Lacosamide adjunctive therapy for partial-onset seizures: a meta-analysis.

Area of Science:

• Neurology
• Pharmacology

Background:

• The comparative efficacy and safety of lacosamide as an adjunctive therapy for epilepsy remain incompletely defined.
• Existing research has not thoroughly evaluated lacosamide against other antiepileptic drugs (AEDs) in adults with partial-onset seizures.

Purpose of the Study:

• To assess the efficacy and safety of lacosamide compared to other AEDs in adults with partial-onset seizures.
• To evaluate potential benefits of lacosamide, including reduced hospital stay and improved quality of life.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) involving lacosamide for partial-onset seizures.
• Literature search included Medline, EMBASE, and Cochrane Central Register up to February 2012, with no language or publication status restrictions.
• Data extraction and risk of bias assessment were performed independently; random effects model was used for pooled analyses.

Main Results:

• Three RCTs with 1311 patients met the inclusion criteria.
• Lacosamide significantly increased the 50% responder rate compared to placebo (RR 1.68; 95% CI 1.36 to 2.08).
• Discontinuation due to adverse events (ataxia, dizziness, fatigue, nausea) was significantly higher with lacosamide (RR 3.13; 95% CI 1.94 to 5.06).

Conclusions:

• Lacosamide demonstrates increased efficacy in improving the 50% responder rate for partial-onset seizures.
• However, lacosamide is associated with a significantly higher incidence of adverse events compared to placebo.
• The study highlights a trade-off between efficacy and tolerability for lacosamide as adjunctive therapy.