Department of Pediatrics, Division of Neurology, BC Children's Hospital, Vancouver, BC, Canada.
Department of Pediatrics, Division of Neurology, Health Sciences Centre Children's Hospital, Winnipeg, MB, Canada.
J Child Neurol. 2025 Jan;40(1):39-48. doi: 10.1177/08830738241282903. Epub 2024 Oct 8.
Eslicarbazepine (ESL) is a once-daily, third-generation antiseizure medication for focal-onset seizures. The primary mechanism of action is enhancing the slow inactivation of voltage-gated sodium channels. The study objective was to review real-world experience regarding retention rate, efficacy, and tolerability of eslicarbazepine, soon after it became available for children in Canada.
A retrospective review was performed on all patients prescribed eslicarbazepine from September 2017 to June 2020, with at least 3 years of follow-up data, at 3 Canadian tertiary care pediatric centers.
Fifty patients were identified, and the mean age of eslicarbazepine initiation was 12.4 years (range 3-19 years). Most patients had drug-resistant epilepsy, trying a mean of 5.04 (range 0-14) antiseizure medications before the initiation of eslicarbazepine. Twenty-four patients (48.0%) experienced adverse effects, including dizziness (n = 10), drowsiness (n = 6), dizziness and drowsiness (n = 1), nausea and abdominal pain (n = 4), transient unsteadiness and diplopia (n = 1), and negative mood changes (n = 2). None had serious adverse effects, including rash. The retention rate of eslicarbazepine at last follow-up was 70%. Fifteen (30%) had ≥50% seizure reduction, with 2 of these patients becoming seizure free. Ten (20%) had 25% to 50% reduction, 2 (4%) had worsening of seizures, and 17 (34%) had no change in seizure frequency.
The study results support the long-term effectiveness and tolerability of eslicarbazepine in a cohort of children with predominantly drug-resistant epilepsy in a real-life setting from 3 Canadian centers with initial use after approval. Adverse effects were nonserious, infrequently leading to eslicarbazepine discontinuation.
依沙佐匹克隆（ESL）是一种每日一次的第三代抗癫痫药物，用于局灶性发作性癫痫。其主要作用机制是增强电压门控钠离子通道的缓慢失活。本研究旨在回顾 ES 自 2017 年 9 月在加拿大上市后不久，在加拿大 3 个三级儿科中心对其保留率、疗效和耐受性的真实世界经验。
对 2017 年 9 月至 2020 年 6 月期间在加拿大 3 个三级儿科中心至少有 3 年随访数据的所有服用 ES 患者进行回顾性分析。
共发现 50 例患者，ES 起始年龄为 12.4 岁（范围 3-19 岁）。大多数患者患有耐药性癫痫，在开始服用 ES 之前尝试了平均 5.04 种（范围 0-14 种）抗癫痫药物。24 例（48.0%）患者出现不良反应，包括头晕（n=10）、困倦（n=6）、头晕和困倦（n=1）、恶心和腹痛（n=4）、短暂性不稳和复视（n=1）、负性情绪变化（n=2）。无严重不良反应，包括皮疹。最后一次随访时 ES 的保留率为 70%。15 例（30%）癫痫发作减少≥50%，其中 2 例患者癫痫发作消失。10 例（20%）减少 25%-50%，2 例（4%）癫痫发作恶化，17 例（34%）癫痫发作频率无变化。
本研究结果支持 ES 在加拿大 3 个中心的真实世界环境中，在批准后最初使用时，对以耐药性癫痫为主的儿童具有长期有效性和耐受性。不良反应不严重，很少导致 ES 停药。
