Kim Hyun Kyung, Kwack Dong Won, Kim Dong Wook
Department of Neurology, National Medical Center, Seoul, Korea.
Department of Neurology, Konkuk University Hospital, Seoul, Korea.
Clin Neuropharmacol. 2025;48(3):93-96. doi: 10.1097/WNF.0000000000000633.
Eslicarbazepine acetate (ESL) is a third-generation antiseizure medication (ASM) approved for the treatment of focal seizures. Because of the delayed approval of ESL in Asian countries, there is limited information on the clinical usefulness of ESL in the Asian population. We performed a retrospective analysis of retention rate and seizure outcomes for ESL treatment in Korean epilepsy patients.
A 2-year retrospective observational study was conducted, in which 160 epilepsy patients (82 males; age range, 17-81 years) were treated with ESL. The starting dose of ESL was 400 mg/d, and optimal dose adjustments were made based on individual clinical responses. We analyzed efficacy and tolerability during the 2-year follow-up period.
This study found that the overall retention rate was 81.5% at 1 year and 76.1% at 2 years. The retention rate at 2 years was 86.5% in the monotherapy group and 69.8% in the adjunctive therapy group. Adverse events, mostly dizziness/somnolence and skin eruption, were reported in 38 (23.8%) of patients, leading to discontinuation of ESL in 24 patients. Laboratory hyponatremia was noted in 2 patients, but neither of them experienced symptomatic hyponatremia. Switching from other dibenzazepine ASMs, carbamazepine and oxcarbazepine, was performed in 31 patients (19.4%), and most patients (26 of 31 patients, 83.9%) continued to take ESL until their last follow-up.
Our study demonstrates that treatment with ESL results in favorable retention rates and tolerability among Korean epilepsy patients, which is consistent with data from Western countries. Additionally, our findings suggest that ESL-induced hyponatremia is infrequent and largely asymptomatic when used cautiously and switching from other dibenzazepine ASMs may be a useful option for selected patients.
醋酸艾司利卡西平（ESL）是一种被批准用于治疗局灶性癫痫发作的第三代抗癫痫药物（ASM）。由于ESL在亚洲国家获批较晚，关于ESL在亚洲人群中的临床实用性信息有限。我们对韩国癫痫患者接受ESL治疗的留存率和癫痫发作结果进行了回顾性分析。
进行了一项为期2年的回顾性观察研究，其中160例癫痫患者（82例男性；年龄范围17 - 81岁）接受了ESL治疗。ESL的起始剂量为400mg/天，并根据个体临床反应进行最佳剂量调整。我们分析了2年随访期内的疗效和耐受性。
本研究发现，1年时总体留存率为81.5%，2年时为76.1%。单药治疗组2年时的留存率为86.5%，辅助治疗组为69.8%。38例（23.8%）患者报告了不良事件，主要是头晕/嗜睡和皮疹，导致24例患者停用ESL。2例患者出现实验室低钠血症，但均未出现症状性低钠血症。31例（19.4%）患者从其他二苯并氮䓬类ASM（卡马西平和奥卡西平）转换而来，大多数患者（31例中的26例，83.9%）持续服用ESL直至最后一次随访。
我们的研究表明，ESL治疗在韩国癫痫患者中具有良好的留存率和耐受性，这与西方国家的数据一致。此外，我们的研究结果表明，谨慎使用时，ESL引起的低钠血症并不常见且大多无症状，对于选定的患者，从其他二苯并氮䓬类ASM转换可能是一个有用的选择。
