View in EDS HTML Full Text PDF Full Text

Lacosamide and sodium channel-blocking antiepileptic drug cross-titration against levetiracetam background therapy.

Saved in:
Bibliographic Details
Title: Lacosamide and sodium channel-blocking antiepileptic drug cross-titration against levetiracetam background therapy.
Authors: Baulac, M., Byrnes, W., Williams, P., Borghs, S., Webster, E., De Backer, M., Dedeken, P.
Source: Acta Neurologica Scandinavica. Apr2017, Vol. 135 Issue 4, p434-441. 8p.
Subjects: Vimpat, Treatment of epilepsy, Sodium channel blockers, Anticonvulsants, Pharmacodynamics, Longitudinal method
Abstract: Objective To assess prospectively the effectiveness of lacosamide ( LCM) added to levetiracetam ( LEV) after down-titration of a concomitant sodium channel blocker ( SCB) among patients with focal epilepsy not adequately controlled on LEV and SCB. Methods In this open-label trial, LCM was initiated at 100 mg/day and up-titrated to 200-600 mg/day over 9 weeks; SCB down-titration started when LCM dose reached 200 mg/day. Patients remained on stable LCM/ LEV doses for 12 weeks' maintenance (21-week treatment period). The primary outcome was retention rate on LCM. Results Due to recruitment challenges, fewer than the planned 300 patients participated in the trial, resulting in the trial being underpowered. Overall, 120 patients (mean age 39.7 years) started and 93 completed the trial. The most frequently used SCBs were lamotrigine (39.2%), carbamazepine (30.8%) and oxcarbazepine (27.5%). Eighty-four patients adhered to protocol and discontinued their SCB after cross-titration, but there was insufficient evidence for 36 patients. Retention rate was 73.3% (88/120) for all patients and 83.3% (70/84) for those with evidence of SCB discontinuation. Seizure freedom for patients completing maintenance was 14.0% (13/93). Discontinuation due to adverse events (6.7%) and lack of efficacy (3.3%) occurred primarily during cross-titration. Most frequently reported adverse events during treatment were dizziness (23.3%), headache (15.0%) and fatigue (8.3%). Conclusions In patients with uncontrolled seizures on LEV/ SCB, the LCM/ LEV combination appeared to be effective and well tolerated. A cross-titration schedule-flexible LCM up-titration, concomitant SCB down-titration and stable background LEV-could present a feasible and practical approach to initiating LCM while minimizing pharmacodynamic interactions with a SCB. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 121502205
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Lacosamide and sodium channel-blocking antiepileptic drug cross-titration against levetiracetam background therapy.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Baulac%2C+M%2E%22">Baulac, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Byrnes%2C+W%2E%22">Byrnes, W.</searchLink><br /><searchLink fieldCode="AR" term="%22Williams%2C+P%2E%22">Williams, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Borghs%2C+S%2E%22">Borghs, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Webster%2C+E%2E%22">Webster, E.</searchLink><br /><searchLink fieldCode="AR" term="%22De+Backer%2C+M%2E%22">De Backer, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Dedeken%2C+P%2E%22">Dedeken, P.</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. Apr2017, Vol. 135 Issue 4, p434-441. 8p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Vimpat%22">Vimpat</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+of+epilepsy%22">Treatment of epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Sodium+channel+blockers%22">Sodium channel blockers</searchLink><br /><searchLink fieldCode="DE" term="%22Anticonvulsants%22">Anticonvulsants</searchLink><br /><searchLink fieldCode="DE" term="%22Pharmacodynamics%22">Pharmacodynamics</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective To assess prospectively the effectiveness of lacosamide ( LCM) added to levetiracetam ( LEV) after down-titration of a concomitant sodium channel blocker ( SCB) among patients with focal epilepsy not adequately controlled on LEV and SCB. Methods In this open-label trial, LCM was initiated at 100 mg/day and up-titrated to 200-600 mg/day over 9 weeks; SCB down-titration started when LCM dose reached 200 mg/day. Patients remained on stable LCM/ LEV doses for 12 weeks' maintenance (21-week treatment period). The primary outcome was retention rate on LCM. Results Due to recruitment challenges, fewer than the planned 300 patients participated in the trial, resulting in the trial being underpowered. Overall, 120 patients (mean age 39.7 years) started and 93 completed the trial. The most frequently used SCBs were lamotrigine (39.2%), carbamazepine (30.8%) and oxcarbazepine (27.5%). Eighty-four patients adhered to protocol and discontinued their SCB after cross-titration, but there was insufficient evidence for 36 patients. Retention rate was 73.3% (88/120) for all patients and 83.3% (70/84) for those with evidence of SCB discontinuation. Seizure freedom for patients completing maintenance was 14.0% (13/93). Discontinuation due to adverse events (6.7%) and lack of efficacy (3.3%) occurred primarily during cross-titration. Most frequently reported adverse events during treatment were dizziness (23.3%), headache (15.0%) and fatigue (8.3%). Conclusions In patients with uncontrolled seizures on LEV/ SCB, the LCM/ LEV combination appeared to be effective and well tolerated. A cross-titration schedule-flexible LCM up-titration, concomitant SCB down-titration and stable background LEV-could present a feasible and practical approach to initiating LCM while minimizing pharmacodynamic interactions with a SCB. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=121502205
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/ane.12691
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 434
    Subjects:
      – SubjectFull: Vimpat
        Type: general
      – SubjectFull: Treatment of epilepsy
        Type: general
      – SubjectFull: Sodium channel blockers
        Type: general
      – SubjectFull: Anticonvulsants
        Type: general
      – SubjectFull: Pharmacodynamics
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
    Titles:
      – TitleFull: Lacosamide and sodium channel-blocking antiepileptic drug cross-titration against levetiracetam background therapy.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Baulac, M.
      – PersonEntity:
          Name:
            NameFull: Byrnes, W.
      – PersonEntity:
          Name:
            NameFull: Williams, P.
      – PersonEntity:
          Name:
            NameFull: Borghs, S.
      – PersonEntity:
          Name:
            NameFull: Webster, E.
      – PersonEntity:
          Name:
            NameFull: De Backer, M.
      – PersonEntity:
          Name:
            NameFull: Dedeken, P.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 04
              Text: Apr2017
              Type: published
              Y: 2017
          Identifiers:
            – Type: issn-print
              Value: 00016314
          Numbering:
            – Type: volume
              Value: 135
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Acta Neurologica Scandinavica
              Type: main
ResultId 1