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The effectiveness and safety of lacosamide in children with epilepsy in a clinical practice setting
Francesc Sanmartí-Vilaplana1, Asunción Díaz-Gómez1
1Department of Neurology, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Insights
Lacosamide effectively reduced seizure frequency in children with refractory focal epilepsy over 12 months. This epilepsy treatment showed progressive improvement and few adverse effects, offering a promising therapeutic option for pediatric patients.
Area of Science:
- Pediatric Neurology
- Epilepsy Research
- Pharmacology
Background:
- Refractory epilepsy affects up to 30% of children, significantly impacting their quality of life.
- Lacosamide is being investigated for its potential efficacy in pediatric refractory epilepsy cases.
Purpose of the Study:
- To evaluate the effectiveness and safety of lacosamide in pediatric patients with refractory focal epilepsy.
- To analyze seizure reduction rates and adverse events associated with lacosamide treatment.
Main Methods:
- Retrospective analysis of 191 pediatric patients (<18 years) with focal epilepsy treated with lacosamide.
- Data collected at baseline and 3, 6, and 12 months post-initiation.
- Response categorized by seizure frequency reduction (seizure freedom, ≥75%, ≥50%, <50%).
Main Results:
- At 12 months, 16.0% of patients achieved seizure freedom, and 44.4% had ≥50% seizure reduction.
- Patients with fewer prior or concomitant anti-epileptic drugs showed better response rates.
- Common adverse events included increased seizure frequency (14.7%), diplopia, dizziness, ataxia, and drowsiness.
Conclusions:
- Lacosamide demonstrated progressive seizure reduction in children with refractory focal epilepsy over 12 months.
- The treatment was associated with a manageable safety profile, indicating its potential as a therapeutic option.
- Further research may identify predictive factors for optimal lacosamide response in pediatric epilepsy.
Background:
Seizures in up to 30% of children with epilepsy become refractory to treatment, decreasing their quality of life. Studies suggest that lacosamide may be effective in pediatric patients with refractory epilepsy.
Aims:
To assess the effectiveness and safety of lacosamide in a population of children with mostly focal refractory epilepsy.
Methods:
Retrospective analysis of children aged <18years presenting to a single hospital in Spain. Data from baseline, and 3, 6, and 12months after lacosamide initiation were collected and analyzed. Response to lacosamide was categorized by seizure frequency (seizure freedom or ≥75%, ≥50%, and <50% reduction in seizures).
Results:
One hundred ninety-one pediatric patients (~55% male) with focal epilepsy treated with lacosamide were included. The mean age at lacosamide initiation was 9.4years, and the mean duration of epilepsy was 5.4years. Seizure-free rates at 3, 6, and 12months were 9.7%, 11.8%, and 16.0%. At 12months, 44.4% of the population had a ≥50% reduction in seizure frequency. When analyzing response according to the number of previous/concomitant AEDs, those patients who received ≤2 previous AEDs/fewer concomitant AEDs had significantly greater response rates than those who received greater numbers of previous/concomitant AEDs; however, no predictive factors for response were identified. The most common adverse events were seizure number increased (14.7%), diplopia (5.2%), dizziness (3.7%), ataxia (2.1%), and drowsiness (2.1%).
Conclusions:
Lacosamide use in children with refractory focal epilepsy can result in a reduction in seizure rate that improves progressively over time with few adverse effects, making lacosamide a promising option in these patients.
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