{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:16:55Z","timestamp":1780715815204,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the single\u2010center experience of Cenobamate's (CNB) off\u2010label use in adults with idiopathic generalized epilepsy (IGE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of electronic health records within a large healthcare system to identify IGE patients prescribed CNB. Extensive clinical and medication\u2010related data were extracted, including monthly seizure frequency at baseline, 3, 6, and 12\u2009months, and at last follow\u2010up. We used CNB retention, a marker of its potential effectiveness and tolerability, for 12\u2009months as the primary outcome of interest. Statistical analysis, including Kaplan\u2013Meier 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixteen IGE patients (median age\u2009=\u200936\u2009years; 11 females) treated with CNB were included. Twelve (75%) had JME. Median epilepsy duration was 18\u2009years, and a median of 8 ASMs were tried before CNB use. Among the 14 patients with at least a 12\u2010month follow\u2010up, 8 (57%) achieved the primary outcome. Median CNB retention based on survival analysis was 34\u2009months, and 31% of patients stopped CNB within 3\u2009months. At 3, 6, and 12\u2009months, \u226550% seizure reduction was seen in 75%, 86%, and 63% of patients, respectively. Of 8 patients on CNB at last follow\u2010up (median CNB use of 21\u2009months), 3 (38%) were seizure\u2010free. Median ER visits declined significantly in the 6\u2009months post\u2010CNB (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028; Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.66). 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The study found CNB's use in IGE to be effective, including decreased ER visits. These findings provide preliminary evidence to suggest that off\u2010label use of CNB can be considered in drug\u2010resistant IGE patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Cenobamate (CNB), an anti\u2010seizure medicine, was studied for off\u2010label use in 16 adults with drug\u2010resistant idiopathic generalized epilepsy (IGE). Most had juvenile myoclonic epilepsy and long\u2010standing seizures despite many prior treatments. Over half continued CNB for at least 12\u2009months, and around 30% stopped within 3\u2009months. At 3, 6, and 12\u2009months, 63%\u201386% had at least 50% fewer seizures; three patients became seizure\u2010free. 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\u2010to\u2010treat IGE, warranting further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70157","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:19:02Z","timestamp":1759882742000},"page":"1871-1882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Using Cenobamate for managing idiopathic generalized epilepsy: A single\u2010center experience and systematic literature review"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6374-9542","authenticated-orcid":false,"given":"Nicole","family":"Woodrich","sequence":"first","affiliation":[{"name":"Epilepsy Center, Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0214-3286","authenticated-orcid":false,"given":"Andreas","family":"Alexopoulos","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9663-7222","authenticated-orcid":false,"given":"Dileep","family":"Nair","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5192-2089","authenticated-orcid":false,"given":"Imad M.","family":"Najm","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-6736","authenticated-orcid":false,"given":"Vineet","family":"Punia","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17236"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17410"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12671"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00583-9"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208076"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2025.03.012"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1177\/2050313X251324079","article-title":"Successful treatment of pediatric patient with Dravet syndrome with cenobamate: case report","volume":"13","author":"Lobanov OV","year":"2025","journal-title":"SAGE Open Med Case Rep"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200133"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12510-1"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18308"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18257"},{"key":"e_1_2_10_13_1","unstructured":"Epic Interoperability. 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