Clinical analysis of Lacosamine supplementation in the treatment of refractory epilepsy in children and adolescents_Journal of Epilepsy

Authors：

LIN Haisheng , DAI jin , PENG Bingwei , ZHU Haixia , LI Xiaojing , WANG Xiuying , LI Jialing , SHI Kaili , GAO Yuanyuan ,  CHEN Wenxiong

Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510120, China;

Corresponding author：

CHEN Wenxiong, Email: gzchcwx@126.com

Keywords：

Refractory epilepsy; Lacosamine; Add on; Efficacy; Safety

DOI：

10.7507/2096-0247.202407002

Video：

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Objective To observe and analyze the efficacy and adverse reactions of Lacosamide (LCM) in the treatment of refractory epilepsy in children and adolescents. Methods A retrospective cohort study was conducted on 85 patients with refractory epilepsy, with 50 males and 35 females, aged 0.5 ~ 15 years with an average age of (6.90±3.61) years, who were treated in the Department of Neurology of Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, from January 2020 to March 2023. A self-controlled study was conducted by oral LCM add on treatment, and follow-up was performed to compare and observe the efficacy as well as the adverse reactions before and after the use of LCM. Results By self-control, after 12 months of follow-up after addition of LCM treatment, compared with baseline, the frequency of seizures decreased after 3, 6 and 12 months of treatment, the differences were statistically significant (P<0.05), and the effective rate of analysis after 3, 6 and 12 months of addition of treatment were 36.47%, 42.35% and 41.18%, respectively. There were 22 cases without seizure after 12 months of LCM treatment, and the seizure-free rate was 25.88%. Enrolled patients used a variety of antiseizure medications at baseline, and the three drugs used by the most patients were sodium valproate in 54 cases (63.53%), levetiracetam in 41 cases (48.24%) and oxcarbazepine in 24 cases (28.24%) respectively. After addition of LCM, a total of 10 cases experienced adverse reactions, such as dizziness, headache, nausea, etc. The incidence of adverse reactions was 11.76%. The retention rate at 12 months after adding LCM was 63.5%. Conclusions The addition of LCM in the treatment of refractory epilepsy in children and adolescents can effectively improve the frequency of seizures, with fewer adverse reactions and higher retention rates.

Citation： LIN Haisheng, DAI jin, PENG Bingwei, ZHU Haixia, LI Xiaojing, WANG Xiuying, LI Jialing, SHI Kaili, GAO Yuanyuan, CHEN Wenxiong. Clinical analysis of Lacosamine supplementation in the treatment of refractory epilepsy in children and adolescents. Journal of Epilepsy, 2024, 10(5): 404-410. doi: 10.7507/2096-0247.202407002 Copy

1.	Hirtz D, Thurman DJ, Gwinn-Hardy K, et al. How common are the common neurologic disorders? Neurology, 2007, 68(5): 326-337.
2.	Brodie MJ, Dichter MA. Antiepileptic drugs. N Engl J Med, 1996, 334(3): 168-175.
3.	中国抗癫痫协会. 临床诊疗指南•癫痫病学分册(2023修订版). 北京: 人民卫生出版社, 2015: 1-151.
4.	He Z, Li J. The therapeutic effects of lacosamide on epilepsy-associated comorbidities. Front Neurol, 2023, 14: 1063703.
5.	Driessen JT, Wammes-van der Heijden EA, Verschuure P, et al. Effectiveness and tolerability of lacosamide in children with drug resistant epilepsy. Epilepsy Behav Rep, 21: 100574.
6.	Zhao T, Yu LH, Zhang HL, et al. Long-term effectiveness and safety of lacosamide as adjunctive therapy in children and adolescents with refractory epilepsy: a real-world study. BMC Pediatr, 2023, 23(1): 249.
7.	Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia, 2010, 51(6): 1069-1077.
8.	Wilson SM, Khanna R. Specific binding of lacosamide to collapsin response mediator protein 2 (CRMP2) and direct impairment of its canonical function: implications for the therapeutic potential of lacosamide. Mol Neurobiol, 2015, 51(2): 599-609.
9.	张鹤声, 张恩惠, 刘文钰, 等. 拉考沙胺单药治疗癫痫发作的研究进展. 中国新药与临床杂志, 2022, 41(2): 79-84.
10.	Pasha I, Kamate M, Suresh DK. Safety of lacosamide in children with refractory partial epilepsy. Saudi Pharm J, 2015, 23(5): 556-61.
11.	Romoli M, Mazzocchetti P, D'Alonzo R, et al. Valproic acid and epilepsy: from molecular mechanisms to clinical evidences. Curr Neuropharmacol, 2019, 17(10): 926-946.
12.	王婷, 杨文秋, 余彦萤, 等. 左乙拉西坦的药物基因组学与疗效预测研究进展. 中华神经科杂志. 2021, 54(9): 973-978.
13.	Ambrósio AF, Soares-Da-Silva P, Carvalho CM, et al. Mechanisms of action of carbamazepine and its derivatives, oxcarbazepine, BIA 2-093, and BIA 2-024. Neurochem Res, 2002, 27(1-2): 121-130.
14.	de Biase S, Valente M, Gigli GL, et al. Pharmacokinetic drug evaluation of lacosamide for the treatment of partial-onset seizures. Expert Opin Drug Metab Toxicol, 2017, 13(9): 997-1005.
15.	冯杰, 高丽, 李岩, 等. 拉考沙胺在儿童难治性癫痫添加治疗的临床效果观察. 癫痫杂志, 2020, 6(2): 98-101.
16.	Ortiz de la Rosa JS, Ladino LD, Rodríguez PJ, et al. Efficacy of lacosamide in children and adolescents with drug-resistant epilepsy and refractory status epilepticus: a systematic review. Seizure, 2018, 56: 34-40.
17.	Miskin C, Khurana DS, Valencia I, et al. Efficacy and tolerability of lacosamide in the treatment of children with refractory generalized epilepsy. J Child Neurol, 2016, 31(7): 925-928.
18.	Zhou R, Qu R, Liu M, et al. Perampanel and lacosamide monotherapy in pediatric patients with newly diagnosed focal epilepsy: a prospective study evaluating efficacy, tolerability, and behavior. Epilepsy Behav, 2023, 146: 109353.
19.	Driessen JT, Wammes-van der Heijden EA, Verschuure P, et al. Effectiveness and tolerability of lacosamide in children with drug resistant epilepsy. Epilepsy Behav Rep, 2023, 21: 100574.
20.	Lu YT, Lin CH, Ho CJ, et al. Evaluation of cardiovascular concerns of intravenous lacosamide therapy in epilepsy patients. Front Neurol, 2022, 13(7): 891368.

