The 2025 American Epilepsy Society’s (AES) Annual Meeting recently concluded in Atlanta, Georgia. The AES Annual Meeting is the largest gathering of epilepsy professionals in the country. For five days in December, it facilitates the exchange of scientific knowledge and clinical expertise, along with being an excellent networking opportunity for healthcare providers, researchers, and advocates dedicated to improving outcomes for individuals affected by epilepsy.

Today, we are taking a look at some of the abstracts presented during AES 2025 focusing on or related to anti-seizure medications (ASM). Some of the associated descriptions and conclusions of the following ASM abstracts were edited for brevity and clarity. For a complete look at all the abstracts presented at AES 2025, visit the conference’s abstracts page.

AES 2025 Abstracts on Anti-Seizure Medications

Efficacy, Safety, and Pharmacokinetics of Lacosamide in Neonates With Seizures: Results of a Phase 2/3, Open-Label, Randomized, Active Comparator Trial

  • Description: To evaluate the efficacy, safety, and pharmacokinetics of lacosamide (LCM) in neonates with repeated electroencephalographic neonatal seizures.
  • Conclusion: In this first randomized clinical trial of LCM in neonates, LCM treatment reduced seizure burden and was well tolerated. Although LCM exposure tended to be higher in neonates, serum concentrations were generally in agreement with exposure in adults at a dose of 400 mg/day LCM (without use of inducers).

Long-Term Safety, Tolerability, and Efficacy of Brivaracetam in Patients With Childhood Absence Epilepsy or Juvenile Absence Epilepsy

  • Description: Childhood absence epilepsy (CAE) and juvenile absence epilepsy (JAE) have limited treatment options. Long-term safety, tolerability, and efficacy of brivaracetam (BRV) were assessed in patients with CAE or JAE aged 2-26 yrs who had participated in the ongoing core Phase 3 trial N01269 (NCT04666610).
  • Conclusion: Long-term BRV was well-tolerated and potentially efficacious in patients aged 2-26 yrs with CAE or JAE, and the results were consistent with the overall BRV safety profile. Further studies, including the completion of the ongoing core Phase 3 trial N01269, are needed to confirm the efficacy of BRV for treating CAE and JAE.

Lipid Fractions and Markers of Vascular Risk with Anti-seizure Medication Use: A Meta-Analysis and Systematic Review of the Effects of Carbamazepine and Valproic Acid

  • Description: This study aimed to perform a meta-analysis and systematic review to confirm the association of vascular risk markers (elevated lipid fractions, total cholesterol, HDL, LDL, triglycerides, homocysteine, and CRP) with the use of carbamazepine and valproic acid monotherapy in epileptic patients with a focus on the lesser-studied markers, apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB), as no comprehensive meta-analysis on all these markers previously existed.
  • Conclusion: This meta-analysis confirms significant associations between carbamazepine use and elevated levels of various lipid markers. The findings for valproic acid were more varied, showing age-dependent negative associations with ApoA1 and duration-dependent negative associations with ApoB, alongside a positive association with homocysteine.

Long-Term Safety and Efficacy of Azetukalner, a Novel, Potent Kv7 Potassium Channel Opener, in Adults With Focal Epilepsy: ≥42-Month Interim Analysis of the Ongoing 7-Year X-TOLE Open-Label Extension

  • Description: Eligible participants who completed the double-blind period began treatment with azetukalner 20 mg daily with food in the open-label extension. Site visits began at open-label extension week 3 and occurred at 3 or 6 months thereafter. Safety was assessed as frequency and severity of treatment-emergent adverse events and serious adverse events. The efficacy outcome was median percentage change in monthly (28 days) focal onset seizure frequency from double-blind period baseline.
  • Conclusion: In this updated analysis of the ongoing X-TOLE OLE, azetukalner was generally well tolerated, and no new safety signals were identified. These promising interim data continue to support the long-term safety and efficacy of azetukalner in a difficult-to-treat population of patients with focal onset seizures.

Trade Offs of Anti-Seizure Medications in Patients with Well Controlled Epilepsy

  • Description: [Researchers] sought to quantify patients’ levels of concern when presented with various hypothetical seizure risks compared to downsides of antiseizure medications.
  • Conclusion: The options chosen as the most concerning were a 50% seizure risk in the next year and difficulty thinking…The least concerning hypotheticals were the burden of medication twice daily, a cost of $10/month, and 1% seizure risk in the next year.

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