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Evidence summaries

Lacosamide Add-on Therapy for Partial Epilepsy

Lacosamide is effective and fairly well tolerated in the short term when used as add-on treatment for drug-resistant partial epilepsy in adults. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included 3 RCTs with a total of 1311 subjects. All trials assessed doses ranging from 200 mg to 600 mg per day. Trial durations ranged from 24 to 26 weeks. The overall risk ratio for a 50% or greater reduction in seizure frequency for all doses of lacosamide compared with placebo was 1.70 (95% CI 1.38 to 2.10; 3 studies, n=1294); for seizure freedom for all doses of lacosamide compared with placebo was 2.50 (95% CI 0.85 to 7.34; 3 studies, n=1294); and for treatment withdrawal for all doses of lacosamide compared with placebo was 1.88 (95% CI 1.40 to 2.52; 3 studies, n=1308). Adverse effects significantly associated with lacosamide were abnormal co-ordination (RR 6.12, 99% CI 1.35 to 27.77), diplopia (RR 5.29, 99% CI 1.97 to 14.23), dizziness (RR 3.53, 99% CI 2.20 to 5.68), nausea (RR 2.37, 99% CI 1.23 to 4.58) and vomiting (RR 3.49, 99% CI 1.43 to 8.54). Adverse effects that were not statistically significant were headache (RR 1.34, 99% CI 0.83 to 2.18), fatigue (RR 2.11, 99% CI 0.92 to 4.85), nystagmus (RR 1.47, 99% CI 0.61 to 3.52) and somnolence (RR 1.44, 99% CI 0.67 to 3.09).

Clinical comments

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    References

    • Weston J, Shukralla A, McKay AJ et al. Lacosamide add-on therapy for partial epilepsy. Cochrane Database Syst Rev 2015;6():CD008841. [PubMed]

Primary/Secondary Keywords