One year after initiating XCOPRI, 8 out of 10 patients were still on treatment2
Five years post-initiation, 61% of patients were still taking XCOPRI
1 Year
2 Years
3 Years
4 Years
5 Years
About the analysis:
These retention data are based on Kaplan-Meier estimates of time to discontinuation of open-label XCOPRI in the pooled population from 3 clinical studies. Conclusions of long-term efficacy and safety should not be drawn based on this data.
80% of patients were on 2-3 concomitant ASMs at the start of open-label cenobamate treatment. In this pooled population, the median duration of cenobamate exposure was 2.8 years, with a median cenobamate modal dose of 200 mg/day.
OVER
100,000
patients treated worldwide and counting.*
*Worldwide new-to-brand cenobamate prescriptions as of March 2024. Source: IQVIA.
References: 1.XCOPRI [package insert]. Paramus, NJ: SK Life Science, Inc.
2.Sander JW, Rosenfeld WE, Halford JJ, Steinhoff BJ, Biton V, Toledo M. Long-term individual retention with cenobamate in adults with focal seizures: pooled data from the clinical development program. Epilepsia. 2022;63(1):139-149.
3.Krauss GL, Klein P, Brandt C, et al. Safety and efficacy of adjunctive cenobamate (YKP3089) in patients with uncontrolled focal seizures: a multicentre, double-blind, randomized, placebo-controlled, dose-response trial. Lancet Neurol. 2020;19(1):38-48.
4.Chung SS, French JA, Kowalski J, et al. Randomized phase 2 study of adjunctive cenobamate in patients with uncontrolled focal seizures. Neurology. 2020;94(22):e2311-e2322.
Study population: treated yet uncontrolled1
XCOPRI was studied across 2 multicenter, randomized, double-blind, placebo-controlled studies in adult patients with partial-onset seizures with or without secondary generalization1
concomitant ASMs were not adequately controlling patients at baseline.*
Patients in the placebo arm remained on their current ASM(s)3,4
of patients were taking 2 or more concomitant ASMs1
was the approximate mean duration of epilepsy for patients in both studies1
per 28 days was the median baseline seizure frequency for patients in both studies1
*The more frequently used ASMs were levetiracetam, lamotrigine, valproate or valproic acid, carbamazepine, oxcarbazepine, clobazam, lacosamide, and topiramate.1,3,4
Study design (Open-Label Extension Analysis)4
Study 2 was a randomized, double-blind, placebo-controlled study in adult patients with partial-onset seizures with an OLE phase. An analysis of the OLE data evaluated the long-term safety and efficacy (up to 48 months] of adjunctive XCOPRI® (cenobamate tablets) CV. Patients with uncontrolled focal seizures despite concomitant treatment with 1 to 3 ASMs who completed the 18-week double-blind study (n=360) could enter the OLE (n=355), where they underwent a 2-week blinded conversion to a target dosage of XCOPRI 300 mg/day. Doses of concomitant ASMs could be adjusted during the conversion phase. During the OLE treatment phase, concomitant ASMs could be added, removed, or adjusted (no cenobamate monotherapy allowed) and the XCOPRI dosage could be increased or decreased, if clinically indicated, to a minimum of 50 mg/day and a maximum of 400 mg/day. Scheduled OLE assessments occurred every 3 months. Safety assessments included evaluation of treatment-emergent adverse events, including frequency, seriousness, timing, and those leading to discontinuation.
INDICATION
XCOPRI® (cenobamate tablets) CV is indicated for the treatment of partial‑onset seizures in adult patients.
Important Safety Information and indication
CONTRAINDICATIONS
XCOPRI® is contraindicated in any patients with known hypersensitivity to the compound or any of the components of the drug product. XCOPRI is contraindicated in patients with Familial Short QT syndrome.
IMPORTANT SAFETY INFORMATION and INDICATION for XCOPRI® (cenobamate tablets) CV
CONTRAINDICATIONS
XCOPRI is contraindicated in any patients with known hypersensitivity to the compound or any of the components of the drug product.
XCOPRI is contraindicated in patients with Familial Short QT syndrome.
WARNINGS AND PRECAUTIONS
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Also known as Multiorgan hypersensitivity, has been reported in patients taking antiepileptic drugs, including XCOPRI. DRESS has been reported, including one fatality, when XCOPRI is titrated rapidly (weekly or faster titration). No cases of DRESS were reported in an open-label safety study of 1339 partial-onset seizure patients when XCOPRI was initiated at 12.5 mg/day and titrated every two weeks. This finding does not establish that the risk of DRESS is prevented by a slower titration; however, XCOPRI should be initiated at 12.5 mg once daily and titrated every two weeks. DRESS typically, although not exclusively, presents with fever, rash, and/or lymphadenopathy, in association with other organ system involvement. Eosinophilia is often present. If such signs or symptoms are present, the patient should be evaluated immediately. XCOPRI should be discontinued immediately and not restarted if an alternative etiology for the signs or symptoms cannot be established.
QT Shortening: XCOPRI can cause shortening of the QT interval. Caution should be used when administering XCOPRI and other drugs that shorten the QT interval as there may be a synergistic effect on the QT interval that would increase the QT shortening risk.
Suicidal Behavior and Ideation: Antiepileptic drugs (AEDs), including XCOPRI, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Advise patients, their caregivers, and/or families to be alert for these behavioral changes and report them immediately to a healthcare provider.
Neurological Adverse Reactions: XCOPRI causes dose-dependent increases in the neurologic adverse reactions including, dizziness, diplopia, disturbance in gait and coordination, somnolence, and fatigue.
Prescribers should advise patients against engaging in hazardous activities requiring mental alertness, such as operating motor vehicles or dangerous machinery, until the effect of XCOPRI is known.
Withdrawal of AEDs: As with all antiepileptic drugs, XCOPRI should generally be withdrawn gradually because of the risk of increased seizure frequency and status epilepticus. But if withdrawal is needed because of a serious adverse event, rapid discontinuation can be considered.
MOST COMMON ADVERSE REACTIONS
In adult adjunctive therapy placebo-controlled clinical studies, the most common adverse reactions that occurred in XCOPRI-treated patients (incidence at least 10% and greater than placebo) were somnolence, dizziness, fatigue, diplopia, headache.
DOSING CONSIDERATIONS
Dosage adjustment of XCOPRI or other concomitant medications may be necessary.
Consider gradually reducing phenytoin dosages by up to 50% during initial titration.
Consider reducing dosages of phenobarbital and clobazam as needed when used concomitantly with XCOPRI. When XCOPRI and carbamazepine or lamotrigine are taken concomitantly, consider increasing dosages as needed of carbamazepine or lamotrigine.
Consider increasing dosages as needed of drugs which are CYP2B6 and CYP3A substrates and decreasing dosages as needed of drugs which are CYP2C19 substrates.
Effectiveness of hormonal oral contraceptives may be reduced when administered concomitantly with XCOPRI. Women should use additional or alternative non-hormonal birth control.
Dosage reduction of XCOPRI may be considered in patients with mild to moderate and severe renal impairment. XCOPRI use is not recommended in end‑stage renal disease.
The maximum recommended daily dose is 200 mg for patients with mild or moderate hepatic impairment. XCOPRI use is not recommended in patients with severe hepatic impairment
DRUG ABUSE
XCOPRI is a Schedule V controlled substance.
INDICATION
XCOPRI is indicated for the treatment of partial-onset seizures in adult patients.
