Abstracts

Rationale: The post-marketing experience with efficacy and tolerability of new antiepileptic drugs (AEDs) in clinical practice can be different than in controlled trials. Eslicarbazepine (ESL) is the latest marketed AED, with 30-42% responder rate and only 10% drop-out rate in add-on clinical trials. We analyzed efficacy and tolerability of add-on ESL in all patients started on ESL.Methods: The patient records were retrospectively reviewed for all patients started on ESL for epilepsy between April 2014 and May 2015 in our adult epilepsy clinic. We included all patients started on ESL for partial epilepsy, who had at least one follow up visit or phone communication. We recorded demographic characteristics, seizure types, baseline AEDs, initial and maximal dose of ESL, seizure frequency prior to and after ESL, adverse experiences, duration of ESL treatment, and reason for discontinuing ESL.Results: Seventeen patients (3 men) qualified for the study. Their mean age was 36.2 years (range 19 to 51). 13 patients (76%) were still taking ESL at the last follow up. The average duration of treatment was 6 months (range 0.5-13). Two patients discontinued ESL for lack of efficacy and two for intolerable side effects. The average length of treatment for those who discontinued ESL was 3.6 months. The most common adverse effect causing discontinuation was headache, worsening of acne and sweating. The other adverse effects were poor appetite, weight gain. The most common dose prescribed was 800 mg daily(mean dose prescribed was about 1000 mg daily, range 400-1600mg) At last followup twelve patients (70.6%) reported reduction in seizure frequency including five patients (29%) who became seizure free after addition of ESL. Three of these five patients had previously failed oxcarbazepine (OXC) due to inefficacy. In our cohort we had a total of 7 seizure free patients. Of 13 patients(76%) that remained on ESL, five patients were on ESL monotherapy, four patients were on 3 AEDs in addition to ESL, three patients were on 2 AEDs in addition to ESL and one patient was on one AED in addition to ESL.Conclusions: In this small cohort of patient on ESL, the data shows good efficacy and tolerability. Hyponatremia was not seen as a side effect of ESL. Patients who failed OXC may be rendered seizure free with ESL. Further studies are needed as ESL becomes more widely used.