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Introduction <p>In Germany, approximately 30% of people with epilepsy do not achieve seizure control with anti-seizure medication (ASM). ASM prescription timing and selection are crucial parameters affecting outcomes; however, the prescription characteristics of patients with refractory epilepsy in Germany are poorly understood. Therefore, understanding the pathways of how patients start their first ASM regimen and change to new ASM regimens could be a crucial step towards optimising therapeutic strategies and reducing the negative consequences of uncontrolled seizures.</p> Methods <p>A retrospective, population-based analysis was carried out using data from the German IQVIA™ Disease Analyzer (DA) and Longitudinal Prescriptions (LRx) databases. Over a 5-year period from 2018 to 2022, approximately 80% of Statutory Health Insurance (SHI)-reimbursed prescriptions were covered. Filtering processes were used to select and analyse patients treated only for epilepsy, and their prescription journeys.</p> Results <p>Prevalence and incidence in the selected group was in line with other reported data. Over a third of patients (36.6%) waited ≥ 1&#xa0;day to receive their first ASM regimen prescription, and all patients stayed on their first ASM regimen for the longest period. Time to change from first and further regimens was on average &gt; 300&#xa0;days. Levetiracetam was the most prescribed ASM, and newer ASMs licensed in the past decade had much lower prescriptions. Prescribing differences were observed between specialities.</p> Discussion <p>This analysis contributes to the understanding of current epilepsy treatment shortfalls, showing delays in time to treatment and time to regimen change, and relatively low use of more recent ASMs. Additional work is required to evaluate how much improvement in outcome could be achieved by advancing first prescription timing and ASM selection, which may help reduce epilepsy disease burden.</p>

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Initial Monotherapy and Further Anti-seizure Medication Regimens in Adult Patients with Epilepsy: A Population-Based, Longitudinal, Retrospective Analysis of German Prescription Data

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  • 发表日期：

    2026年3月12日

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  • Adam Strzelczyk,
  • Karel Kostev,
  • Nils G. Margraf,
  • Andreas Schulze-Bonhage

摘要

Introduction

In Germany, approximately 30% of people with epilepsy do not achieve seizure control with anti-seizure medication (ASM). ASM prescription timing and selection are crucial parameters affecting outcomes; however, the prescription characteristics of patients with refractory epilepsy in Germany are poorly understood. Therefore, understanding the pathways of how patients start their first ASM regimen and change to new ASM regimens could be a crucial step towards optimising therapeutic strategies and reducing the negative consequences of uncontrolled seizures.

Methods

A retrospective, population-based analysis was carried out using data from the German IQVIA™ Disease Analyzer (DA) and Longitudinal Prescriptions (LRx) databases. Over a 5-year period from 2018 to 2022, approximately 80% of Statutory Health Insurance (SHI)-reimbursed prescriptions were covered. Filtering processes were used to select and analyse patients treated only for epilepsy, and their prescription journeys.

Results

Prevalence and incidence in the selected group was in line with other reported data. Over a third of patients (36.6%) waited ≥ 1 day to receive their first ASM regimen prescription, and all patients stayed on their first ASM regimen for the longest period. Time to change from first and further regimens was on average > 300 days. Levetiracetam was the most prescribed ASM, and newer ASMs licensed in the past decade had much lower prescriptions. Prescribing differences were observed between specialities.

Discussion

This analysis contributes to the understanding of current epilepsy treatment shortfalls, showing delays in time to treatment and time to regimen change, and relatively low use of more recent ASMs. Additional work is required to evaluate how much improvement in outcome could be achieved by advancing first prescription timing and ASM selection, which may help reduce epilepsy disease burden.