Treatment Patterns for Adult Patients with Newly Diagnosed Focal Epilepsy in Germany

OBJECTIVES: No representative data about the drug treatment of German epilepsy patients exist. Therefore, the aim of this study was to investigate the antiepileptic drug (AED) treatment of adults with newly diagnosed focal epilepsy in Germany. METHODS: The analysis was based on a claims data set covering the years 2007 to 2014, provided by a regional German statutory health insurance. Patients aged 16 years or older were included if at least one in- or outpatient diagnosis of focal epilepsy in 2007 or 2008 and at least one prescription of an AED in 2014 was observed. Furthermore, patients should not have had any previous epilepsy diagnoses/AED prescriptions in the 6 months before the first focal epilepsy diagnosis. Patient observation started at date of first documented inpatient or outpatient diagnosis. Number of previously prescribed AEDs stratified by type of prescribed AEDs in 2014 were calculated. RESULTS: Of 4,555 incident adult focal epilepsy patients, we identified 1,639 patients in 2014 (mean age 53.4 years at index, 45.4% female) with prescriptions of AEDs, approved for focal epilepsies. The mean number of previously prescribed AEDs varied between the substances: 0 to 1 previous AED for Carbamazepine (0.53), Gabapentin (0.84), Valproic acid (0.87); 1 to 2 previous AEDs for Oxcarbazepine (1.07), Lamotrigine (1.08), Levetiracetarn (1.13),Topiramate (1.25), and Pregabalin (1.57); 2 to 3 previous AEDs for Clobazam (2.38), Zonisamide (2.55), and Lacosamide (2.59); and more than 3 previously prescribed AEDs for Eslicarbazepine (3.42). Perampanel, Retigabine.Tiagabine, andVigabatrin were only rarely or not prescribed in 2014. CONCLUSIONS: A variety of AEDs are available for the treatment of focal epilepsy. Many patients remain on their first- or second-line treatment with established AEDs. Novel AEDs like Lacosamide and Eslicarbazepine, which were introduced in the last decade, were only rarely prescribed and relatively late in the treatment course.