Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Epilepsy Behav. 2021 Dec;125:108397. doi: 10.1016/j.yebeh.2021.108397. Epub 2021 Nov 20.
This multicenter study examined the effectiveness and tolerability of lacosamide (LCM) for children and young adults with epilepsy, particularly in patients who had previously been treated with other sodium channel blockers (SCBs) and the difference in effectiveness and tolerability when using other concomitant SCBs.
We retrospectively studied the clinical information of patients aged <30 years given LCM to treat epilepsy. The effectiveness and adverse events (AEs) of LCM and the other SCBs were investigated. Factors related to the effectiveness and AEs of LCM, such as the number of antiepileptic drugs (AEDs) tried before LCM and concomitantly used SCBs, were also studied.
We enrolled 112 patients (median age = 11 years). One year after starting LCM, 29% of the patients were seizure free, and 50% had a ≥50% seizure reduction. Of the patients, 17% experienced AEs, the most common being somnolence. A ≥50% seizure reduction was observed for LCM in 30% of patients in whom other SCBs had not been effective. Lacosamide produced a ≥50% seizure reduction in 35% of the patients taking one concomitant SCB. By contrast, no patients had ≥50% seizure reduction, and 33% developed AEs, when LCM was administered concomitantly with two SCBs.
Lacosamide was effective in 30% of children and young adults in whom other SCBs had not been effective. The effectiveness of LCM may differ from that of other SCBs, and it is worth trying in patients with epilepsy resistant to other AEDs.
本多中心研究旨在评估拉科酰胺（LCM）治疗儿童和青少年癫痫的疗效和耐受性，尤其关注既往使用过其他钠离子通道阻滞剂（SCB）的患者，以及使用其他 SCB 时疗效和耐受性的差异。
我们回顾性研究了使用 LCM 治疗癫痫的<30 岁患者的临床资料。评估了 LCM 和其他 SCB 的疗效和不良反应（AE）。还研究了与 LCM 疗效和 AE 相关的因素，如使用 LCM 前尝试的抗癫痫药物（AED）数量和同时使用的 SCB。
共纳入 112 例患者（中位年龄 11 岁）。起始 LCM 治疗 1 年后，29%的患者无发作，50%的患者发作减少≥50%。17%的患者出现 AE，最常见的是嗜睡。在其他 SCB 无效的患者中，30%的患者使用 LCM 后有≥50%的发作减少。在同时使用一种 SCB 的患者中，35%的患者 LCM 有≥50%的发作减少。相比之下，同时使用两种 SCB 时，无患者有≥50%的发作减少，33%的患者出现 AE。
在其他 SCB 无效的儿童和青少年中，LCM 有效率为 30%。LCM 的疗效可能与其他 SCB 不同，对于其他 AED 耐药的癫痫患者，值得尝试。
