Lacosamide and sodium channel-blocking antiepileptic drug cross-titration against levetiracetam background therapy

Baulac, Michel; Byrnes, William; Williams, Paulette; Borghs, Simon; Webster, Elizabeth; Backer, Marc De; Dedeken, Peter

doi:10.1111/ane.12691

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Though not significant, those who were concomitantly receiving sodium channel blocking AEDs in this study had higher frequency of dizziness compared to subjects receiving non-sodium channel blocking AEDs. This is in accordance with the study by Novy et al, in which lacosamide when concomitantly administered with other sodium channel blocking AEDs was observed to cause increased side effects (diplopia, dizziness, drowsiness) [21] .…”

Section: Pre and Post Lacosamide Cognitionsupporting

confidence: 93%

Cognitive Effects of Lacosamide in Patients with Drug Refractory Focal Epilepsy: A Prospective Observational Study

Asha

Iype

et al. 2021

ijirms

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Objectives: This study was conducted to obtain data on the cognitive effects of lacosamide in Indian population. Methodology: An open labelled prospective observational study in 22 patients who suffered from focal epilepsy. Results: All the pre and post lacosamide cognition scores showed statistically significant positive correlation in this study. Average initial seizure frequency per month was 3.56 (SD 2.58) and median frequency 2.5 seizures per month. Range being 1-8 per month. At the final follow-up at 6months, 87.5% of the study subjects had no seizures. In the remaining12.5% of patients, reduction in seizure frequency was observed. The difference in frequency is statistically significant (Wilcoxon Signed Ranks TestP <0.001). Conclusion: Excellent seizure control is observed in patients with refractory focal epilepsy treated with lacosamide. Also, lacosamide has no serious adverse effects or drug interactions. In this study, it is observed that unlike many AEDs, lacosamide contributed to significant improvement in cognition.

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Section: Pre and Post Lacosamide Cognitionsupporting

confidence: 93%

Cognitive Effects of Lacosamide in Patients with Drug Refractory Focal Epilepsy: A Prospective Observational Study

Asha

Iype

et al. 2021

ijirms

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“…This is in accordance with the study by Novy et al, in which lacosamide when concomitantly administered with other sodium channel blocking AEDs was observed to cause increased side effects (diplopia, dizziness, drowsiness). [20] In the present study, comparison of on-treatment versus baseline ECG results did not demonstrate any change in heart rate, PR interval, QT interval, or QRS duration in the study subjects. No cardiac adverse events were reported during the study period.…”

Section: Discussioncontrasting

confidence: 48%

Cognitive Adverse Effects of Lacosamide in Patients With Localization Related Epilepsy - A Prospective Observational Study

Sb¹,

Asha²,

Iype³

et al. 2021

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More than 30% of epilepsy patients remain refractory to pharmacotherapy. Combined administration of AEDs or the application of novel AEDs is a therapeutic option especially when surgical treatment cannot be offered. The newer AEDs offer new mechanisms of action and more favourable safety profiles than the older AEDs. Lacosamide (LCM) is one of the third generation AEDs approved for adjunctive use in partial-onset seizures. Patients with epilepsy frequently experience cognitive dysfunctions. Because antiepileptic drugs (AEDs) are the major therapeutic modality for epilepsy, the adverse effects of AEDs on cognition are important. Objectives: This study was conducted to obtain reliable data on the cognitive adverse effects of lacosamide in Indian population. METHODOLOGY : An open labelled prospective observational study in 22 patients who suffered from localization related epilepsy. Results: Average Initial seizure frequency per month was 3.56 (SD 2.58) and median frequency 2.5 seizures per month. Range being 1-8 per month. At the final followup at 6months, only 2 persons experienced seizure and that too only single episodes. The difference in frequency is statistically significant (Wilcoxon Signed Ranks TestP <0.001). All the pre and post lacosamide cognition scores showed statistically significant positive correlation in this study. Conclusion: Excellent seizure control is observed in patients with refractory localization related epilepsy treated with lacosamide. Also, lacosamide has no serious adverse effects or drug interactions. In this study, it is observed that unlike many AEDs, lacosamide contributed to significant improvement in cognition and can improve the quality of life in such patients.

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“…Indeed, cross-titration and flexible titration have previously been suggested as feasible and practical approaches for dosing lacosamide while minimizing pharmacodynamic interactions with a sodium channel blocking AED. 21 The incidence of ADRs in patients aged ≥65 years (16.4%) tended to be higher than that observed in those aged <65 years (10.0%).…”

Section: Discussionmentioning

confidence: 77%

“…While the low documented incidence of dizziness may indicate a level of underreporting of less severe AEs in retrospective studies, it may also be possible that the incidence of this ADR is lower in clinical practice due to individualized titration (usually slower than in clinical trials) and dosing. Indeed, cross‐titration and flexible titration have previously been suggested as feasible and practical approaches for dosing lacosamide while minimizing pharmacodynamic interactions with a sodium channel blocking AED 21. The incidence of ADRs in patients aged ≥65 years (16.4%) tended to be higher than that observed in those aged <65 years (10.0%).…”

Section: Discussionmentioning

confidence: 99%

Lacosamide monotherapy in clinical practice: A retrospective chart review

et al. 2018

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ObjectiveTo assess effectiveness and tolerability of first‐line and conversion to lacosamide monotherapy for focal seizures.Materials and MethodsRetrospective, non‐interventional chart review of lacosamide monotherapy patients aged ≥16 years in Europe. Outcomes included retention rate at observational point (OP) 3 (12 ± 3 months), seizure freedom rates at OP2 (6 ± 3 months) and OP3 and adverse drug reactions (ADRs).ResultsA total of 439 patients were included (98 first‐line and 341 conversion to monotherapy; 128 aged ≥65 years [25 first‐line and 103 conversion to monotherapy]). First‐line and conversion to monotherapy retention rates were 60.2% (59/98; 95% confidence interval [CI] 49.8%‐70.0%) and 62.5% (213/341; 57.1%‐67.6%), respectively. Kaplan‐Meier estimates of 12‐month retention rates were 81.2% and 91.4% for first‐line and conversion to monotherapy, respectively. First‐line and conversion to monotherapy retention rates in patients aged ≥65 years were 60.0% (38.7%‐78.9%) and 68.9% (59.1%‐77.7%), respectively. At OP2, 66.3% of first‐line and 63.0% of conversion to monotherapy patients were seizure free. At OP3, 60.2% of first‐line and 52.5% of conversion to monotherapy patients were seizure free. In the ≥65 years subgroup, seizure freedom rates at OP2 were 72.0% and 68.0% for first‐line and converted to monotherapy, respectively, and at OP3, 68.0% and 56.3%, respectively. Overall, 52 of 439 (11.8%) patients reported ADRs (16.4% in ≥65 years subgroup), most commonly dizziness (5.0%), headache (2.1%) and somnolence (1.6%).ConclusionsLacosamide was effective and well tolerated as first‐line or conversion to monotherapy in a clinical setting in adult and elderly patients with focal seizures.

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Lacosamide and sodium channel-blocking antiepileptic drug cross-titration against levetiracetam background therapy

Cited by 15 publications

References 26 publications

Cognitive Effects of Lacosamide in Patients with Drug Refractory Focal Epilepsy: A Prospective Observational Study

Cognitive Effects of Lacosamide in Patients with Drug Refractory Focal Epilepsy: A Prospective Observational Study

Cognitive Adverse Effects of Lacosamide in Patients With Localization Related Epilepsy - A Prospective Observational Study

Lacosamide monotherapy in clinical practice: A retrospective chart review

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