Oxcarbazepine add-on for drug-resistant focal epilepsy

Bresnahan, Rebecca; Atim-Oluk, Margaret; Marson, Anthony G

doi:10.1002/14651858.cd012433.pub2

Cited by 11 publications

(6 citation statements)

References 38 publications

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“…The attenuation effect of dopaminergic neurotoxicity by valproic acid was assumed to be effective (19). Oxcarbazepine might effectively reduce seizure frequency when used as an add-on for drug-resistant epilepsy (20), but the mechanism by which valproic acid and oxcarbazepine combination works in patients with SATB1 variants needs further investigation. Treatment process and prognosis of our case could provide reliable reference for management of patients with same gene mutation.…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental disorders and anti-epileptic treatment in a patient with a SATB1 mutation: A case report

Li¹,

Li²,

Chen³

et al. 2022

Front. Pediatr.

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SATB1 variants causing developmental delay with dysmorphic facies and dental anomalies have been reported in a small cohort. Most patients present epilepsy as a main clinical feature in neurodevelopmental disorders; however, its treatment is unknown. Here, we present a Chinese patient with a de novo truncating variation in SATB1 who presented with mild developmental delay. We disclose the detailed anti-epileptic pharmacological treatment that enabled a favorable outcome. Our study provides important information that may aid clinicians in the prognosis and treatment of rare neurological developmental disorders caused by gene mutations.

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Section: Discussionmentioning

confidence: 99%

Neurodevelopmental disorders and anti-epileptic treatment in a patient with a SATB1 mutation: A case report

Li¹,

Li²,

Chen³

et al. 2022

Front. Pediatr.

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“…Psychiatric side effects in predisposed patients should be considered especially for LEV [32]. The use of OXC is based on low quality findings and safety data suggest a high risk of treatment withdrawal due to side effects [33]. LCM seems to be effective and well tolerated but not at high doses (>400 mg per day) [34].…”

Section: Adjunctive Treatmentmentioning

confidence: 99%

Pharmacological treatment of focal epilepsy in adults: an evidence based approach

Mula

2020

Expert Opinion on Pharmacotherapy

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Introduction:Focal seizures represent the most common seizure type and focal epilepsies the most common epilepsy type. Anti-seizure medications (ASMs) still represent the main form of treatment for epilepsy. Areas covered:The aim of this review article is to provide an overview of available evidence about current and upcoming pharmacological options and strategies for adults with focal epilepsy focusing on the last 5 years.Expert opinion: Seventeen drugs are currently approved for the treatment of focal seizures including cenobamate as the very latest option. Ten of these drugs are also licensed for monotherapy. Level A evidence for initial monotherapy is available for seven drugs with no robust data supporting that one drug is superior to the other. Safety, tolerability as well as pharmacoeconomic reasons would then drive treatment decisions. Data on adjunctive treatment are available for 13 ASMs showing again no obvious difference in terms of efficacy. Evidence on specific drug combinations is almost non-existent and the final decision of combining specific drugs is based on the experience of the individual clinician rather than on robust evidence. Current outcome measures do not consider number of previously failed drugs and the observation period is often too short.

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“…A novel ASM, oxcarbazepine (OXC), is a derivative that improves the safety and pharmacokinetic characteristics of carbamazepine (CBZ) and reduces the interaction between CBZ and other ASMs ( 6 ). OXC's mechanism of action blocks sodium channels and controls the abnormal firing of neurons ( 7 ). Another novel ASM, levetiracetam (LEV), demonstrates the antiepileptic mechanism of action through combination with synaptic vesicle protein SV2A, interference with neurotransmitter release in vesicles, control of rapid firing of neurons, inhibition of Ca 2+ release and blockage of Ca 2+ channels, and control of the excessive synchronization between neurons ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of levetiracetam vs. oxcarbazepine in the treatment of children with epilepsy: a systematic review and meta-analysis

Liu,

Wang,

et al. 2024

Front. Pediatr.

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BackgroundLevetiracetam (LEV) and oxcarbazepine (OXC) are new antiseizure medications (ASMs). In recent years, OXC monotherapy is widely used in children with epilepsy; however, no consensus exists on applying LEV monotherapy among children with epilepsy.ObjectiveThe present work focused on comparing the efficacy and safety of LEV and OXC monotherapy in treating children with epilepsy.MethodsWe conducted a comprehensive search across multiple databases including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang Database, VIP, and China Biology Medicine disc, covering studies from inception to August 26, 2023. We included randomized controlled trials (RCTs) and cohort studies evaluating the efficacy and safety of LEV and OXC monotherapy for treating epilepsy in children. We utilized Cochrane Risk of Bias Tool in RevMan 5.3 software for assessing included RCTs quality. In addition, included cohort studies quality was determined using Newcastle-Ottawa Scale (NOS). A random-effects model was utilized to summarize the results.ResultsThis meta-analysis included altogether 14 studies, including 893 children with epilepsy. LEV and OXC monotherapy was not statistical different among children with epilepsy in seizure-free rate (relative risk [RR] = 1.010, 95% confidence interval [CI] [0.822, 1.242], P > 0.05) and seizure frequency decrease of ≥50% compared with baseline [RR = 0.938, 95% CI (0.676, 1.301), P > 0.05]. Differences in total adverse reaction rate [RR = 1.113, 95% CI (0.710, 1.744), P > 0.05] and failure rate because of serious adverse reaction [RR = 1.001, 95% CI (0.349, 2.871), P > 0.05] were not statistical different between LEV and OXC treatments among children with epilepsy. However, the effects of OXC monotherapy on thyroid among children with epilepsy was statistically correlated than that of LEV (thyroid stimulating hormone: standardized mean difference [SMD] = −0.144, 95% CI [−0.613, 0.325], P > 0.05; free thyroxine: SMD = 1.663, 95% CI [0.179, 3.147], P < 0.05).ConclusionThe efficacy of LEV and OXC monotherapy in treating children with epilepsy is similar. However, OXC having a more significant effect on the thyroid than that of LEV. Therefore, LEV may be safer for children with epilepsy who are predisposed to thyroid disease than OXC.Systematic Review Registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42024514016)

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Oxcarbazepine add-on for drug-resistant focal epilepsy

Cited by 11 publications

References 38 publications

Neurodevelopmental disorders and anti-epileptic treatment in a patient with a SATB1 mutation: A case report

Neurodevelopmental disorders and anti-epileptic treatment in a patient with a SATB1 mutation: A case report

Pharmacological treatment of focal epilepsy in adults: an evidence based approach

Efficacy and safety of levetiracetam vs. oxcarbazepine in the treatment of children with epilepsy: a systematic review and meta-analysis

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