Abstract Details

Title Efficacy and Tolerability of Switching from Traditional Sodium Channel Blockers to Lacosamide in Epilepsy Patients

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-015

Objective The objective of the study is to analyze the efficacy and tolerability of switching from traditional sodium channel blockers (SCBs) to lacosamide (LCM) in epilepsy patients.

Background LCM is a recently developed SCB and has its major mode of action on the slow activation state of sodium channels. Although LCM shares a range of dose-dependent adverse effects with traditional SCBs, it has several advantages over traditional SCBs in that it does not induce hepatic metabolism enzymes and has lower chances of drug interaction and idiosyncratic adverse effects.

Design/Methods We retrospectively analyzed the efficacy and tolerability of switching from traditional SCBs to LCM. The causes of switching were classified by insufficient efficacy, adverse effects and concerns of metabolic derangement by long-term use of traditional SCBs such as atherosclerosis and osteoporosis.

Results LCM was used as switching from traditional SCBs in 75 patients. The causes of switching were insufficient efficacy in 39 patients, dose-dependent or idiosyncratic adverse effects in 19 patients (8 patients for dizziness or ataxia, 8 patients for allergic skin reaction and 3 patients for hair loss) and concerns of metabolic derangement in 17 patients. The chance of successful switching was generally high (61 of 75 patients, 81.3%), but it strongly depends on the causes of switching because patients with lack of or insufficient efficacy to traditional SCBs had lower chance of successful switching (28 of 39 patients, 71.8%) compared to those in patients with adverse effects (17 of 19 patients, 89.5%) or concerns of metabolic derangement (16 of 17 patients, 94.1%) (p = 0.038 by Fisher’s exact test).

Conclusions Our study shows that switching from traditional SCBs to LCM was usually successful and the chance of successful switching was higher in patients with adverse effects or concerns of metabolic derangement.

Authors/Disclosures
Wonshik Kim, MD (Kunkuk Universitiy Hospital) PRESENTER	No disclosure on file
Dong Wook KIM	No disclosure on file

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