THE EFFECTIVENESS AND TOLERABILITY OF CLOBAZAM IN THE PEDIATRIC POPULATION: ADJUNCTIVE THERAPY AND MONOTHERAPY IN A LARGE-COHORT MULTICENTER STUDY

• Published in: Epilepsy research 2022-08, Vol.184, p.106963-106963, Article 106963
• Main Authors: Kamaşak, Tülay, Serdaroğlu, Esra, Yılmaz, Özlem, Kılıç, Betül Aydın, Polat, Burçin G., Erdoğan, Irmak, Yücel Şen, A.Derda, Özen, Nalan, Durgut, Betül Diler, Nihal Yıldız, Pınar, Kart, Özkan, Dilber, Beril, Arslan, Elif Acar, Şahin, Sevim, Topçu, Yasemin, Gencpinar, Pınar, Serin, H. Mine, Hız, Semra A., Çarman, Kürşat Bora, Dündar, Nihal Olgaç, Okuyaz, Çetin, Aydın, Kürşat, Serdaroğlu, Ayşe, Tekgül, Hasan, Cansu, Ali
• Format: Article
• Language: English
• Subjects: childhood epilepsy; Clobazam; Lennox-Gastaut syndrome; reversible effect of clobazam; West syndrome
• ISSN: 0920-1211; 1872-6844
• DOI: 10.1016/j.eplepsyres.2022.106963

To evaluate the effectiveness and tolerability of clobazam therapy in the pediatric population in terms of seizure semiology, epileptic syndromes, and etiological subgroups. A retrospective cohort study was conducted consisting of 1710 epileptic children from eight centers in seven geographic regions of Turkey. The initial efficacy of clobazam therapy was evaluated after three months of treatment. The long-term effectiveness of the drug, overall seizure outcomes, and overall therapeutic outcomes were evaluated during 12 months of therapy. Analysis of initial efficacy after the first three months of clobazam therapy showed that 320 (18.7%) patients were seizure-free, 683 (39.9%) had >50% seizure reductions, and 297 (17.4%) had 50% seizure reduction) was determined for focal-onset (62.3%) seizures, epileptic spasms (61.5%), and generalized onset seisures (57.4). The highest positive response rate among the epileptıc syndromes was for self-limited epilepsy with centrotemporal spikes (SeLECTS). The highest negative response rate was for developmental and/or epileptic encephalopathies (DEEs). Magnetic resonance imaging (MRI) revealed a structural etiological diagnosis in 25.8% of the cohort. A higher positive response rate was observed at MRI in patients with sequelae lesions than in those with congenital lesions. The seizure recurrence rate was higher in the patient group with epilepsy wıth genetic and metabolic causes, in individuals with more than one seizure type, and in those using three or more antiseizure drugs. This cohort study provides additional evidence that clobazam is an effective and well-tolerable drug with a high seizure-free rate (18.7%), a significant seizure reduction rate (57.3%), and with excellent overall therapeutic outcomes with a low seizure relapse rate and considerable reversible benefits in the pediatric population. •Clobazam is a well-tolerable drug with a high seizure-free rate (18.7%) and a significant seizure reduction rate (57.3%)•A positive response (seizure-free and >50% seizure reduction) was observed in focal-onset (62.3%) and generalized-onset (57.4%) seizures.•The highest positive response and the lowest tolerance among the epileptic seizures was observed in the self-limited epilepsy with centrotemporal spikes group. The highest negative response and tolerance were observed in the developmental/epileptic encephalopathies group•Reversible benefit may occur wit