Villanueva V, Bermejo P, Montoya J, Toledo M, Gómez-Ibáñez A, Garcés M, Vilella L, López-González F J, Rodriguez-Osorio X, Campos D, Martínez P, Giner P, Zurita J, Rodríguez-Uranga J, Ojeda J, Mauri J A, Camacho J L, Ruiz-Giménez J, Poza J J, Massot-Tarrús A, Galiano M L, Bonet M
Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Hospital Universitario Puerta Hierro, Madrid, Spain.
Acta Neurol Scand. 2017 Sep;136(3):254-264. doi: 10.1111/ane.12720. Epub 2016 Dec 9.
Evaluate real-life experience with eslicarbazepine acetate (ESL) after first monotherapy failure in a large series of patients with focal epilepsy.
Multicentre, retrospective, 1-year, observational study in patients older than 18 years, with focal epilepsy, who had failed first antiepileptic drug monotherapy and who received ESL. Data from clinical records were analysed at baseline, 3, 6 and 12 months to assess effectiveness and tolerability.
Eslicarbazepine acetate was initiated in 253 patients. The 1-year retention rate was 92.9%, and the final median dose of ESL was 800 mg. At 12 months, 62.3% of patients had been seizure free for 6 months; 37.3% had been seizure free for 1 year. During follow-up, 31.6% of the patients reported ESL-related adverse events (AEs), most commonly somnolence (8.7%) and dizziness (5.1%), and 3.6% discontinued due to AEs. Hyponatraemia was observed in seven patients (2.8%). After starting ESL, 137 patients (54.2%) withdrew the prior monotherapy and converted to ESL monotherapy; 75.9% were seizure free, 87.6% were responders, 4.4% worsened, and 23.4% reported ESL-related AEs.
Use of ESL after first monotherapy failure was associated with an optimal seizure control and tolerability profile. Over half of patients were converted to ESL monotherapy during follow-up.
在一大组局灶性癫痫患者中，评估醋酸艾司利卡西平（ESL）在首次单药治疗失败后的实际应用经验。
对年龄大于18岁、患有局灶性癫痫、首次抗癫痫药物单药治疗失败且接受ESL治疗的患者进行多中心、回顾性、为期1年的观察性研究。在基线、3个月、6个月和12个月时分析临床记录数据，以评估有效性和耐受性。
253例患者开始使用醋酸艾司利卡西平。1年保留率为92.9%，ESL的最终中位剂量为800mg。在12个月时，62.3%的患者无癫痫发作达6个月；37.3%的患者无癫痫发作达1年。在随访期间，31.6%的患者报告了与ESL相关的不良事件（AE），最常见的是嗜睡（8.7%）和头晕（5.1%），3.6%的患者因AE停药。7例患者（2.8%）出现低钠血症。开始使用ESL后，137例患者（54.2%）停用先前的单药治疗并转换为ESL单药治疗；75.9%的患者无癫痫发作，87.6%的患者有反应，4.4%的患者病情恶化，23.4%的患者报告了与ESL相关的AE。
首次单药治疗失败后使用ESL与最佳的癫痫控制和耐受性相关。超过一半的患者在随访期间转换为ESL单药治疗。
