Department of Neurology Tampere University Hospital Tampere Finland.
Department of Neurology University of Tampere and Tampere University Hospital Tampere Finland.
Brain Behav. 2017 Jan 27;7(3):e00634. doi: 10.1002/brb3.634. eCollection 2017 Mar.
There 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.
The 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.
Twenty-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.
This 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.
在耐受性方面,奥卡西平(OXC)和依索卡宾(ESL)之间的临床证据有限,或者如何从 OXC 转换为 ESL。我们报告了由于耐受性问题,将局灶性癫痫患者从以前的 OXC 治疗转换为 ESL 的过程。报告了从 OXC 转换的原理,并根据耐受性和疗效分析了与该原理相对应的结果。
在医院住院环境中,患者在一夜之间从 OXC 过渡到 ESL。在 1 个月和 3 个月后评估转换的效果。在转换期后记录所有不良事件(AE)。根据 AE 的结果对受试者进行分类。
23 名患者从 OXC 转换为 ESL。15 名患者 OXC 相关 AE 在转换后显著减少。特别是,大多数(93%)在早晨出现的 AE 在转换为 ESL 后得到解决。没有患者在转换后癫痫发作频率增加。ESL 相关 AE 的发生率在 1 个月时为 39%,在 3 个月时为 13%;然而,所有患者在整个研究期间均继续使用 ESL。
本研究表明,在转换为 ESL 后,患有 OXC 相关 AE 的患者在耐受性方面有所改善,同时保持了癫痫发作控制。如果 OXC 相关 AE 在 OXC 早晨剂量后最为明显,则这种改善更为明显。可以在门诊环境中安全地进行转换。