Effectiveness and tolerability of lacosamide in children with drug resistant epilepsy

Abstract

We retrospectively studied the efficacy and tolerability of lacosamide (LCM) in children with drug-resistant epilepsy in a tertiary care centre in the Netherlands, from 2013 till 2019, with a follow-up of two years. 79 children, aged<18years, were included. Retention rate, effectiveness, reason for termination, and side-effects were analysed. Furthermore, prognostic variables for discontinuation as well as the incidence of side-effects were determined. The LCM retention rate and effectiveness of response were analysed at three, twelve and twenty-four months. The retention rate of LCM was respectively 89.9%, 68.4% and 54.4%. LCM gave an effective response in 60.5%, 67.9% and 71.4% of the participants who were still using LCM at the three follow-up periods. Lack of efficacy was most frequently reported as a reason for discontinuation (58.3%). Side-effects occurred in 50.6% of the patients, somnolence (18.2%) being the most common, followed by behavioural changes (15.6%), headache (9.1%) and dizziness (9.1%). Use of≥1 sodium channel blocker (SCB) was associated with an increased risk (OR=4.038) of side-effects. An increasing number of anti-seizure medications (ASM) was associated with a reduced risk (OR=0.524) of stopping LCM. To conclude, LCM is an effective ASM with acceptable side-effects in children with drug-resistant epilepsy.