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Lacosamide: A Review in Focal Seizures in Patients with Epilepsy

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Abstract

Lacosamide (Vimpat®) is a functionalized amino acid available orally (as a solution or tablets) and as an intravenous infusion for use as monotherapy (only in the USA) or adjunctive therapy for the treatment of focal seizures in adult and adolescent (aged ≥17 years in the USA) patients with epilepsy. As adjunctive therapy to other antiepileptic drugs (AEDs), lacosamide provided effective seizure control and was generally well tolerated in adults and adolescents (aged ≥16 years) in randomized clinical trials and in the real-world setting. In clinical trials, adjunctive lacosamide provided significantly greater reductions in 28-day seizure rates than adjunctive placebo, with these benefits maintained after up to 8 years of therapy in open-label extension studies. Moreover, patients were effectively switched from oral to short-term intravenous adjunctive therapy at the same dosage, which may be particularly beneficial in situations where oral therapy is not suitable. Conversion to lacosamide monotherapy was superior to a historical-control cohort in patients with focal seizures converting from previous AED therapy. In the absence of head-to-head comparisons with other AEDs, the exact position of lacosamide relative to other AEDs remains to be fully determined. In the meantime, oral and intravenous lacosamide provides a useful option as monotherapy (only in the USA) or adjunctive therapy for the treatment of focal seizures in adult and adolescent (aged ≥17 years in the USA) patients with epilepsy.

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Acknowledgments

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 author on the basis of scientific and editorial merit.

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    Lesley J. Scott

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  1. Lesley J. Scott
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Correspondence to Lesley J. Scott.

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The preparation of this review was not supported by any external funding.

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Lesley Scott is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: G. K. Bergey, Department of Neurology, John Hopkins School of Medicine, John Hopkins Hospital, Baltimore, MD, USA; G. Krauss, Department of Neurology, John Hopkins University, Baltimore, MD, USA; F. Rosenow, Department of Neurology, Goethe-University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Frankfurt am Main, Germany; R. B. Shah, Department of Pharmacology, GMERS (Gujarat Medical Education and Research Society) Medical College and Hospital, Gandhinagar, Gujarat, India.

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Scott, L.J. Lacosamide: A Review in Focal Seizures in Patients with Epilepsy. Drugs 75, 2143–2154 (2015). https://doi.org/10.1007/s40265-015-0514-7

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