Practical guidance and considerations for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate — Expert opinion

Peltola, Jukka; Holtkamp, Martin; Rocamora, Rodrigo; Ryvlin, Philippe; Sieradzan, Kasia; Villanueva, Vicente

doi:10.1016/j.yebeh.2015.05.036

Cited by 24 publications

(37 citation statements)

References 26 publications

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Section: Discussionmentioning

confidence: 99%

“…Moreover, given the pharmacological differences between ESL and OXC and CBZ [21, 23, 24], there may be other clinical situations in which it is appropriate to consider transitioning patients from CBZ or OXC to ESL [50]. When transitioning patients from OXC to ESL, a dose ratio of 1:1 is recommended and it has been claimed that the change is possible to undertake in a single step, with no adjustment to comedication required [50]. The transitioning of patients from CBZ to ESL is less straightforward and should be carefully considered on a case-by-case basis, taking account of the patient’s clinical characteristics and comedications, which may require dose adjustment due to CBZ being a strong inducer of CYP enzymes [50].…”

Section: Discussionmentioning

confidence: 99%

“…When transitioning patients from OXC to ESL, a dose ratio of 1:1 is recommended and it has been claimed that the change is possible to undertake in a single step, with no adjustment to comedication required [50]. The transitioning of patients from CBZ to ESL is less straightforward and should be carefully considered on a case-by-case basis, taking account of the patient’s clinical characteristics and comedications, which may require dose adjustment due to CBZ being a strong inducer of CYP enzymes [50]. In general, a CBZ:ESL dose ratio of 1:1.3 should be used and patients should be transitioned over a minimum period of 1–2 weeks [50] although longer periods of switching are often advised.…”

Section: Discussionmentioning

confidence: 99%

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Eslicarbazepine acetate: its effectiveness as adjunctive therapy in clinical trials and open studies

et al. 2017

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Eslicarbazepine acetate (ESL) is a once-daily antiepileptic drug that is approved as adjunctive therapy in adults with focal-onset seizures. Following oral administration, ESL is rapidly metabolized to its active metabolite, eslicarbazepine, which acts primarily by enhancing slow inactivation of voltage-gated sodium channels. The efficacy and safety/tolerability of ESL in the adjunctive setting were established in a comprehensive Phase III program (n = 1702 randomized patients) and this evidence has been supported by several open studies (n = 864). ESL treatment has demonstrated improvements in health-related quality of life, in both randomized clinical trials and open studies. ESL has also been shown to be usually well tolerated and efficacious when used in the adjunctive setting in elderly patients. The effectiveness of ESL as the only add-on to antiepileptic drug monotherapy has been demonstrated in a multinational study (n = 219), subgroup analyses of which have also shown it to be efficacious and generally well tolerated in patients who had previously not responded to carbamazepine therapy. Open studies have also demonstrated improvements in tolerability in patients switched overnight from oxcarbazepine to ESL. Due to differences in pharmacokinetics, pharmacodynamics, and metabolism, there may be clinical situations in which it is appropriate to consider switching patients from oxcarbazepine or carbamazepine to ESL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Eslicarbazepine acetate: its effectiveness as adjunctive therapy in clinical trials and open studies

et al. 2017

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“…Earlier expert group′s opinion hypothesized there might be situations in which it may be reasonable to convert patients from OXC to ESL; most appropriately those who experience OXC‐related AEs or have poor compliance with twice‐daily OXC dosing (Peltola et al., 2015). Recent study by Schmid et al.…”

Section: Discussionmentioning

confidence: 99%

Transition from oxcarbazepine to eslicarbazepine acetate: A single center study

2017

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ObjectivesThere is limited clinical evidence for comparison between oxcarbazepine (OXC) and eslicarbazepine acetate (ESL) in terms of tolerability, or how to execute the change from OXC to ESL. We report the process of transitioning patients with focal epilepsy from previous OXC treatment to ESL due to tolerability problems. The rationale for change from OXC is reported, and the outcome with respective to this rationale is analyzed in terms of tolerability and efficacy.Materials and MethodsThe subjects were transitioned overnight from OXC to ESL in a hospital inpatient setting. An evaluation of the effects of the transition was made after 1 and 3 months. All adverse events (AEs) were recorded following the transition period. Subjects were classified by outcome in terms of AEs.ResultsTwenty‐three subjects were transitioned from OXC to ESL. Fifteen patients OXC‐related AEs reduced significantly after transition. Particularly, most of (93%) the AEs presented in the morning resolved after transition to ESL. No patient had an increase in seizure frequency following the transition. The incidence of ESL‐related AEs was 39% at 1 month and 13% at 3 month follow‐up; however, all patients continued ESL throughout the study period.ConclusionsThis study demonstrates that patients suffering from OXC‐related AEs improve in terms of tolerability after a switch to ESL with maintaining seizure control. This improvement is more pronounced if the OXC‐related AEs are most evident following morning dosing of OXC. Transition can be safely executed in an outpatient setting.

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“…В связи с этим, если предполагается продолжить применение блокаторов натриевых каналов, целесообразно предварять присоединение ПЕР переключением с КБМ на ОКС (1:1,5), или эсликарбазепин (1:1,3), которые проявля-ют свойства слабых индукторов CYP3А4 [19][20][21]. Способ та-ких переключений не сложен и предполагает возможность одношаговой взаимозамены без длительного титрования [22,23].…”

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Analysis of the clinical experience with perampanel in the Moscow Region: Efficacy, tolerability, individual choice priorities

Рудакова¹,

Белова²

2017

RJTAO

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Целью исследования стал анализ нашего опыта применения перампанела (ПЕР) в клинической практике с оценкой эффективно-сти, переносимости и индивидуальных приоритетов выбора. Пациенты и методы. В исследование были включены 28 пациентов с фармакорезистентной фокальной эпилепсией, средний воз-раст 38,3±10,7 года, доля мужчин -46,4%, длительность заболевания -от 8 до 33 лет (средняя -20,2 года

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Practical guidance and considerations for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate — Expert opinion

Cited by 24 publications

References 26 publications

Eslicarbazepine acetate: its effectiveness as adjunctive therapy in clinical trials and open studies

Eslicarbazepine acetate: its effectiveness as adjunctive therapy in clinical trials and open studies

Transition from oxcarbazepine to eslicarbazepine acetate: A single center study

Analysis of the clinical experience with perampanel in the Moscow Region: Efficacy, tolerability, individual choice priorities

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