{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:16:39Z","timestamp":1780330599570,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To gather real\u2010world evidence on antiseizure medications (ASMs) treatment patterns and related outcomes in patients with drug\u2010resistant focal epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical insurance claims from the start of 2014 till the end of 2019 were used. Patient selection criteria included International Classification of Diseases (ICD) codes followed by documented ASM use. Baseline patient demographics along with ASM and rescue medication use patterns and related patient outcome were documented for first (index) ASM regimen. Patients who failed the first regimen and then failed the second regimen were considered drug resistant. Multivariate analyses were performed to identify risks and other characteristics for positive or negative treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Study cohort consisted of 46\u2009474 patients with a mean age of 47.23 (SD: 16.94). Levetiracetam was the most first\u2010encountered ASM (37.94%). At baseline, 87.14% were treated with ASMs prior to having study\u2010confirmed diagnoses. Mental comorbidities were present in 37.86% of patients. After first\u2010year ASM treatment, 34.61% of patients persisted on their index regimen and 5.91% were seizure\u2010free. Patients failing first ASM regimen numbered 12\u2009868 (27.69%). Drug\u2010resistant patients who failed first and then second ASM regimens numbered 6335 (49.23%). Percentages of patients who had successful second treatment and seizure\u2010free were 21.32 and 3.65, respectively.<\/jats:p><jats:p>Initiating patients on lamotrigine or carbamazepine (relative to levetiracetam), baseline use of index ASM, rescue medications, and older age or male gender all lowered the risk for treatment failure. Having higher comorbidity, comorbid mental illness, headache, or neoplasty increased such a risk. Baseline use of index ASM, depressive episode, or anxiety disorder all entailed higher risk of failing second ASM treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Overall, reported findings indicated that patient history at baseline and the early selection of an ASM all influenced treatment outcomes. Findings pointed to the complex nature of ASM treatment in drug\u2010resistant focal epilepsy patients calling for additional research to identify the optimal treatment to achieve beneficial patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12845","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T08:26:37Z","timestamp":1697444797000},"page":"1556-1565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Real\u2010world antiseizure medication treatment outcomes in drug\u2010resistant focal epilepsy patients"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2147-6954","authenticated-orcid":false,"given":"Hind T.","family":"Hatoum","sequence":"first","affiliation":[{"name":"Pharmacy Systems Outcomes and Policy University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Arcona","sequence":"additional","affiliation":[{"name":"Global Value &amp; Access, Cerevel Therapeutics  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbin","family":"Mao","sequence":"additional","affiliation":[{"name":"Global Value &amp; Access, Cerevel Therapeutics  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surrey","family":"Walton","sequence":"additional","affiliation":[{"name":"Pharmacy Systems Outcomes and Policy University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10600"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000503831"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2020.20111"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028020948056"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3949"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119431893.ch5"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.5698\/1535\u20107597.18.4s1.1"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016402"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.777888"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2012.751918"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-814877-8.00002-7"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(15)00225\u20102"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107426"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13817"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007004"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2020.106414"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-04898-2_111"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2015.12.039"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12845","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T10:37:33Z","timestamp":1702723053000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.12845"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,31]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/epi4.12845"],"URL":"https:\/\/doi.org\/10.1002\/epi4.12845","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,31]]},"assertion":[{"value":"2023-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}