Azetukalner (XEN1101)

Focal seizures are more common than generalized seizures, with a median focal seizure incidence rate of 30.4 per 100,000 per year compared with 19.6 per 100,000 per year for generalized seizures, and focal epilepsy comprises about 55.7% to 61.1% of the overall epilepsy population. In 2021, 1.1% of US adults, approximately 2,865,000 people, reported active epilepsy. Approximately 40% of people with epilepsy are drug resistant, and among US adults using antiseizure medications for focal epilepsy, 66.4% had persistent seizures of more than one per year. Mortality is elevated: the weighted median standardized mortality ratio was 2.3 across population-based incidence cohorts, sudden unexpected death in epilepsy occurs at 1.2 per 1,000 patient-years in adults and at up to 6.3 per 1,000 people in drug-resistant focal epilepsy, and the suicide-specific standardized mortality ratio is 3.3. Quality of life tracks with seizure control: the mean QOLIE-31-P total score was 56.4 in drug-resistant focal epilepsy compared with 70.8 in drug-responsive focal epilepsy. US spending attributable to epilepsy or seizure was $6,853 per person per year above matched controls, an aggregate of $24.5 billion, and adjusted total direct costs rose from $18,600 per year at less than one seizure per year to $43,708 per year at one or more seizures per week.