Pharmacokinetic variability, efficacy and tolerability of eslicarbazepine acetate–A national approach to the evaluation of therapeutic drug monitoring data and clinical outcome

Svendsen, Torleiv; Brodtkorb, Eylert; Reimers, Arne; Molden, Espen; Sætre, Erik; Johannessen, Svein I.; Landmark, Cecilie Johannessen

doi:10.1016/j.eplepsyres.2016.12.001

Cited by 15 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, neither efficacy nor tolerability appeared to be different in the two groups, although there was a slight predominance of more responders and less recorded adverse effects in the ID group, which conceivably had an impact on the retention rate. As compared to other recently approved AEDs, we previously demonstrated a retention rate of 83%, 72%, and 63% of eslicarbazepine acetate in patients with refractory epilepsy after 1, 2, and 3 years of treatment, respectively . In another study with patients with refractory epilepsy and ID, the retention rate of perampanel was 46% and 42%, after 1 and 2 years, respectively …”

Section: Discussioncontrasting

confidence: 80%

“…Our findings indicate that serum concentrations of LCM below 10 µmol/L (ie, the lower limit of the reference range) result in poor efficacy. Some of these patients with low concentrations seemed to have relevant therapeutic daily dosages above 200 mg, which underlines the importance of using TDM when experiencing lack of efficacy . Concomitantly used AEDs contributed only moderately to variability between patients.…”

Section: Discussionmentioning

confidence: 94%

“…Retrospective studies have a number of limitations, as medical records and TDM databases may be incomplete. Nevertheless, we recently compared the data from TDM request forms and found that the given information about AEDs and dosages was in accordance with the medical records . Retrospective, uncontrolled studies may be a valuable supplement to prospective studies by the possibility to identify rare adverse effects in subgroups of patients as they represent a real‐life setting .…”

Section: Discussionmentioning

confidence: 99%

“…Therapeutic drug monitoring is an important tool for optimizing drug treatment in epilepsy. In previous studies, we have emphasized the value of TDM in treating patients with LCM . In patients with ID and epilepsy, comparative and combined studies of clinical and pharmacokinetic data are lacking.…”

Section: Introductionmentioning

confidence: 99%

“…In previous studies, we have emphasized the value of TDM in treating patients with LCM. [18][19][20] In patients with ID and epilepsy, comparative and combined studies of clinical and pharmacokinetic data are lacking. By combining such data, a more comprehensive evaluation of the patient is possible, and pharmacokinetic variability may be accounted for, when it comes to individual factors, drug interactions and polypharmacy in epilepsy or comorbid disorders.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Clinical experience combined with therapeutic drug monitoring of lacosamide

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective Lacosamide (LCM) is an antiepileptic drug (AED) with insufficient clinical experience in patients with intellectual disability (ID). They often have more severe epilepsy with comorbidities. The objective was to evaluate the efficacy and tolerability of lacosamide (LCM) in patients with refractory epilepsy with and without ID in a real‐life setting, taking drug monitoring (TDM) data into account therapeutic. Methods Retrospectively, we identified 344 patients using LCM from the TDM service covering the majority of the country, at the National Center for Epilepsy in Norway (2013‐2018). Clinical and TDM data were available for 132 patients. Results Forty‐four of the 132 patients (33%) had ID. The retention rate was significantly higher in the ID vs the non‐ID group after 1 year (84% vs 68%, P < .05). By combining clinical and TDM data, we demonstrated that 37/38 responding patients had serum concentrations above the lower limit of the reference range (>10 µmol/L), and 16/17 with lower concentrations were non‐responders. Mean serum concentration/dose ratios were similar in both groups, 0.06 and 0.07 µmol/L/mg. There were no significant differences regarding efficacy and tolerability. The risk of LCM withdrawal was significantly higher when LCM was added to sodium channel blockers, even if the latter was discontinued. Significance Lacosamide was generally well tolerated in patients with drug‐resistant epilepsy, where one third had ID, and in these patients the retention rate was higher. The combination of clinical and TDM data could possibly facilitate LCM therapy in these vulnerable patients.

show abstract

Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Clinical experience combined with therapeutic drug monitoring of lacosamide

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

Pharmacokinetic Factors to Consider in the Selection of Antiseizure Drugs for Older Patients with Epilepsy

Anderson

Hakimian

2018

Drugs Aging

View full text Add to dashboard Cite

Eslicarbazepine Acetate: A New Improvement on a Classic Drug Family for the Treatment of Partial-Onset Seizures

Galiana¹,

Gauthier²,

Mattson³

2017

Drugs R D

View full text Add to dashboard Cite

Eslicarbazepine acetate is a new anti-epileptic drug belonging to the dibenzazepine carboxamide family that is currently approved as adjunctive therapy and monotherapy for partial-onset (focal) seizures. The drug enhances slow inactivation of voltage-gated sodium channels and subsequently reduces the activity of rapidly firing neurons. Eslicarbazepine acetate has few, but some, drug–drug interactions. It is a weak enzyme inducer and it inhibits cytochrome P450 2C19, but it affects a smaller assortment of enzymes than carbamazepine. Clinical studies using eslicarbazepine acetate as adjunctive treatment or monotherapy have demonstrated its efficacy in patients with refractory or newly diagnosed focal seizures. The drug is generally well tolerated, and the most common side effects include dizziness, headache, and diplopia. One of the greatest strengths of eslicarbazepine acetate is its ability to be administered only once per day. Eslicarbazepine acetate has many advantages over older anti-epileptic drugs, and it should be strongly considered when treating patients with partial-onset epilepsy.

show abstract

Pharmacokinetic variability, efficacy and tolerability of eslicarbazepine acetate–A national approach to the evaluation of therapeutic drug monitoring data and clinical outcome

Cited by 15 publications

References 28 publications

Clinical experience combined with therapeutic drug monitoring of lacosamide

Clinical experience combined with therapeutic drug monitoring of lacosamide

Pharmacokinetic Factors to Consider in the Selection of Antiseizure Drugs for Older Patients with Epilepsy

Eslicarbazepine Acetate: A New Improvement on a Classic Drug Family for the Treatment of Partial-Onset Seizures

Contact Info

Product

Resources

About