Characteristics of Clobazam and Non-Clobazam–Treated Lennox–Gastaut Syndrome Patients: A Retrospective Cohort Study

Characteristics of Clobazam and Non-Clobazam–Treated Lennox–Gastaut Syndrome Patients: A Retrospective Cohort Study

2016 68th AAN Annual Meeting

Francois, C. | Stern, V. | Ogbonnaya, A. | Lokhandwala, T. | Landsman, P. | Duhig, A. | Shen, V. | Volume: , Issue: , Pages: ,

Objective: To investigate seizure-related pharmacotherapy practices in Lennox-Gastaut syndrome (LGS), clinical and treatment characteristics were evaluated by clobazam (CLB) treatment status. Background: CLB is an FDA-approved adjunctive treatment for LGS, a severe form of childhood-onset epilepsy for which pharmacotherapy options are limited. Methods: De-identified data from MarketScan Commercial, Medicare Supplemental, and Medicaid claims databases (10/1/2010 through 3/31/2014) were used to identify patients who initiated CLB or other anti-epileptic drugs (AEDs) following a diagnosis suggestive of LGS (as there is no LGS-specific ICD-9-CM code). Demographics, clinical characteristics, and seizure-related healthcare utilization in the 12 months prior to the qualifying AED prescription (baseline) were compared between CLB and non-CLB groups. Results: A total of 1,974 probable Commercial/Medicare LGS patients (590 CLB, 1,384 non-CLB) and 2,012 probable Medicaid LGS patients (647 CLB, 1,365 non-CLB) were identified. In both populations, CLB patients were younger than non-CLB patients (Commercial/Medicare: 14.8 vs 31.0 years, P<0.0001; Medicaid: 13.7 vs 24.1 years, P<0.0001). More CLB-treated patients in the Commercial/Medicare population were male (54.6[percnt] CLB vs 49.3[percnt] non-CLB; P=0.03), while gender was equally distributed among Medicaid patients. Within both populations, more non-CLB-treated patients had baseline comorbidities, while prior AED use was greatest among CLB patients (mean 1.7 vs 0.5). CLB patients had significantly longer seizure-related hospital stays and more inpatient, outpatient, and laboratory visits than non-CLB patients. ER and radiology visits were similar across treatment cohorts in each population. Conclusions: In Commercial/Medicare and Medicaid populations, CLB-treated patients with probable LGS were younger and received more clinical care prior to treatment initiation than patients treated with other AEDs, suggesting a prescribing preference of CLB for the LGS patients included in this investigation. These results are similar to those of a previously conducted UK database analysis. Additional studies may determine whether LGS treatment initiation changes over time. Funding: Lundbeck, LLC