Losigamone add-on therapy for focal epilepsy

Area of Science:

• Neurology
• Pharmacology

Background:

• Epilepsy affects 50 million globally, with many requiring multiple antiepileptic drugs (AEDs).
• Losigamone is a newer AED investigated for add-on therapy in focal epilepsy.
• This systematic review updates previous analyses from 2012 and 2015.

Purpose of the Study:

• To evaluate the efficacy and safety of losigamone as an add-on treatment for focal epilepsy.
• To analyze seizure frequency reduction, seizure freedom, treatment withdrawal, and adverse events.

Main Methods:

• Systematic review of randomized controlled trials comparing losigamone with placebo.
• Searched Cochrane Epilepsy Specialized Register, CENTRAL, and MEDLINE up to February 2017.
• Primary outcomes: >=50% seizure reduction and seizure freedom; Secondary outcomes: withdrawal and adverse events.

Main Results:

• Losigamone significantly increased the likelihood of a >=50% seizure reduction (RR 1.76).
• However, it also significantly increased treatment withdrawal (RR 2.16) and overall adverse events (RR 1.34).
• Dizziness was a significantly reported adverse event (RR 3.82); higher doses increased efficacy but also adverse event-related dropouts.

Conclusions:

• Losigamone demonstrates efficacy in reducing seizure frequency for focal epilepsy.
• Its use is associated with increased treatment withdrawal and adverse events, particularly dizziness.
• Moderate quality evidence suggests a need for well-designed, longer-term trials to fully assess losigamone's role.