Department of Clinical Neurosciences, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Seizure. 2012 Sep;21(7):512-7. doi: 10.1016/j.seizure.2012.05.005. Epub 2012 Jun 12.
Lacosamide (LCS) is a new antiepileptic drug (AED) licensed in the European Union (EU) and United States (US) in 2008.
To evaluate the efficacy and tolerability of add-on LCS in an out-patient epilepsy clinic setting to obtain useful information for everyday practice.
We pooled data retrospectively from the case note of patients with refractory epilepsy in whom LCS had been prescribed in 19 hospitals across the United Kingdom.
Four hundred and three patients were included (mean age 41.9 years, 50.6% women, 18.1% with learning disabilities (LD)). Mean follow-up (FU) was 11.6 months (range one day to 42 months). Most patients (86.9%) presented with symptomatic partial epilepsy (SPE) and 80% were taking two or more antiepileptic drugs (AEDs) when LCS was added (mean 2, range 0-4). Retention rates were 80% at six months, 68% at one year and 45% at two years. The efficacy of LCS was evaluated at three months and at the final FU. At three months one hundred and eight patients (31.1%) reported ≥ 50% seizure reduction and 32 (9.2%) were seizure free. At the final FU 102 (37.5%) reported ≥ 50% seizures reduction and 28 (9.8%) were seizure free. One hundred and ninety three patients (48.7%) reported adverse effects (AEs). The most frequent were sedation and dizziness, followed by nausea. Lacosamide was discontinued in 150 patients (38%), 60 due to AEs alone.
LCS appears to be an effective and safe AED when used as adjunctive therapy in patients with refractory partial epilepsy.
拉考沙胺（LCS）是一种新型抗癫痫药物（AED），于 2008 年在欧盟（EU）和美国（US）获得许可。
评估在门诊癫痫诊所中添加 LCS 的疗效和耐受性，为日常实践提供有用信息。
我们从英国 19 家医院的病历中回顾性地收集了接受 LCS 治疗的难治性癫痫患者的数据。
共纳入 403 例患者（平均年龄 41.9 岁，50.6%为女性，18.1%有学习障碍（LD））。平均随访（FU）时间为 11.6 个月（范围为 1 天至 42 个月）。大多数患者（86.9%）表现为症状性部分性癫痫（SPE），当添加 LCS 时，80%的患者正在服用两种或更多种抗癫痫药物（AEDs）（平均 2 种，范围 0-4 种）。六个月时的保留率为 80%，一年时为 68%，两年时为 45%。LCS 的疗效在三个月和最终 FU 时进行评估。在三个月时，有 108 例患者（31.1%）报告≥50%的癫痫发作减少，32 例（9.2%）无癫痫发作。在最终 FU 时，有 102 例（37.5%）报告≥50%的癫痫发作减少，28 例（9.8%）无癫痫发作。193 例患者（48.7%）报告有不良反应（AE）。最常见的是镇静和头晕，其次是恶心。由于 AE，有 150 例患者（38%）停止使用 LCS，其中 60 例仅因 AE 而停药。
当作为辅助治疗用于治疗难治性部分性癫痫患者时，拉考沙胺似乎是一种有效且安全的 AED。
