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Adjunctive Eslicarbazepine Acetate in Pediatric Patients with Focal Epilepsy: A Systematic Review and Meta-Analysis

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Abstract

Background

In the treatment of pediatric epilepsy, there is a critical demand for effective and safe therapeutic options to address patients’ unmet clinical needs. Eslicarbazepine acetate is a novel once-daily antiepileptic drug and a third-generation single enantiomer member of the dibenzazepine family.

Objective

The objective of this study was to evaluate the efficacy and safety of eslicarbazepine acetate as add-on treatment for focal-onset seizures in pediatric patients using meta-analytical techniques.

Methods

Randomized, placebo-controlled, single- or double-blinded add-on trials of eslicarbazepine acetate in patients < 18 years of age with focal-onset seizures uncontrolled by concomitant stable antiepileptic drug regimens were identified through a systematic literature search. The assessed outcomes included the mean relative change and ≥ 50% reduction in the baseline seizure frequency, the incidence of treatment withdrawal, serious adverse events, and treatment-emergent adverse events. Risk ratio and weighted mean difference with 95% confidence intervals were estimated for dichotomous/continuous outcomes.

Results

Two trials were included involving 386 participants (age range 2–18 years), 217 for eslicarbazepine acetate and 169 for placebo groups, respectively. At the dosage of 30 mg/kg/day, eslicarbazepine acetate-treated patients had a significantly greater reduction in baseline seizure frequency (weighted mean difference − 21.67, 95% confidence interval − 40.87 to − 2.46; p = 0.027) and 58 patients (44.6%) were seizure responders compared with 27 controls (29.7%) [risk ratio 1.48, 95% confidence interval 0.99–2.20; p = 0.055]. There were no differences in treatment withdrawal (risk ratio 1.24, 95% confidence interval 0.65–2.37; p = 0.513), serious adverse events (risk ratio 1.40, 95% confidence interval 0.69–2.86; p = 0.350), and treatment-emergent adverse events (risk ratio 1.07, 95% confidence interval 0.94–1.22; p = 0.313).

Conclusions

Adjunctive eslicarbazepine acetate could be an effective well-tolerated option in children and adolescents with focal-onset seizures uncontrolled by one or more concomitant anti-epileptic drugs.

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Authors and Affiliations

  1. Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, Ancona, 60020, Italy

    Simona Lattanzi, Claudia Cagnetti & Mauro Silvestrini

  2. Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy

    Francesco Brigo

  3. Division of Neurology, “Franz Tappeiner” Hospital, Merano, BZ, Italy

    Francesco Brigo

  4. Medical Department Eisai s.r.l., San Donato Milanese, Italy

    Elisabetta Grillo

  5. Department of Pediatrics, University of L’Aquila, L’Aquila, Italy

    Alberto Verrotti

  6. Unit of Neurology, Department of Medicine, USL Centro Toscana Health Authority, Firenze, Italy

    Gaetano Zaccara

Authors
  1. Simona Lattanzi
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  2. Francesco Brigo
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  3. Elisabetta Grillo
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  4. Claudia Cagnetti
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  5. Alberto Verrotti
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  6. Gaetano Zaccara
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  7. Mauro Silvestrini
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Corresponding author

Correspondence to Simona Lattanzi.

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Funding

No funding has been received for the conduct of this study.

Conflict of interest

Simona Lattanzi, Claudia Cagnetti, Alberto Verrotti, and Mauro Silvestrini have no conflicts of interest directly relevant to the content of this study. Francesco Brigo acted as a consultant for Eisai. Elisabetta Grillo is an employee of Eisai s.r.l. Gaetano Zaccara has received speaker’s or consultancy fees from Eisai, Sanofi-Aventis, and UCB Pharma.

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Lattanzi, S., Brigo, F., Grillo, E. et al. Adjunctive Eslicarbazepine Acetate in Pediatric Patients with Focal Epilepsy: A Systematic Review and Meta-Analysis. CNS Drugs 32, 189–196 (2018). https://doi.org/10.1007/s40263-018-0504-x

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  • DOI: https://doi.org/10.1007/s40263-018-0504-x

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