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Oxcarbazepine adjunctive therapy in infants and young children with partial seizures
J E Piña-Garza1, R Espinoza, D Nordli
1Vanderbilt Children's Hospital, Pediatric Neurology, Nashville, TN 37232, USA. eric.pina-garza@vanderbilt.edu
Insights
High-dose oxcarbazepine effectively reduced partial seizures in young children. This study found higher doses significantly improved seizure control compared to lower doses in infants and toddlers.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Partial seizures in infants and young children present significant treatment challenges.
- Oxcarbazepine is an antiepileptic drug used for seizure management.
Purpose of the Study:
- To assess the efficacy, safety, and pharmacokinetics of oxcarbazepine as adjunctive therapy.
- To compare high-dose versus low-dose oxcarbazepine in pediatric patients aged 1 month to under 4 years.
Main Methods:
- A rater-blind, randomized, parallel-group study involving 128 pediatric patients.
- Patients received either high-dose (60 mg/kg/day) or low-dose (10 mg/kg/day) oxcarbazepine.
- Efficacy was measured by the change in electrographic partial seizure frequency per 24 hours.
Main Results:
- High-dose oxcarbazepine showed a significantly greater reduction in seizure frequency compared to the low-dose group.
- Median absolute change in type 1 seizure frequency was -2.00 for high-dose vs. -1.37 for low-dose (p=0.043).
- Common adverse events included somnolence and pyrexia, mostly mild.
Conclusions:
- High-dose oxcarbazepine demonstrated superior efficacy in controlling partial seizures in infants and very young children.
- Oxcarbazepine is a viable adjunctive treatment option for this age group.
Objective:
To evaluate the efficacy, safety, and pharmacokinetics of oxcarbazepine as adjunctive therapy in infants and young children (1 month to < 4 years).
Methods:
Children 1 month to < 4 years of age with inadequately controlled partial seizures taking up to two concomitant antiepileptic drugs (AEDs) were enrolled in this rater-blind, randomized, parallel-group study. Patients received either high-dose (60 mg/kg/day) or low-dose (10 mg/kg/day) oxcarbazepine as oral suspension. The primary efficacy variable was the absolute change in electrographic partial seizures with a behavioral correlate (type 1 seizure) frequency per 24 hours during the last 72 hours of continuous video-EEG monitoring in the treatment phase compared with baseline seizure frequency.
Results:
Of 191 patients screened, 128 were randomized: 64 to both oxcarbazepine dose groups. The median absolute change in type 1 seizure frequency per 24 hours was more effective for the high-dose group (-2.00) compared with the low-dose group (-1.37; p = 0.043). The median percentage reduction in type 1 seizure frequency per 24 hours was also greater in the high-dose group (83.33%) than in the low-dose group (46.18%; p = 0.047). The most frequent adverse events (> or = 10%) were somnolence and pyrexia, and most were mild in severity.
Conclusions:
In this study, high-dose oxcarbazepine was significantly more effective than low-dose oxcarbazepine in controlling partial seizures in infants and very young children.
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