Clinical experience with using lacosamide for the treatment of epilepsy in a tertiary centre
Acta Neurologica Scandinavica, 08/02/2012
Kamel JT et al. – This post–marketing analysis suggests that lacosamide in clinical practice at least mirrors, and possibly outperforms the results seen in previous phase II/III trials.Methods
- The authors report the clinical experience from a tertiary referral epilepsy centre, which has been using lacosamide for the past 18 months, with 128 patients treated during this time.
- Fifty–three patients (41%) achieved at least a 50% reduction in seizure frequency, with 14 patients (11%) achieving seizure freedom for a mean time of 35 weeks.
- This 50% responder rate matches, and the seizure free rate outperforms that seen in previous pooled trials.
- The efficacy of lacosamide did not vary with concurrent sodium channel blocking agent (SCB) use, and a statistically significant dose–dependent response was not shown, which is in contrast to previous trials.
- Treatment emergent adverse effects (TEAEs) were noted in 52 patients (41%), with 24 patients (19%) discontinuing the medication.
- TEAEs were more frequent in patients on concurrent SCBs, affecting 51% vs. 28% of patients not on other SCBs.
- This increased risk of TEAEs from concurrent SCB use was of statistical significance (P=0.01).
- The most frequently noted TEAEs from lacosamide were dizziness, sedation and diplopia, which all appeared to be dose–related.