An overview of third-generation antiseizure drugs

Spanaki, Marianna V.; Barkley, Gregory L.

doi:10.1212/cpj.0b013e31826af264

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…AEDs are classified into three generations based on their FDA approval date: first-generation AEDs were approved prior to the 1990s, second-generation AEDs were approved in the 1990s and third-generation AEDs in the 2000s. For this study, we classified first-generation AEDs as “old” and the second-/third-generation AEDs as “newer” (Tables 1 and 3 ) [ 23 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

Association Between Adverse Events and Discontinuation of Antiepileptic Drugs Among Drug-Naïve Adults with Epilepsy

Peasah

Fishman

Ems

et al. 2020

Drugs - Real World Outcomes

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Background Adherence to antiepileptic drugs (AEDs) remains the primary management tool to prevent recurrent seizures in patients with epilepsy. Adverse events associated with AEDs could have an impact on adherence and result in treatment failures. Objective The goal of this study was to assess the association between adverse events and discontinuation of AEDs for AED-naïve patients with epilepsy. Our second objective was to estimate the economic burden of AED discontinuation. Methods We retrospectively analyzed IBM MarketScan administrative data from 2014 to 2017. The cohort consisted of new users of AEDs with an epilepsy diagnosis and with two or more subsequent AED claims. Outpatient and inpatient cohorts were analyzed separately. Adverse events were identified by injury codes (E-CODES) or by International Classification of Diseases, Ninth/Tenth Edition (ICD-9/10) codes for disease manifestations reported in the literature or product inserts (LADE). Discontinuation of AEDs was defined as a gap of ≥ 60 days without a refill. All cost comparisons were based on 1:1 propensity-score matching. Associations between adverse events and discontinuation were estimated using logistic regression, adjusting for predefined covariates such as age, sex, Charlson Comorbidity Index, insurance type, and AED type. Results The overall discontinuation rate was 9% (E-CODES rate was 0.1% and LADE rate was 27%). The discontinued group was older (56.1 vs. 52.8 years; p < 0.0001). Adults aged ≥ 65 years had the highest discontinuation rate (11%). Patients who discontinued had fewer AED claims (6.8 vs. 9.2; p < 0.0001), more outpatient claims (19.3 vs. 17.8; p < 0.0001), and longer hospital stays (6.6 vs. 5.3 days; p < 0.0001). Differences in daily outpatient costs between patients with and without adverse events were statistically significant (E-CODES $US213 vs. 105; p = 0.001; LADE $US188 vs. 161; p < 0.0001). Additionally, total cost of AEDs in the outpatient cohort was higher for patients with adverse events (E-CODES and LADE). There was no association between E-CODES and AED discontinuation; however, there was a positive association between LADE and discontinuation in the outpatient cohort but a negative association in the inpatient cohort. Conclusion We found that total costs of prescriptions claimed and total costs of outpatient visits among the outpatient cohort were higher for those with adverse drug events than for those without. An association between adverse events and discontinuation was inconclusive because it depended on the target population and how the adverse events were identified.

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Section: Methodsmentioning

confidence: 99%

Association Between Adverse Events and Discontinuation of Antiepileptic Drugs Among Drug-Naïve Adults with Epilepsy

Peasah

Fishman

Ems

et al. 2020

Drugs - Real World Outcomes

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“…Epilepsy is a clinical syndrome of chronic brain dysfunction that is characterized by unpredictable occurrence of seizures [1]. It is a common neurological disorder, and many antiepileptic drugs have been taken for seizure suppression [2,3]. Lacosamide ((R)-2-acetamido-N-benzyl-3-methoxypropionamide) is a new type of antiepileptic drug and approved by US and European regulatory authorities for use as add-on therapy for partial onset seizures in adults [4].…”

Section: Introductionmentioning

confidence: 99%

Identification of forced degradation products of lacosamide by LC-QQLIT-MS and LC-IT/TOF-MS

Zhou

et al. 2019

Acta Chromatographica

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Lacosamide, a new type of antiepileptic drug, was subjected to forced degradation under the conditions of hydrolysis (acidic and alkaline), oxidation, dry heat, and photolysis to characterize its possible degradation products. The drug showed significant degradation under acidic, alkaline and oxidative conditions. The degradation products were separated on an Agilent Zorbax SB-C 18 column with gradient elution using a mobile phase consisting of acetonitrile and ammonium acetate (0.002 mol/L) with formic acid as additive. A combination of liquid chromatography hybrid triple quadrupole-linear ion trap mass spectrometry (LC-QqLIT-MS) and liquid chromatography hybrid ion trap/time-of-flight mass spectrometry (LC-IT/TOF-MS) was used to identify degradation products. A total of 7 products including 4 novel degradation products were characterized. The mechanisms of degradation products of lacosamide were discussed. Application of the method to study degradation products of lacosamide provided fragment information, allowing further investigation of the degradation pathways and intrinsic stability of the drug.

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Channelopathies in epilepsy: an overview of clinical presentations, pathogenic mechanisms, and therapeutic insights

Ng,

Chahine,

Scantlebury

et al. 2024

J Neurol

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An overview of third-generation antiseizure drugs

Cited by 6 publications

References 8 publications

Association Between Adverse Events and Discontinuation of Antiepileptic Drugs Among Drug-Naïve Adults with Epilepsy

Association Between Adverse Events and Discontinuation of Antiepileptic Drugs Among Drug-Naïve Adults with Epilepsy

Identification of forced degradation products of lacosamide by LC-QQLIT-MS and LC-IT/TOF-MS

Channelopathies in epilepsy: an overview of clinical presentations, pathogenic mechanisms, and therapeutic insights

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