Department of Neurology and Psychiatry, "Sapienza" University of Rome, Italy.
Clinical and Experimental Pharmacology Unit, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Seizure. 2017 Dec;53:1-3. doi: 10.1016/j.seizure.2017.09.023. Epub 2017 Oct 3.
Several studies have demonstrated that treatment with enzyme-inducing antiepileptic drugs is associated with increased serum lipid levels. Eslicarbazepine acetate (ESL) is a novel antiepileptic drug specifically designed with the objective to identify carbamazepine and oxcarbazepine analogues with favorable pharmacodynamic and pharmacokinetic profiles. The present study aimed to assess the changes in lipid profile and sodium levels in patients with epilepsy taking ESL as adjunctive therapy.
This report describes a retrospective cohort study of 36 adult patients with epilepsy, taking ESL as an add-on treatment. The laboratory values assessed prior and after (range 6-18 months) ESL treatment were sodium levels, total cholesterol (TC), low (LDL) and high (HDL) density lipoproteins and triglycerides.
TC and LDL values were significantly decreased already after at least six months of therapy with ESL (191.3±29.6 vs 179.7±29.2mg/dl, p <0.0001 and 114.58±22.7 vs 103.11±19.46mg/dl, p <0.0001 respectively). HDL values before and during ESL treatment were significantly increased (57.5± 9.1 vs 63.9±8.3mg/dl; p<0.0001). No statistically significant changes have been found in triglycerides and sodium values.
Add-on therapy with ESL, in contrast to the negative effects observed with traditional older carboxamides, positively affects lipid metabolism profile in patients with epilepsy over an average follow-up of 11 months. Further research is needed to confirm the obtained results with a focus on a comprehensive assessment of the biochemical and molecular mechanisms involved.
多项研究表明，使用酶诱导型抗癫痫药物治疗会导致血清脂质水平升高。依佐加滨（ESL）是一种新型抗癫痫药物，专门设计用于确定具有有利药效学和药代动力学特征的卡马西平和奥卡西平类似物。本研究旨在评估接受 ESL 辅助治疗的癫痫患者血脂谱和钠水平的变化。
本报告描述了一项对 36 名接受 ESL 作为附加治疗的成年癫痫患者的回顾性队列研究。评估了 ESL 治疗前后（6-18 个月）的实验室值，包括钠水平、总胆固醇（TC）、低（LDL）和高（HDL）密度脂蛋白以及甘油三酯。
TC 和 LDL 值在 ESL 治疗至少六个月后显著降低（191.3±29.6 与 179.7±29.2mg/dl，p<0.0001 和 114.58±22.7 与 103.11±19.46mg/dl，p<0.0001）。在 ESL 治疗期间，HDL 值显著升高（57.5±9.1 与 63.9±8.3mg/dl；p<0.0001）。甘油三酯和钠值无统计学显著变化。
与传统旧的羧酰胺类药物观察到的负面影响相反，ESL 附加治疗可在平均 11 个月的随访中对癫痫患者的脂质代谢谱产生积极影响。需要进一步的研究来证实所获得的结果，重点是全面评估所涉及的生化和分子机制。
