Villanueva V, Ojeda J, Rocamora R A, Serrano-Castro P J, Parra J, Rodríguez-Uranga J J, Bathal H, Viteri C
Hospital Universitario y Politécnico La Fe, València, España.
Hospital Universitario Infanta Sofía, San Sebastián de Los Reyes, Madrid, España.
Neurologia (Engl Ed). 2018 Jun;33(5):290-300. doi: 10.1016/j.nrl.2016.04.014. Epub 2016 Jun 24.
The objective of the EPICON Project is to develop a set of recommendations on how to adequately switch from carbamazepine (CBZ) and oxcarbazepine (OXC) to eslicarbazepine acetate (ESL) in some patients with epilepsy.
A steering committee drafted a questionnaire of 56 questions regarding the transition from CBZ or OXC to ESL in clinical practice (methodology and change situation). The questionnaire was then distributed to 54 epilepsy experts in 2 rounds using the Delphi method. An agreement/disagreement consensus was defined when a median ≥ 7 points or ≤ 3 was achieved, respectively, and a relative interquartile range ≤ 0.40. We analysed the results obtained to reach our conclusions.
Our main recommendations were the following: switching from CBZ to ESL must be carried out over a period of 1 to 3 weeks with a CBZ:ESL dose ratio of 1:1.3 and is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, subjects with cognitive problems, severe osteoporosis-osteopaenia, dyslipidaemia, or liver disease other than acute liver failure, as well as for men with erectile dysfunction caused by CBZ. The transition from OXC to ESL can take place overnight with an OXC:ESL dose ratio of 1:1 and it is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, or those with cognitive problems. The transition was not recommended for patients with prior rash due to CBZ or OXC use.
The EPICON Project offers a set of recommendations about the clinical management of switching from CBZ or OXC to ESL, using the Delphi method.
EPICON项目的目标是就如何在一些癫痫患者中从卡马西平（CBZ）和奥卡西平（OXC）充分转换为醋酸艾司利卡西平（ESL）制定一套建议。
一个指导委员会起草了一份关于临床实践中从CBZ或OXC转换为ESL的56个问题的问卷（方法和变化情况）。然后使用德尔菲法分两轮将问卷分发给54位癫痫专家。当分别达到中位数≥7分或≤3分且相对四分位距≤0.40时，定义达成一致/不一致共识。我们分析所得结果以得出结论。
我们的主要建议如下：从CBZ转换为ESL必须在1至3周的时间内进行，CBZ与ESL的剂量比为1:1.3，推荐用于经常忘记服药的患者、轮班工作的患者、联合用药的患者、有认知问题的患者、严重骨质疏松症-骨质减少症患者、血脂异常患者或除急性肝衰竭外的肝病患者，以及因CBZ导致勃起功能障碍的男性。从OXC转换为ESL可以在一夜之间进行，OXC与ESL的剂量比为1:1，推荐用于经常忘记服药的患者、轮班工作的患者、联合用药的患者或有认知问题的患者。不建议曾因使用CBZ或OXC出现皮疹的患者进行转换。
EPICON项目使用德尔菲法提供了一套关于从CBZ或OXC转换为ESL的临床管理建议。
