{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:54Z","timestamp":1792471134964,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006546","name":"Angelini Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006546","id-type":"DOI","asserted-by":"publisher"}]}],"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 evaluate the effectiveness and tolerability of cenobamate in patients with a significant reduction in concomitant antiseizure medication (ASM) in European cenobamate Early Access Programs (EAPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Anonymized patient data from real\u2010world studies\/registries associated with European cenobamate EAPs were pooled. Patients were included if they had significantly reduced their concomitant drug load (i.e., converted to cenobamate monotherapy or reduced from multiple to one concomitant ASM) between baseline and the last visit. Effectiveness, tolerability, and dosage of cenobamate were evaluated. Responses according to therapeutic regimen at last visit were studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 694 patients within cenobamate EAPs, 75 (10.7%) met the inclusion criteria (mean age 39.5\u2009years [range 19\u201365]). At baseline, the median number of prior ASMs was 10 (interquartile range [IQR] 6\u201313); 46 patients (61.3%) were taking two, 23 (30.7%) were taking three, and six (8%) were taking four concomitant ASMs at baseline. At the last visit, seven patients (9.3%) were converted to monotherapy and 68 (90.7%) were receiving one concomitant ASM. The median cenobamate dosage at last visit was 300\u2009mg (IQR 200\u2013350). Median cenobamate follow\u2010up was 22\u2009months; 73 patients (97%) had at least 1 year of follow\u2010up and one discontinued cenobamate at 1 year. Twenty\u2010five patients (33.3%) were seizure\u2010free at last visit; 51 (68%) had a \u226550% reduction in seizure frequency. The seizure\u2010freedom rate was numerically, but not significantly, higher in patients converted to monotherapy (57.1%) versus those receiving one concomitant ASM (30.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16). Cenobamate plus clobazam was the most effective combination. Adverse events (AEs) were reported in 55\/75 patients (73.3%); the most common were somnolence (30.7%), dizziness\/vertigo (28%), and fatigue (26.7%). No AEs led to treatment discontinuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Cenobamate demonstrated good effectiveness and tolerability in a population of patients within European EAPs who achieved a significant reduction of concomitant ASM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>People with highly drug\u2010resistant epilepsy often need to take several antiseizure medications at the same time. Combined data from European Early Access Programs show that about 10% of people treated with cenobamate were able to stop all other antiseizure medications or reduce treatment to cenobamate plus one other medication. Despite this simplification of treatment, one\u2010third of these patients became seizure\u2010free and more than two\u2010thirds experienced at least a 50% reduction in seizure frequency. Within this group, no patients stopped cenobamate because of side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70344","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:40:19Z","timestamp":1787301619000},"page":"1812-1824","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>DECREASE<\/scp>\n                    study: A European pool\u2010analysis of patients with significant reductions in concomitant antiseizure medications in cenobamate Early Access Programs"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2080-8042","authenticated-orcid":false,"given":"Vicente","family":"Villanueva","sequence":"first","affiliation":[{"name":"Department of Neurology, Refractory Epilepsy Unit Hospital Universitario y Polit\u00e9cnico La Fe, Member of ERN EpiCARE  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-0083","authenticated-orcid":false,"given":"Simona","family":"Lattanzi","sequence":"additional","affiliation":[{"name":"Neurological Clinic, Department of Experimental and Clinical Medicine Marche Polytechnic University  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7260-1292","authenticated-orcid":false,"given":"Javier","family":"Pe\u00f1a\u2010Ceballos","sequence":"additional","affiliation":[{"name":"Department of Neurology Beaumont Hospital  Dublin Ireland"},{"name":"Dublin Neurological Institute Mater Misericordiae University Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2062-8623","authenticated-orcid":false,"given":"Rhys H.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurology Royal Victoria Infirmary  Newcastle upon Tyne UK"},{"name":"Translational and Clinical Research Institute Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5354-1256","authenticated-orcid":false,"given":"Juan","family":"Rodr\u00edguez\u2010Uranga","sequence":"additional","affiliation":[{"name":"Centro Neurolog\u00eda Avanzada  Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6195-9130","authenticated-orcid":false,"given":"Zs\u00f3fia","family":"Jord\u00e1n","sequence":"additional","affiliation":[{"name":"Epilepsy Unit, Department of Neurology Semmelweis University Clinic for Neurosurgery and Neurointervention  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5995-5862","authenticated-orcid":false,"given":"Bernhard J.","family":"Steinhoff","sequence":"additional","affiliation":[{"name":"Department for Adults Kork Epilepsy Centre  Kehl\u2010Kork Germany"},{"name":"Clinic for Neurology and Neurophysiology University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9430-5037","authenticated-orcid":false,"given":"Randi","family":"von Wrede","sequence":"additional","affiliation":[{"name":"Department of Epileptology University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3953-9842","authenticated-orcid":false,"given":"Norman","family":"Delanty","sequence":"additional","affiliation":[{"name":"Department of Neurology Beaumont Hospital  Dublin Ireland"},{"name":"Royal College of Surgeons in Ireland University of Medicine and Health Sciences  Dublin Ireland"},{"name":"FutureNeuro Research Ireland Centre for Translational Brain Science  Dublin 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SS Annunziata Hospital  Taranto Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5385-761X","authenticated-orcid":false,"given":"Laura","family":"Canafoglia","sequence":"additional","affiliation":[{"name":"Epilepsy Unit Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8120-0287","authenticated-orcid":false,"given":"Nicola","family":"Specchio","sequence":"additional","affiliation":[{"name":"Neurology, Epilepsy and Movement Disorders Unit Bambino Ges\u00f9 Children's Hospital, IRCCS, Full Member of ERN EpiCARE  Rome Italy"},{"name":"University Hospitals KU Leuven, Childhood Epilepsy Center Leuven Brain Institute, Member of the ERN EpiCARE  Leuven 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