Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures

Yıl: 2021 Cilt: 27 Sayı: 1 Sayfa Aralığı: 47 - 51 Metin Dili: İngilizce DOI: 10.14744/epilepsi.2020.59244
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Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures

Öz:
Objectives: Lacosamide (LCM) is a new generation amino acid drug that is used in patients with drug-resistant epilepsy, which increases the slow inactivation of voltage-dependent sodium channels. In this study, the short-term results of patients with drug-resistant epilepsy who received add-on LCM therapy were evaluated. Methods: Patients who were at least 16 years old and had focal onset seizures for a minimum period of 1 year were retrospectively assessed. Those who had uncontrolled seizures, despite the use of two appropriate antiepileptic drugs at an effective dose for at least six months, were included in the study. Forty-five eligible patients (11 females, 34 males) underwent further analysis. LCM therapy doses, change in seizure fre-quency, number of seizures before and after LCM therapy, and the effect of LCM add-on therapy on seizures were analyzed. Results: The mean age of the included 45 patients (11 females, 34 males) was 31.42 (16–56) years. Twenty-six of 45 (57.8%) patients under add-on therapy showed a decrease of 50% or more. It was observed that the seizure frequency decreased to a median of 2 (IQR: 0.5–5), which was statistically significant (p<0.001). The dose was not correlated with the seizure decrease ratio (p=0.216). The decrease in seizure frequency was similar in patients with LCM add-on treatment as the second or third drug, when compared with patients using LCM as the fourth or fifth drug (p=0.231).Conclusion: It was observed that LCM add-on therapy significantly decreased seizure frequency, similar to the current literature. On the con-trary, the dose effect or earlier add-on therapy did not show a significant effect on seizure frequency. LCM should be considered as a successful treatment option in patients with drug-resistant focal onset seizures.
Anahtar Kelime:

Konular:
Fen > Tıp > Nörolojik Bilimler
Fen > Tıp > Klinik Nöroloji

Fokal Başlangıçlı Nöbetleri Olan Dirençli Epilepsi HastalarındaLakozamid Ekleme Tedavisinin Kısa Dönem Sonuçları

Öz:
Amaç: Lakozamid, fokal başlangıçlı nöbetleri olan dirençli epilepsi hastalarında kullanılan voltaj bağımlı sodyum kanallarının yavaş inakti-vasyonunu arttıran yeni nesil bir aminoasittir. Bu çalışmada, dirençli epilepsi hastalarında lakozamid ekleme tedavisinin kısa süreli takipteki sonuçlarının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem:Hastanemiz epilepsi polikliniklerine başvuran en az bir yıldır fokal başlangıçlı nöbetleri olan 16 yaş üstü hastaların bilgileri retrospektif olarak taranmıştır. Bu hastalar arasından en az altı aydır uygun iki antiepileptik ilacı efektif dozda kullanmasına rağmen nöbetleri kontrol altına alınamayan ve tedavisinde lakozamid bulunan hastalar çalışmaya dahil edilmiştir. Bu kriterlere uyan 48 hastadan bir ay ve üzeri lakozamid kullanan 45’i analiz edilmiştir. Hastaların tedavi dozu ve nöbet sıklığındaki yüzde azalması, öncesi ve sonrasındaki nöbet sıklıkları, ekleme tedavisinin sırasının nöbet sıklığına etkisi analiz edilmiştir.Bulgular: Çalışmaya dahil edilen 45 (11’i kadın, 34’ü erkek) hastanın yaş ortalaması 31.42 (16-56 yıl) yıl idi. Tedaviye devam eden 45 hastadan 26’sının (%57.8) aylık nöbet sıklığında %50 ve üzerinde azalma tespit edilmiştir. Tedavi sonrası aylık nöbet sıklıklarının medyan 2 (IQR=0.5-5) düzeyine gerilediği izlenmiş ve bu değer istatistiksel olarak anlamlı bulunmuştur (p<0.001). Hastaların kullandıkları doz ile azalma yüzdesi arasında istatistiksel olarak anlamlı fark izlenmemiştir (p=0.216). İkinci ve üçüncü antiepileptik ilaç olarak eklenen hastalar ile dördüncü ve beşinci antiepileptik ilaç olarak eklenen hastalar karşılaştırıldığında nöbet sıklığındaki azalma ile aralarında istatistiksel anlamlı ilişki tespit edilmemiştir (p=0.231).Sonuç:Çalışmamızda lakozamid ekleme tedavisinin nöbet sıklığını literatür ile uyumlu olarak azalttığı gözlenmiştir. Doz ve erken eklemenin nöbet sıklığı üzerine etkisi olmadığı tespit edilmiştir. Lakozamid, fokal başlangıçlı dirençli epilepsi hastalarında ekleme tedavisinde iyi tolere edilebilen bir seçenek olarak akılda tutulmalıdır.
Anahtar Kelime:

Konular:
Fen > Tıp > Nörolojik Bilimler
Fen > Tıp > Klinik Nöroloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ATAKLI D, GÜL G, EREN F, DİRİCAN A, BAYBAŞ S, TEKİN B (2021). Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures. Epilepsi, 27(1), 47 - 51. 10.14744/epilepsi.2020.59244
Chicago ATAKLI Dilek,GÜL Günay,EREN Fulya,DİRİCAN Ayten CEYHAN,BAYBAŞ Sevim,TEKİN Betül Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures. Epilepsi 27, no.1 (2021): 47 - 51. 10.14744/epilepsi.2020.59244
MLA ATAKLI Dilek,GÜL Günay,EREN Fulya,DİRİCAN Ayten CEYHAN,BAYBAŞ Sevim,TEKİN Betül Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures. Epilepsi, vol.27, no.1, 2021, ss.47 - 51. 10.14744/epilepsi.2020.59244
AMA ATAKLI D,GÜL G,EREN F,DİRİCAN A,BAYBAŞ S,TEKİN B Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures. Epilepsi. 2021; 27(1): 47 - 51. 10.14744/epilepsi.2020.59244
Vancouver ATAKLI D,GÜL G,EREN F,DİRİCAN A,BAYBAŞ S,TEKİN B Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures. Epilepsi. 2021; 27(1): 47 - 51. 10.14744/epilepsi.2020.59244
IEEE ATAKLI D,GÜL G,EREN F,DİRİCAN A,BAYBAŞ S,TEKİN B "Short-term Results of The Add-on Lacosamide Therapyin Patients with Drug-resistant Focal Onset Seizures." Epilepsi, 27, ss.47 - 51, 2021. 10.14744/epilepsi.2020.59244