Abstracts

Rationale: Lacosamide (LCM) selectively enhances sodium-channel slow inactivation, and has been approved for treatment of focal onset seizures with or without secondary generalization as monotherapy and adjunctive therapy in patients aged 4 years and older in Japan. LCM is one of the third-generation antiepileptic drugs (AEDs) and now used more frequently. In this study, we assessed LCM monotherapy for patients with epilepsy in daily practice of the real world. Methods: Forty-three patients with epilepsy were treated with LCM monotherapy from the beginning or conversion from other AEDs to LCM. These patients older than 15 years were retrospectively reviewed with their medical records in our hospital. Their seizure frequency, adverse reactions and tolerability were assessed. Results: Twenty-six patients had newly diagnosed epilepsy and were treated with LCM monotherapy from the beginning (Group A). Seventeen patients treated with other AEDs had suffered from residual seizures and then those AEDs were converted to LCM (Group B). Thirty-nine patients had symptomatic localization-related epilepsy and 4 patients had idiopathic generalized epilepsy. Comparing with the baseline, 32 out of 43 patients (74%) achieved seizure freedom, 8 patients (19%) attained a more than 50% reduction in their seizure frequency. Further details revealed that 20 patients obtained seizure freedom in Group A (77%), and 11 patients became free from seizures in Group B (65%). Adverse reactions by LCM (somnolence, dizziness and others) were observed in 6 out of 43 patients (14%). However, these adverse reactions disappeared by only observation or reducing the dose of LCM. Eventually, 37 out of 43 patients (86%) continued LCM monotherapy. Conclusions: LCM demonstrated the excellent drug profile with high seizure freedom (74%) and responder rates (93%) by monotherapy and less adverse reactions in total. More patients became free from seizures in Group A as compared to that in Group B, because patients in Group A were treated earlier from the diagnosis of epilepsy. Therefore LCM could be used as one of the first line AEDs especially for patients with newly diagnosed epilepsy. Funding: No funding