43% of German Epilepsy Patients Achieved 50%+ Seizure Reduction with CBD in Real-World Practice | Research

The takeaway

In a German multicenter chart review of 202 patients with LGS, DS, or TSC, adjunctive CBD achieved 50%+ seizure reduction in 43% at 3 months and 44% at 12 months, with 67% remaining on treatment at 1 year.

pediatric neurologists, epilepsy treatment teams, medical cannabis prescribers, parents of children with severe epilepsy

What the researchers found

Responder rates (>=50% seizure reduction) for total seizures: 43.3% at 3 months, 44.0% at 12 months. For generalized tonic-clonic seizures: 54.3% at 3 months, 47.7% at 12 months. Median seizure days decreased from 30 to 18 per month (p<0.001). CGI-C improvement in 62%. Treatment retention: 89.6% at 3 months, 67.1% at 12 months. Common AEs: sedation and diarrhea.

Why it matters

Real-world evidence complements clinical trial data by showing how CBD performs in typical clinical practice with broader patient populations and less controlled conditions. These German results confirm trial findings translate to practice.

The numbers in context

202 patients (159 LGS, 34 DS, 9 TSC). Median age: 18 years. Median prior ASMs: 6. Target dose: 11.1 mg/kg/day. 50%+ response: 43% (3 mo), 44% (12 mo). GTCS 50%+ response: 54% (3 mo), 48% (12 mo). Seizure days: 30 to 18/month (p<0.001). 67% still on CBD at 12 months.

How the study worked

Multicenter retrospective chart review of 202 German patients with LGS (159), DS (34), or TSC (9) receiving adjunctive CBD (Epidyolex). Assessed treatment characteristics, seizure outcomes, CGI-C, retention rates, and AEs up to 12 months.

What this study cannot tell us

Retrospective chart review with inherent limitations. No control group. Selection bias possible. Variable follow-up completeness. German healthcare system specifics may affect generalizability.

How to read the evidence

Multicenter real-world data confirming clinical trial findings in a treatment-resistant population supports strong evidence.

When this study was published

German real-world clinical data up to 12 months.

The bigger picture

The consistency of response rates between 3 and 12 months suggests sustained benefit rather than a honeymoon effect. The 67% retention rate at 1 year is encouraging for a heavily treatment-resistant population.

Questions still open

Do response rates remain stable beyond 12 months?
Which patient subgroups benefit most from adjunctive CBD?

Common questions

How well does CBD work for severe epilepsy in real clinical practice?

43% of patients achieved at least 50% seizure reduction, and seizure days dropped from 30 to 18 per month on average. These real-world results are consistent with clinical trial findings.

Do patients stay on CBD long-term?

67% of patients remained on CBD treatment at 12 months, suggesting sustained tolerability and perceived benefit in a heavily treatment-resistant population.

Read the original research

Retrospective Multicenter Chart Review Study of Adjunctive Cannabidiol for Seizures Associated with Lennox-Gastaut Syndrome, Dravet Syndrome and Tuberous Sclerosis Complex.

Neurology and therapy, 14(5), 1935-1959

View on PubMed ↗Publisher’s paper ↗

Citation

Strzelczyk, Adam; Klotz, Kerstin Alexandra; Mayer, Thomas; von Podewils, Felix; Knake, Susanne; Kurlemann, Gerhard; Herold, Luise; Immisch, Ilka; Buhleier, Elisa; Rosenow, Felix; Schubert-Bast, Susanne. (2025). Retrospective Multicenter Chart Review Study of Adjunctive Cannabidiol for Seizures Associated with Lennox-Gastaut Syndrome, Dravet Syndrome and Tuberous Sclerosis Complex.. Neurology and therapy, 14(5), 1935-1959. https://doi.org/10.1007/s40120-025-00788-w