OBJECTIVES: To investigate the demographics, clinical characteristics, and Healthcare Resource Utilization (HCRU) amongst people with Focal Drug-Resistant Epilepsy (F-DRE) in Europe.

METHODS: A cohort of F-DRE individuals across UK, Belgium, Germany, France, Spain, and Italy was identified from July 2015 to April 2022. Resistance to treatment was defined based on the failure of two or more tolerated Anti-Seizure Medications (ASMs). Individuals with at least one specific focal-epilepsy (FE) diagnosis (Index date 1), were selected from primary/specialist care databases. The third ASM treatment initiation (Index date 2) was the proxy for treatment resistance. People with a diagnosis of generalized epilepsy, aged <18 or with less than 180 days of follow-up, were excluded. The study population was ASM treatment naïve at Index date 1.

RESULTS: Of 64,439 FE individuals, 1,075 were F-DRE (54.1% female). The median age at Index date 2 was 50 years. Time to first ASM failure from diagnosis ranged from 5.8 months in France, to 12.5 months in Spain, while time to second ASM failure ranged from 15.3 months in France to 33.1 in the UK. Psychiatric disorders like depression and anxiety were the most prevalent comorbidities in all countries. Bipolar affective disorders, psychosis and intellectual disability, were more prevalent in Germany (1.1%, 4.4% and 13.6%) than in the other countries. Hepatic and renal function tests were the most common blood tests, performed mainly after epilepsy diagnosis in Belgium and Germany and after F-DRE in Italy, Spain, and the UK.

CONCLUSIONS: This retrospective real-world study identified people with F-DRE from GP/specialist care databases in six European countries based on a minimum number of ASM treatment changes as indicators of response to therapy. The study showed that psychiatric disorders were the most prevalent comorbidity and that hepatic and renal function tests were the most common recorded laboratory investigations.