Real-world data on rufinamide treatment in patients with Lennox–Gastaut syndrome: Results from a European noninterventional registry study

Abstract Introduction Rufinamide is approved for the adjunctive treatment of seizures associated with Lennox–Gastaut syndrome (LGS) in patients aged ≥ 4 years. The objective of this study was to provide real-world, long-term data on patients with LGS initiating rufinamide as add-on therapy and patients with LGS receiving other antiepileptic drugs (AEDs). Methods A Phase IV, noninterventional, multicenter registry study was conducted in patients with LGS aged ≥ 4 years requiring modification to any AED treatment, including initiation of add-on rufinamide therapy. Safety/tolerability was assessed by evaluating treatment-emergent adverse events (TEAEs), and efficacy was assessed using a generic seizure frequency scale. Results A total of 111 patients from 64 sites in 8 European countries were included, of whom 64 initiated rufinamide (“rufinamide” group) and 21 did not receive rufinamide at any time during the study (“no-rufinamide” group). Mean ages were 16.1 years (rufinamide) and 15.0 years (no rufinamide). The median duration of follow-up was > 2 years (range: 1.3–46.4 months). Antiepileptic drug-related TEAEs were reported for 40.6% (rufinamide) and 33.3% (no rufinamide) of patients and led to discontinuation of 7.8% and 4.8%, respectively. The most frequently reported rufinamide-related TEAEs (≥ 5% patients) were somnolence (7.8%) and decreased appetite (6.3%). There were no unexpected safety/tolerability findings. At month 12, the proportion of patients with improvement in all seizures (“much improved” or “very much improved”) was 28.6% (12/42) for the rufinamide group and 14.3% (2/14) for the no-rufinamide group. Conclusion The study provided valuable information on LGS and its management, and evidence that rufinamide has a consistent and generally favorable safety/tolerability profile when used in routine clinical practice. ClinicalTrials.Gov identifier NCT01991041