Effects of Epidiolex® (Cannabidiol) on seizure-related emergency department visits and hospital admissions: A retrospective cohort study

Epilepsy Behav. 2022 Feb;127:108538. doi: 10.1016/j.yebeh.2021.108538. Epub 2022 Jan 17.

Abstract

Aim: The aim of this study was to evaluate the potential impact of cannabidiol (CBD) on healthcare resource utilization and determine the effect of CBD on seizure-related emergency departments (ED) and hospital admissions in patients with epilepsy.

Methods: This single-center, retrospective longitudinal cohort study included patients ≥1 year on CBD, excluding participants in CBD clinical trials or on <6 months of CBD therapy. Demographics, antiseizure medications (ASM), ED and hospital admissions were collected from the electronic medical record. Co-primary outcomes included change in seizure-related ED and hospital admissions. Secondary outcomes included change in ASMs and total ED or hospital admissions. Co-primary outcomes were assessed using generalized linear modeling. Descriptive statistics were used to analyze all other variables.

Results: In the one-hundred total patients, there was no difference in either seizure-related ED visits (0.012 vs 0.011, p = 0.85) or hospital admissions per month (0.019 vs 0.021, p = 0.7). However, given the low percentage of the total cohort (n = 100) with either a seizure-related ED visits and hospital admissions (9% and 18%, respectively), a subgroup analysis was conducted. Those with seizure-related hospital admissions prior to CBD (n = 18) had significantly less seizure-related hospital admissions after initiation of CBD (23 admissions [0.104 per month] vs 15 admissions [0.055 per month], p = 0.007).

Conclusion: Despite the lack of statistically significant difference in primary outcomes for the total cohort, CBD may have a potential for a clinically beneficial impact in real-world settings on those patients with prior seizure-related admissions, who are the highest utilizers of healthcare resources.

Keywords: CBD; Cannabidiol; Epidiolex; Epilepsy; Hospitalizations; Seizure.

MeSH terms

  • Anticonvulsants / pharmacology
  • Anticonvulsants / therapeutic use
  • Cannabidiol* / pharmacology
  • Cannabidiol* / therapeutic use
  • Drug Resistant Epilepsy* / drug therapy
  • Emergency Service, Hospital
  • Hospitals
  • Humans
  • Longitudinal Studies
  • Retrospective Studies
  • Seizures / drug therapy
  • Seizures / epidemiology

Substances

  • Anticonvulsants
  • Cannabidiol