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The efficiency and tolerability of lacosamide therapy in adolescents and adults with new-onset focal epilepsy in terms of the epileptiform activity index

https://doi.org/10.14412/2074-2711-2020-3-56-62

Abstract

Lacosamide (LCM) is one of the most promising antiepileptic drugs (AEDs) for focal epilepsy (FE); however, in Russia there are only a few works devoted to its practical application.

Objective: to evaluate the efficiency of LCM therapy in adolescents and adults with new-onset FE.

Patients and methods. The investigation enrolled 36 patients aged 16-78 years. All the patients underwent video-ECG monitoring with quantification of the epileptiform activity index (EAI) at baseline and 1, 3, 6 and 12 months of treatment. The treatment efficiency was evaluated using the standard measures: drug-induced remission, a response rate of ≥50%, an insufficient efficiency of ≤50%, higher seizure frequency, and therapy retention rates. Adverse events (AEs) were assessed using the SIDe-effects of AntiEpileptic Drugs (SIDAED) questionnaire.

Results and discussion. Just 3 months after starting treatment, the total EAI substantially decreased from 2.92 [0; 6.7] to 1.95 [0; 3.07] (p<0.05). LCM demonstrated a high efficacy and a good tolerance in the therapy of FE: by the end of 12-month follow-up, there was a considerable decrease in EAI by 1.57 times (p<0.05); the LCM monotherapy retention rate of 72.2% was achieved in 26 patients: 20 (55.6%) patients had drug-induced remission; six (16.7%) patients were responders. AEs were recorded in 5 (13.8%) cases.

Conclusion. LCM is an effective AED for the initial monotherapy of FE. The use of LCM in FE causes a considerable decrease in EAI by 1.57 times (p<0.05). 

About the Authors

V. A. Karlov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

20, Delegatskaya St., Build. 1, Moscow 127473.


Competing Interests:

The conflict of interest has not affected the results of the investigation.



P. N. Vlasov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

Pavel Nikolaevich Vlasov.

20, Delegatskaya St., Build. 1, Moscow 127473.


Competing Interests:

The conflict of interest has not affected the results of the investigation.



A. B. Kozhokaru
A.I. Burnazyan Federal Medical Biophysical Center, Federal Biomedical Agency of Russia,
Russian Federation

23, Marshal Novikov St., Moscow123098. 


Competing Interests:

The conflict of interest has not affected the results of the investigation.



A. S. Samoilov
A.I. Burnazyan Federal Medical Biophysical Center, Federal Biomedical Agency of Russia,
Russian Federation

23, Marshal Novikov St., Moscow123098. 


Competing Interests:

The conflict of interest has not affected the results of the investigation.



A. S. Orlova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

8, Trubetskaya St., Build. 2, Moscow 119991.


Competing Interests: The conflict of interest has not affected the results of the investigation.


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For citations:


Karlov VA, Vlasov PN, Kozhokaru AB, Samoilov AS, Orlova AS. The efficiency and tolerability of lacosamide therapy in adolescents and adults with new-onset focal epilepsy in terms of the epileptiform activity index. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020;12(3):56-62. https://doi.org/10.14412/2074-2711-2020-3-56-62

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)