1. Hirtz D, Thurman DJ, Gwinn-Hardy K, et al. How common are the common neurologic disorders? Neurology, 2007, 68(5): 326-337.
2. Brodie MJ, Dichter MA. Antiepileptic drugs. N Engl J Med, 1996, 334(3): 168-175.
3. 中国抗癫痫协会. 临床诊疗指南•癫痫病学分册(2023修订版). 北京: 人民卫生出版社, 2015: 1-151.
4. He Z, Li J. The therapeutic effects of lacosamide on epilepsy-associated comorbidities. Front Neurol, 2023, 14: 1063703.
5. Driessen JT, Wammes-van der Heijden EA, Verschuure P, et al. Effectiveness and tolerability of lacosamide in children with drug resistant epilepsy. Epilepsy Behav Rep, 21: 100574.
6. Zhao T, Yu LH, Zhang HL, et al. Long-term effectiveness and safety of lacosamide as adjunctive therapy in children and adolescents with refractory epilepsy: a real-world study. BMC Pediatr, 2023, 23(1): 249.
7. Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia, 2010, 51(6): 1069-1077.
8. Wilson SM, Khanna R. Specific binding of lacosamide to collapsin response mediator protein 2 (CRMP2) and direct impairment of its canonical function: implications for the therapeutic potential of lacosamide. Mol Neurobiol, 2015, 51(2): 599-609.
9. 张鹤声, 张恩惠, 刘文钰, 等. 拉考沙胺单药治疗癫痫发作的研究进展. 中国新药与临床杂志, 2022, 41(2): 79-84.
10. Pasha I, Kamate M, Suresh DK. Safety of lacosamide in children with refractory partial epilepsy. Saudi Pharm J, 2015, 23(5): 556-61.
11. Romoli M, Mazzocchetti P, D'Alonzo R, et al. Valproic acid and epilepsy: from molecular mechanisms to clinical evidences. Curr Neuropharmacol, 2019, 17(10): 926-946.
12. 王婷, 杨文秋, 余彦萤, 等. 左乙拉西坦的药物基因组学与疗效预测研究进展. 中华神经科杂志. 2021, 54(9): 973-978.
13. Ambrósio AF, Soares-Da-Silva P, Carvalho CM, et al. Mechanisms of action of carbamazepine and its derivatives, oxcarbazepine, BIA 2-093, and BIA 2-024. Neurochem Res, 2002, 27(1-2): 121-130.
14. de Biase S, Valente M, Gigli GL, et al. Pharmacokinetic drug evaluation of lacosamide for the treatment of partial-onset seizures. Expert Opin Drug Metab Toxicol, 2017, 13(9): 997-1005.
15. 冯杰, 高丽, 李岩, 等. 拉考沙胺在儿童难治性癫痫添加治疗的临床效果观察. 癫痫杂志, 2020, 6(2): 98-101.
16. Ortiz de la Rosa JS, Ladino LD, Rodríguez PJ, et al. Efficacy of lacosamide in children and adolescents with drug-resistant epilepsy and refractory status epilepticus: a systematic review. Seizure, 2018, 56: 34-40.
17. Miskin C, Khurana DS, Valencia I, et al. Efficacy and tolerability of lacosamide in the treatment of children with refractory generalized epilepsy. J Child Neurol, 2016, 31(7): 925-928.
18. Zhou R, Qu R, Liu M, et al. Perampanel and lacosamide monotherapy in pediatric patients with newly diagnosed focal epilepsy: a prospective study evaluating efficacy, tolerability, and behavior. Epilepsy Behav, 2023, 146: 109353.
19. Driessen JT, Wammes-van der Heijden EA, Verschuure P, et al. Effectiveness and tolerability of lacosamide in children with drug resistant epilepsy. Epilepsy Behav Rep, 2023, 21: 100574.
20. Lu YT, Lin CH, Ho CJ, et al. Evaluation of cardiovascular concerns of intravenous lacosamide therapy in epilepsy patients. Front Neurol, 2022, 13(7): 891368.

Journal of Epilepsy

Clinical analysis of Lacosamine supplementation in the treatment of refractory epilepsy in children and adolescents

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