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Efficacy and tolerability of lacosamide as an adjunctive therapy in children with refractory partial epilepsy
Ismail Pasha1, Mahesh Kamate2, Suresh K Didagi3
1Department of Clinical Pharmacy, KLE University's College of Pharmacy, Belgaum, Karnataka, India.
Insights
Lacosamide effectively reduced seizures in children with refractory partial epilepsy. This add-on therapy demonstrated good tolerability in pediatric patients.
Area of Science:
- Pediatric Neurology
- Epileptology
- Pharmacology
Background:
- Refractory partial epilepsy in children presents significant treatment challenges.
- Investigating novel therapeutic options is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and tolerability of lacosamide as adjunctive therapy in pediatric patients with refractory partial epilepsy.
Main Methods:
- A prospective, unicenter study enrolled 79 children (aged 5-15 years) with refractory partial epilepsy.
- Lacosamide was administered orally as add-on therapy, with dose titration and maintenance periods.
- Efficacy, tolerability, ECG, and liver function tests were assessed throughout the study.
Main Results:
- Of 76 patients completing the study, 44.3% achieved seizure freedom.
- An additional 40.6% experienced a ≥50% reduction in seizure frequency.
- Lacosamide demonstrated good tolerability, with only 3.8% discontinuing due to adverse events.
Conclusions:
- Lacosamide is an effective add-on antiepileptic drug for pediatric refractory partial epilepsy.
- The drug is well-tolerated in this patient population.
- Lacosamide offers a promising therapeutic option for difficult-to-treat childhood epilepsy.
Background:
A unicentre, prospective study was performed to investigate the efficacy of lacosamide as adjunctive therapy in children with refractory partial epilepsy.
Methods:
The study was performed at a tertiary care hospital over a period of 30 months between November 2011 and May 2014. Seventy-nine children with refractory partial epilepsy (age 5-15 years) who had failed two or more antiepileptic drugs and in whom lacosamide was used as an add-on drug were enrolled. Lacosamide tablets were administered orally, at a dose of 25 mg for 1 week followed by 50 mg twice daily for the remaining period. Efficacy and tolerability evaluation was performed at every visit of titration, maintenance period (3 months), and two follow-up visits at monthly interval. Electrocardiogram and liver function tests were performed before enrollment and at the end of 3 months of lacosamide therapy. Patient's caregiver or investigator observed adverse events were recorded in a predesigned pro forma.
Results:
A total of 79 patients with uncontrolled partial epilepsy screened from 531 epileptic children were enrolled, after they satisfied the inclusion and exclusion criteria. The mean age of children enrolled was 8.8 ± 3.1 years (range 5-15 years); 53 children (67.0%) were boys. Mean weight of the patients was 24.2 ± 9.8 kg. The mean age at the onset of seizures was 6.4 ± 3.5 years. The mean dose of lacosamide administered was 4.1 mg/kg. Three patients (3.8%) dropped out of the study, because of vomiting, aggressive behavior, and poor response, respectively. Of 76 patients (96.2%) entering the maintenance period, 35 patients (44.3%) were seizure free, 32 patients (40.6%) indicated ≥50% reduction in seizure frequency, 3 patients (3.8%) indicated 25-49% seizure reduction, and 9 patients (11.4%) either had no change in seizure frequency or experience increase in seizure frequency.
Conclusion:
Lacosamide is an effective add-on antiepileptic drug for children with refractory partial epilepsy and is well tolerated.
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