Lacosamide as the first add-on therapy in adult patients with focal epilepsy: A multicenter real-world study

Wenyu Liu; Wenjing Li; Peiyu Wang; Hesheng Zhang; Enhui Zhang; Xintong Wu; Dong Zhou

doi:10.3389/fneur.2023.1136814

Lacosamide as the first add-on therapy in adult patients with focal epilepsy: A multicenter real-world study

Front Neurol. 2023 Apr 6:14:1136814. doi: 10.3389/fneur.2023.1136814. eCollection 2023.

Authors

Wenyu Liu¹, Wenjing Li², Peiyu Wang¹, Hesheng Zhang¹, Enhui Zhang¹, Xintong Wu¹, Dong Zhou¹

Affiliations

¹ Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
² West China Hospital, Sichuan University, Chengdu, China.

Abstract

Background: Prospective observations on the effectiveness, safety, tolerance, and influence of comorbidity of add-on lacosamide (LCM) therapy are still lacking, especially for domestic generic LCM in China.

Objective: In this multicenter real-world study, we aimed to evaluate lacosamide (LCM) as the first add-on therapy in adult Chinese patients with focal epilepsy that had initially been treated with monotherapy.

Methods: A cohort of consecutive focal epilepsy patients aged over 16 years were enrolled and followed at the multi-epilepsy centers in China. LCM was prescribed as the first add-on therapy. The main outcome measures included seizure frequency and response rate. Data on seizure-free rate, retention rate, scales of depression and anxiety, and adverse events were also collected as additional outcome measures.

Results: A total number of 107 adult subjects (60 men, 56.07%) were enrolled. The mean age was 37.16 ± 15.01 years, and the mean age at seizure onset was 312.35 ± 199.97 months. After the LCM add-on therapy, the ≥50% response rates were 76.19, 81.73, 94.12, and 95.79% at the visit at 4 weeks (visit 2), 8 weeks (visit 3), 16 weeks (visit 4), and 24 weeks (visit 5), respectively, compared to the baseline (visit 1). A total of 34 patients (31.78%) had no seizures during the whole follow-up period. The posttreatment emotional performance of the 97 subjects, defined as generalized anxiety disorder (GAD) and Neurological Disorders Depression Inventory (NDDI) scores, was significantly better than the baseline one. Only one patient suffered from mild dizziness.

Conclusion: LCM as the first add-on therapy in adult focal epilepsy in China was effective and safe. Further prospective studies with long-term follow-up periods are needed to confirm our present findings.

Clinical trial registration: http://www.chictr.org.cn, ChiCTR2100042485.

Keywords: add-on therapy; adult; efficacy; focal epilepsy; lacosamide.

Grants and funding

This study was supported by QingFeng Pharma. The authors acknowledge the support of the investigators and clinical doctors from multi-centers in China including West China Hospital of Sichuan University, Wuhan Union Hospital, Affiliated Brain Hospital of Nanjing Medical University, Qilu Hospital of Shandong University, Xijing Hospital Affiliated to Fourth Military Medical University, The First Hospital of Jilin University, The First Affiliated Hospital of Harbin Medical University, Daqing Oilfield General Hospital, The First Affiliated Hospital of Jinan University, Huaian Third People's Hospital, The Second Affiliated Hospital of Guangzhou Medical College, Guangdong Sanjiu Brain Hospital, First Affiliated Hospital of Zhengzhou University, and The First Affiliated Hospital of China Medical University. This study was also supported by Sichuan Science and Technology Program (Grant No. 2023NSFSC1574).