Efficacy Of Intravenous Lacosamide Research Articles

Multi-centric Phase III, single-arm, open-label clinical study to assess clinical safety, tolerability, and efficacy of intravenous lacosamide in focal onset seizures

Background: In hospitalized seizure patients and during clinical seizure emergencies, parenteral administration of antiepileptic therapy (AED) is primary treatment modality. Appropriate selection and administration of AED is essential for immediate seizure control. The purpose of this study was to evaluate the safety, tolerability, and efficacy of lacosamide injection in adult patients with focal onset seizures (FOS) with or without secondary generalized tonic-clonic seizures or focal to bilateral tonic-clonic seizures. Methods: In this Phase 3 study, we enrolled 60 patients (≥18 years) with FOS and maintained on stable doses of oral lacosamide. Patients were switched to intravenous (i.v.) lacosamide (10 mg/ml); daily i.v. dosage and frequency were kept equivalent to oral lacosamide per patient. Lacosamide was infused intravenously over for 30 to 60 minutes at 12 hourly intervals for five consecutive days. Primary outcome was evaluating the safety and secondary outcome included measuring the seizure frequency during the treatment (day 1- 5) and at follow-up (day 12). Results: All patients enrolled completed the study. No significant changes in vital signs, or laboratory parameters, were observed at the end of treatment or follow-up when compared to baseline. The frequency analysis for all the components of electrocardiogram (ECG) was within the normal limits at all times. There were no serious adverse events (AEs) reported in this study. Overall, 26.66% of patients had mild to moderate AE intensity that resolved spontaneously without any other intervention. Most common AEs (frequency=5%) were abdominal pain upper, injection site pruritus, and nausea. The anti-seizure activity for lacosamide was maintained despite oral to i.v. switch of lacosamide. Conclusions: The study showed that i.v. lacosamide is a safe and effective strategy in patients with FOS and can be co-administered with other anti-epileptic drugs (AEDs), especially in acute settings with primary generalized tonic-clonic seizures. Registration: CTRI (CTRI/2011/07/001888; 14th July 2011).

The efficacy of intravenous lacosamide in psychiatric hospital

To evaluate the efficacy and tolerability of intravenous lacosamide (vimpat) in inpatients with frequent partial-onset seizures and affective and cognitive disorders. Fifteen patients were enrolled including 14 patients diagnosed with «organic personality disorder associated with epilepsy» (cryptogenic or symptomatic epilepsy with frequent partial-onset and/or secondary-generalized seizures (serial seizures in some cases) and 1 patient with a preliminary diagnosis of «organic schizophrenia-like disorder», which was changed for «organic personality disorder associated with epilepsy» after examination. Patients were treated with 2--3 antiepileptic drugs (AEDs), but no one of them received earlier lacosamide. Lacosamide was used intravenously in drops in the dose of 200 or 400 mg daily during 5 days. In 4 patients with marked personality disorders, the frequency of seizures decreased by 75%, no seizures were noted after 2--3 days of treatment in 11 patients. A positive effect of lacosamide on the affective sphere and quality-of-life was observed in 11 (73.4%) patients with epilepsy. Mild and moderate adverse effects were found only in 2 patients. It has been concluded that lacosamide demonstrates the high efficacy in patients with frequent drug-resistant seizures.

The potential efficacy of intravenous lacosamide in epilepsy at hospital cases

The potential efficacy of intravenous lacosamide in epilepsy at hospital cases

Efficacy of intravenous lacosamide as an add-on treatment in refractory status epilepticus: A multicentric prospective study

ObjectiveTreatment of status epilepticus (SE) has not changed in the last few decades, benzodiazepines plus phenytoin or valproate being the most common treatment. Once this first and second line treatment has failed SE is considered refractory (RSE). This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in RSE. MethodPatients with RSE who were treated with ivLCM in six Spanish centers were prospectively included. Efficacy was defined as cessation of seizures after starting ivLCM, with no need for any further antiepileptic drug. All patients had been unsuccessfully treated following the standard protocol (benzodiazepines plus phenytoin or valproate) before ivLCM was added. ResultsThirty-four patients were included, 52.9% men, with mean age of 60.15 years. In 58.9% of patients the etiology was symptomatic, and the most common type of SE was focal convulsive (82.4%). Mean initial bolus dose of LCM was 323.53mg. ivLCM was effective in more than half of patients (64.7%), with termination of SE before 12h in 50% of them. ivLCM was used as a fourth or later option in 76.5% of patients. No serious adverse events attributable to LCM were reported. ConclusionsLCM might be a fast, effective and safe add-on treatment in RSE.

Efficacy and safety of intravenous lacosamide in refractory nonconvulsive status epilepticus

Lacosamide (LCM) is a novel antiepileptic drug (AED) recently approved as an adjunctive therapy in the treatment of partial seizures in adults. LCM is available in oral and intravenous formulations, has linear pharmacokinetics and a unique mechanism of action. To evaluate the safety and efficacy of intravenous LCM in the treatment of nonconvulsive status epilepticus (NCSE) after failure of conventional therapy. We retrospectively reviewed all patients with NCSE treated with LCM. We reviewed the clinical and electrographic changes before and after LCM administration. We also noted any reported side effects including electrocardiographic changes. We report four cases of NCSE that were refractory to conventional treatment, but readily responsive to LCM. No side effects attributable to LCM were identified. Intravenous LCM may be safe and efficacious as an add-on AED for the treatment of NCSE when standard therapy fails.