Seizure Burden Falls Over Time in Treatment‑Resistant Focal Epilepsy: Implications for Interpreting Open‑Label Disease‑Modifying Claims

Highlights

– In the Human Epilepsy Project 2 (HEP2), a prospective observational cohort of focal treatment‑resistant epilepsy (FTRE), 68.3% of participants experienced lower seizure frequency in the second half of follow‑up compared with the first half.
– Modeled mean monthly seizure frequency fell by 68.7% (95% CI, 52.9%–84.5%) overall across 18–36 months of follow‑up; reductions were observed across follow‑up epochs but exhibited variable precision.
– Adding an antiseizure medication (ASM) was common (54.7%) and associated with seizure reduction in two‑thirds of those treated, but seizure freedom remained uncommon; participants with implantable devices did not have statistically different seizure trajectories than those without devices.

Background: disease context and unmet needs

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