter SL9 0RJ, United Kingdom. Electronic address: tim.wehner@uclh.nhs.uk. 2. NIHR University College London Hospitals Biomedical Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom. Electronic address: dr.chinnasami.suganthi@gmail.com. 3. NIHR University College London Hospitals Biomedical Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom; Epilepsy Society, Chalfont St Peter SL9 0RJ, United Kingdom; Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, CH-1011 Lausanne, Switzerland. Electronic address: jan.novy@chuv.ch. 4. NIHR University College London Hospitals Biomedical Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom; Epilepsy Society, Chalfont St Peter SL9 0RJ, United Kingdom. Electronic address: gail.bell@ucl.ac.uk. 5. NIHR University College London Hospitals Biomedical Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom; Epilepsy Society, Chalfont St Peter SL9 0RJ, United Kingdom. Electronic address: j.duncan@ucl.ac.uk. 6. NIHR University College London Hospitals Biomedical Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom; Epilepsy Society, Chalfont St Peter SL9 0RJ, United Kingdom; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, 2103 SW Heemstede, Netherlands. Electronic address: l.sander@ucl.ac.uk.
Abstract
PURPOSE: To assess the utility of retigabine (RTG) for epilepsy in clinical practice at a single UK tertiary centre. METHODS: We identified all individuals who were offered RTG from April 2011 to May 2013. We collected demographics, seizure types, previous and current antiepileptic drugs (AEDs), starting and maximum attained daily dose of RTG, clinical benefits, side effects, and reason to discontinue RTG from in- and outpatient encounters until February 28, 2014. RESULTS: 145 people who had failed a median of 11 AEDs took at least one dose of RTG. One year retention was 32% and decreased following the safety alert by the US Federal Drug Administration (FDA) in April 2013. None became seizure free. 34 people (24%) reported a benefit that was ongoing at last assessment in five (3%). The most relevant benefit was the significant reduction or cessation of drop attacks or seizure-related falls in four women, this persisted at last assessment in two. The presence of simple partial seizures was associated with longer retention, as was a higher attained dose of RTG. Adverse effects were seen in 74% and largely CNS-related or nonspecific and affected the genitourinary system in 13%. CONCLUSION: Retention of RTG was less favourable compared to data from open label extension studies of the regulatory trials. In comparison with historical data on similar retention audits retention of RTG at one year appears to be less than lamotrigine, topiramate, levetiracetam, pregabalin, zonisamide, and lacosamide, and slightly higher than gabapentin.
PURPOSE: To assess the utility of retigabine (RTG) for epilepsy in clinical practice at a single UK tertiary centre. METHODS: We identified all individuals who were offered RTG from April 2011 to May 2013. We collected demographics, seizure types, previous and current antiepileptic drugs (AEDs), starting and maximum attained daily dose of RTG, clinical benefits, side effects, and reason to discontinue RTG from in- and outpatient encounters until February 28, 2014. RESULTS: 145 people who had failed a median of 11 AEDs took at least one dose of RTG. One year retention was 32% and decreased following the safety alert by the US Federal Drug Administration (FDA) in April 2013. None became seizure free. 34 people (24%) reported a benefit that was ongoing at last assessment in five (3%). The most relevant benefit was the significant reduction or cessation of drop attacks or seizure-related falls in four women, this persisted at last assessment in two. The presence of simple partial seizures was associated with longer retention, as was a higher attained dose of RTG. Adverse effects were seen in 74% and largely CNS-related or nonspecific and affected the genitourinary system in 13%. CONCLUSION: Retention of RTG was less favourable compared to data from open label extension studies of the regulatory trials. In comparison with historical data on similar retention audits retention of RTG at one year appears to be less than lamotrigine, topiramate, levetiracetam, pregabalin, zonisamide, and lacosamide, and slightly higher than gabapentin.