Efficacy and safety of lacosamide as first add-on or later adjunctive treatment for uncontrolled partial-onset seizures

Purpose To evaluate the efficacy and safety of lacosamide administered as either first add-on or later add-on antiepileptic drug (AED) therapy for patients with uncontrolled partial-onset seizures (POS). Methods In this open-label, multicentre trial, patients with POS initiated oral lacosamide (titr...

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Detalles Bibliográficos
Autores: Zadeh, Wendy Waldman, Escartín Siquier, Antonio E, Byrnes, William, Tennigkeit, Frank, Borghs, Simon, Li, Ting, Dedeken, Peter, De Backer, Marc
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:299412
Acceso en línea:https://ddd.uab.cat/record/299412
https://dx.doi.org/urn:doi:10.1016/j.seizure.2015.07.001
Access Level:acceso abierto
Palabra clave:Focal epilepsy
Lacosamide
Quality of life
Seizure freedom
Descripción
Sumario:Purpose To evaluate the efficacy and safety of lacosamide administered as either first add-on or later add-on antiepileptic drug (AED) therapy for patients with uncontrolled partial-onset seizures (POS). Methods In this open-label, multicentre trial, patients with POS initiated oral lacosamide (titrated to 400 mg/day) either as add-on to first AED monotherapy, or as later add-on to 1-3 concomitant AEDs after 2 previous AEDs. The primary efficacy variable was the proportion of patients achieving seizure freedom for the first 12 weeks of the 24-week Maintenance Phase. Results 456 patients received 1 dose of lacosamide (96 as first add-on, 360 as later add-on). In the first add-on cohort, 27/72 (37.5%) patients completed 12 weeks treatment and remained seizure-free; 18/68 (26.5%) remained seizure-free after 24 weeks. 64/91 (70.3%) patients achieved 50% reduction in seizure frequency during maintenance treatment. This was accompanied by a mean 7.1 ± 16.00 point improvement from Baseline in the Quality of Life Inventory in Epilepsy (QOLIE-31-P) total score for 24-week completers, with improvement reported in all subscales. Most common treatment-emergent adverse events (TEAEs) were dizziness (31.3%) and headache (13.5%). In the later add-on cohort, 39/261 (14.9%) and 29/249 (11.6%) patients remained seizure-free after completing 12 and 24 weeks' treatment, respectively. 178/353 (50.4%) patients achieved 50% reduction in seizure frequency during maintenance treatment. Mean change in QOLIE-31-P total score was 4.8 ± 14.74 points among 24-week completers. Common TEAEs were dizziness (33.6%), somnolence (15.0%) and headache (11.4%). Conclusions Lacosamide initiated as first add-on treatment was efficacious and well tolerated in patients with uncontrolled POS.