A simple upgrade to SEPM12.1RU5 will reduce the amount stored in that file, as RU5 swaps fille def files for deltas in storage.
After the upgrade is complete, you'll likely find that the sem5 DB in SQL has a load of free space within it, but that the file sizes haven't changed. At this point, you'd need to run a SQL DB shrink in order to recover the disk space and reduce the size of the SQL files.
Note however, that loads of blogs out there recommend against using the SQL DB Shrink (as it can impair performance). So check with your DBAs.
Alternatively, you could just reduce the number of defs used by the SEPM, run a LiveUpdate, then run the DB shrink.