Lacosamide: a review of its use as adjunctive therapy in the management of
partial-onset seizures.
Author(s): Hoy SM.
Affiliation(s): Author information:
Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754,
Auckland, New Zealand, demail@springer.com.
Publication date & source: 2013, CNS Drugs. , 27(12):1125-42
Lacosamide (Vimpat(®)) is a functionalized amino acid available orally (as a
syrup or tablet) and as an intravenous infusion. It is believed to exert its
antiepileptic effect by selectively enhancing the slow inactivation of
voltage-gated sodium channels. Lacosamide is approved in several countries
worldwide as an adjunctive therapy for the treatment of partial-onset seizures;
however, prescribing regulations differ between countries. This article reviews
the use of lacosamide as indicated in adults and adolescents (aged 16-18 years)
in the EU, where it is approved in this patient population as an adjunctive
therapy to other AEDs in the treatment of partial-onset seizures, with or without
secondary generalization. In three randomized, double-blind, placebo-controlled,
multicentre studies in adults and adolescents (aged 16-18 years) with
partial-onset seizures, adjunctive therapy with oral lacosamide (administered for
an initial titration period followed by 12 weeks' maintenance therapy) generally
reduced the frequency of seizures to a significantly greater extent than placebo,
with antiepileptic efficacy sustained following longer-term treatment (up to 8
years) in this patient population. Oral and intravenous lacosamide were generally
well tolerated in clinical studies, with the majority of adverse events being
mild or moderate in severity. Very common adverse reactions following adjunctive
therapy with oral lacosamide included diplopia, dizziness, headache and nausea;
the tolerability profile of intravenous lacosamide appeared consistent with that
of oral lacosamide, although intravenous administration was associated with local
adverse events, such as injection site discomfort or pain, irritation and
erythema. Thus, oral and intravenous lacosamide as an adjunctive therapy to other
AEDs provides a useful option in the treatment of patients with partial-onset
seizures.
|