Cenobamate: A comprehensive review

), sparing transient sodium currents, and augmentation of GABA-mediated tonic currents. In 3 randomized, placebo-controlled trials in adults with focal seizures, median 28-day seizure frequency reductions ranged from 36.0%-100% at CNB doses of 100-400 mg/day. During the maintenance phases of these trials, CNB at higher doses demonstrated 100% seizure-free rates in 21.0%-52.4% of patients. In a recent randomized, controlled study of patients aged 12-65 years with primary generalized tonic-clonic seizures, the seizure-free rates with CNB and with placebo were 43% and 20%, respectively (p=0.0034). Since CNB's approval in multiple countries, many open-label extension, postmarketing, and observational studies have been published for patients with focal epilepsy and other epilepsy types, and remarkably high seizure freedom rates have been consistently reported. Seizure-free rates reported are also very high among treatment-resistant patients, but many studies report even higher rates in patients with milder or shorter-duration epilepsy.