Lacosamide A Review of Its Use as Adjunctive Ther

Authors: Sheridan M Hoy

Publish Date: 2013/11/08

Volume: 27, Issue: 12, Pages: 1125-1142

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Abstract

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 voltagegated sodium channels Lacosamide is approved in several countries worldwide as an adjunctive therapy for the treatment of partialonset 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 partialonset seizures with or without secondary generalization In three randomized doubleblind placebocontrolled multicentre studies in adults and adolescents aged 16–18 years with partialonset 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 longerterm 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 partialonset seizuresThe manuscript was reviewed by RDC Elwes Department of Clinical Neurosciences King’s College Hospital NHS Foundation Trust London UK A Husain Department of Neurology Duke University Medical Center Durham NC USA S Rüegg Division of Clinical Neurophysiology Department of Neurology University Hospital Basel Basel Switzerland V Villanueva Unidad Multidisciplinar de Epilepsia Servicio de Neurología Hospital Universitario y Politécnico La Fe Valencia SpainThe preparation of this review was not supported by any external funding During the peer review process the manufacturer of the agent under review was offered an opportunity to comment on this article Changes resulting from comments received were made by the authors on the basis of scientific and editorial merit

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