What does this research mean for the field?

Cenobamate maintains high effectiveness and tolerability in patients with highly drug-resistant epilepsy even when concomitant antiseizure medications are significantly reduced to monotherapy or a single additional drug. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the effectiveness and tolerability of cenobamate in epilepsy patients achieving significant reductions in concomitant antiseizure medication within European Early Access Programs.

August 23, 2026Epilepsia OpenOpen Access

DECREASE study: A European pool‐analysis of patients with significant reductions in concomitant antiseizure medications in cenobamate Early Access Programs

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Authors

VVVicente VillanuevaHospital Universitari i Politècnic La Fe SLSimona LattanziMarche Polytechnic University JPJavier Peña‐CeballosBeaumont Hospital

Discussion

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Implication

Pooled analysis reveals high seizure reduction with cenobamate in drug-resistant epilepsy, suggesting safe simplification of drug regimens.

Key Points

To evaluate the effectiveness and tolerability of cenobamate in epilepsy patients achieving significant reductions in concomitant antiseizure medication within European Early Access Programs.
Pooled analysis of anonymized real-world registry data from European cenobamate Early Access Programs.
Included 75 patients (out of 694, 10.7%; mean age 39.5 years) who transitioned to cenobamate monotherapy (n=7) or reduced polytherapy to one concomitant antiseizure medication (n=68) with a median follow-up of 22 months.
At the last visit, 33.3% of patients (25/75) achieved complete seizure freedom, and 68.0% (51/75) achieved a ≥50% reduction in seizure frequency.
Seizure-freedom rates were 57.1% in the monotherapy group versus 30.9% in the dual-therapy group (p = 0.16), with cenobamate combined with clobazam identified as the most effective regimen.
Adverse events occurred in 73.3% of patients (55/75)—mainly somnolence (30.7%), dizziness/vertigo (28.0%), and fatigue (26.7%)—with no adverse events leading to drug discontinuation.

Cite This Study

Villanueva et al. (2026) studied this question.

synapsesocial.com/papers/6a8aadf37677a341144467e3 https://doi.org/10.1002/epi4.70344

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Implication

Pooled analysis reveals high seizure reduction with cenobamate in drug-resistant epilepsy, suggesting safe simplification of drug regimens.

DECREASE study: A European pool‐analysis of patients with significant reductions in concomitant antiseizure medications in cenobamate Early Access Programs

Discussion

Member takes

Implication

Key Points

Cite This Study

DECREASE study: A European pool‐analysis of patients with significant reductions in concomitant antiseizure medications in cenobamate Early Access Programs

Discussion

Member takes

Implication

Key Points

Cite This Study

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