Lacosamide add-on therapy for focal epilepsy

Area of Science:

• Neurology
• Pharmacology

Background:

• Epilepsy affects many, with a significant portion unresponsive to initial treatments.
• Drug-resistant focal epilepsy necessitates add-on therapies for seizure control.
• Lacosamide is a licensed add-on treatment for this condition.

Purpose of the Study:

• To assess the efficacy and tolerability of lacosamide as an add-on therapy.
• To evaluate lacosamide's effectiveness in both children and adults with drug-resistant focal epilepsy.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Inclusion of five placebo-controlled trials with 2199 participants.
• Assessment of outcomes including seizure frequency reduction, seizure freedom, adverse events, and treatment withdrawal.

Main Results:

• Lacosamide significantly increased the proportion of participants achieving a 50% or greater reduction in seizure frequency (RR 1.79).
• A potential increase in seizure freedom was observed (RR 2.27), though with low certainty evidence.
• Common adverse events included dizziness, somnolence, and nausea; higher doses correlated with increased adverse events and withdrawal.

Conclusions:

• Lacosamide demonstrates short-term efficacy and tolerability for drug-resistant focal epilepsy.
• The drug enhances seizure frequency reduction and may improve seizure freedom compared to placebo.
• Further research is needed on long-term outcomes and its use in pediatric populations.