{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:56Z","timestamp":1792471136514,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the 12\u2010month clinical impact of cenobamate (CNB) in adults with drug\u2010resistant focal epilepsy in clinical practice, exploring whether outcomes differed according to prior antiseizure medication (ASM) exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center, retrospective, observational, real\u2010world study included 91 adults stratified by the number of prior ASMs: \u2264\u20096 prior ASMs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944) and &gt;\u20096 prior ASMs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200947). Outcomes assessed at 3, 6, and 12\u2009months included monthly seizure frequency, seizure freedom, retention rate, CNB dose, concomitant ASM burden, and adverse drug reactions (ADRs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the overall cohort, mean monthly seizure frequency decreased from 28.77 at baseline to 22.73 (3\u2009months), 19.37 (6\u2009months), and 14.58 (12\u2009months), representing mean reductions of 21%, 33%, and 49%, respectively. Seizure freedom was achieved by 12% (11\/91) of patients at 3\u2009months, 13% (11\/87) at 6\u2009months, and 19% (16\/82) at 12\u2009months. Treatment retention rate was 100% at 3\u2009months, 95.6% at 6\u2009months, and 90.1% at 12\u2009months. Both subgroups showed clinical benefit, but outcomes were more favorable in patients with \u2264\u20096 prior ASMs, who had a lower baseline seizure burden and higher 12\u2010month seizure freedom than those with &gt;\u20096 prior ASMs (29% vs. 10%). At 12\u2009months, most patients were receiving CNB doses of 200\u2009mg or higher, and 79% were maintained on \u2264\u20092 concomitant ASMs. Overall, 38.5% (35\/91) of patients reported at least one ADR (most frequently somnolence, vertigo, and asthenia).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In this real\u2010world cohort of adults with drug\u2010resistant focal epilepsy, CNB was associated with sustained seizure reduction, high 12\u2010month retention rate, and acceptable tolerability, while most patients were maintained on a low concomitant ASM burden during follow\u2010up. Improvement was observed even in highly treatment\u2010experienced patients, although outcomes were more favorable in those with lower prior ASM burden, supporting the hypothesis that earlier CNB positioning may provide greater efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70299","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:50:27Z","timestamp":1785945027000},"page":"1490-1501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sustained seizure reduction, treatment simplification, and high retention with cenobamate: A 12\u2010month real\u2010world study in refractory and ultra\u2010refractory focal epilepsy"],"prefix":"10.1002","volume":"11","author":[{"given":"Francesca","family":"Cutropia","sequence":"first","affiliation":[{"name":"Department of Pharmacy\u2010Drug Sciences University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Di Claudio","sequence":"additional","affiliation":[{"name":"Neurology Unit\u2010Epilepsy Center Fondazione IRCCS Casa Sollievo Della Sofferenza  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Robustella","sequence":"additional","affiliation":[{"name":"Neurology Unit\u2010Epilepsy Center Fondazione IRCCS Casa Sollievo Della Sofferenza  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2325-4137","authenticated-orcid":false,"given":"Umberto","family":"Costantino","sequence":"additional","affiliation":[{"name":"Neurology Unit\u2010Epilepsy Center Fondazione IRCCS Casa Sollievo Della Sofferenza  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela Pia","family":"Ferro","sequence":"additional","affiliation":[{"name":"Neurology Unit\u2010Epilepsy Center Fondazione IRCCS Casa Sollievo Della Sofferenza  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Miscio","sequence":"additional","affiliation":[{"name":"Medicina Trasfusionale e Laboratorio Analisi Fondazione IRCCS Casa Sollievo Della Sofferenza  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Pharmacy\u2010Drug Sciences University of Bari \u201cAldo Moro\u201d  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Department of Pharmacy\u2010Drug Sciences University of Bari \u201cAldo Moro\u201d  Bari 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