Switching to eslicarbazepine acetate in patients with epilepsy: a field-practice observation
Abstract
Aim: To provide field-practice information on the safety and efficacy of eslicarbazepine. Patients & methods: Patients who switched from carbamazepine or oxcarbazepine to eslicarbazepine were consecutively and retrospectively identified in two Italian reference centers for the treatment of epilepsy. Results: Eighteen patients with a mean age of 39 ± 16 years were recruited. Mean monthly seizure frequency was 18 ± 22 (range: 2–59) before switching to eslicarbazepine, and decreased to 11 ± 18 (0–56) after switching (p = 0.03). The monthly number of seizures decreased in 16/18 patients (89%) and it remained unchanged in one. Six patients became seizure-free after switching, five of whom had underwent overnight switch. The mean score of the adverse event profile questionnaire before switching was 42.5 ± 9.5 and it decreased to 35.0 ± 6.4 with eslicarbazepine therapy; 8/11 patients (73%) reported improved scores. Conclusion: Although the limited number of patients should be taken into account, switching to eslicarbazepine allowed a reduction of monthly number of seizures in about 55% of patients. Furthermore, eslicarbazepine showed a good safety profile with a potential lower impact on quality of life of patients.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1 . A review of the efficacy and safety of eslicarbazepine acetate in the management of partial-onset seizures. Ther. Adv. Neurol. Disord. 8(4), 178–186 (2015). • Review article on the efficacy and safety of eslicarbazepine acetate that describes the development program of this once-daily antiepileptic drug.
- 2 . Which drug-induced side effects would be tolerated in the prospect of seizure control? Epilepsy Behav. 29, 141–143 (2013).
- 3 . Adherence to antiepilepsy drug therapy. Epilepsy Behav. 25(3), 297–302 (2012).
- 4 . Adverse effects of antiepileptic drugs. Lancet Neurol. 11(9), 792–802 (2012).
- 5 Relationship between adverse effects of antiepileptic drugs, number of coprescribed drugs, and drug load in a large cohort of consecutive patients with drug-refractory epilepsy. Epilepsia 51(5), 797–804 (2010).
- 6 Determinants of health-related quality of life in pharmacoresistant epilepsy: results from a large multicenter study of consecutively enrolled patients using validated quantitative assessments. Epilepsia 52(12), 2181–2291 (2011).
- 7 . Clinical utility of eslicarbazepine: current evidence. Drug Des. Devel. Ther. 10(9), 781–789 (2015).
- 8 . Eslicarbazepine acetate: a double-blind, add-on, placebo-controlled exploratory trial in adult patients with partial-onset seizures. Epilepsia 48, 497–504 (2007). •• Pivotal study for eslicarbazepine acetate as adjunctive therapy in adult patients with partial epilepsy providing evidence on the efficacy and favorable safety profile of this third-generation member of the dibenzazepine family.
- 9 . Efficacy and safety of eslicarbazepine acetate as adjunctive treatment in adults with refractory partial-onset seizures: a randomized, double-blind, placebo-controlled, parallel-group Phase III study. Epilepsia 50, 454–463 (2009). •• Pivotal multicenter, parallel-group study providing evidence that eslicarbazepine acetate, 800 and 1200 mg once daily, was well tolerated and more effective than placebo in patients who were refractory to treatment with one or two concomitant antiepileptic drugs.
- 10 . Eslicarbazepine acetate as adjunctive therapy in adult patients with partial epilepsy. Epilepsy Res. 89, 278–285 (2010).
- 11 . Efficacy and safety of 800 and 1200 mg eslicarbazepine acetate as adjunctive treatment in adults with refractory partial-onset seizures. Acta Neurol. Scand. 120, 281–287 (2009).
- 12 Efficacy and safety of eslicarbazepine acetate as add-on treatment to carbamazepine in patients with partial-onset seizures. Epilepsia 50(Abstract P299), 65–66 (2009).
- 13 . Long-term safety and efficacy of eslicarbazepine acetate as adjunctive therapy in the treatment of partial-onset seizures in adults with epilepsy: results of a 1-year; open-label extension study. Epilepsy Res. 103, 262–269 (2013).
- 14 . Safety of eslicarbazepine acetate after 4 years of post marketing experience in Europe. Epilepsia. 55(Abstract P341), 113 (2014).
- 15 . Eslicarbazepine acetate as adjunctive treatment for refractory partial-onset seizures: pooled analysis of safety data from three Phase III controlled trials. Epilepsy Curr. 14(Abstract 2.126), 209 (2014).
- 16 Adverse event profile of eslicarbazepine acetate during dose titration in Phase III controlled studies of patients with refractory partial-onset seizures. Epilepsy Curr. 14(Abstract 3.208), 393–394 (2014).
- 17 . Practical guidance and considerations for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate – expert opinion. Epilepsy Behav. 50, 46–49 (2015).
- 18 . Measuring outcomes of treatment with antiepileptic drugs in clinical trials. Epilepsy Behav. 18(1–2), 24–30 (2010).
- 19 Rational polytherapy with lacosamide in clinical practice: results of a Spanish cohort analysis RELACOVA. Epilepsy Behav. 23, 298–304 (2012).
- 20 . Systematic screening allows reduction of adverse antiepileptic drug effects: a randomized trial. Neurology 62, 23–27 (2004).
- 21 , SECONDO Study Group. Multicentre observational study evaluating immediate and progressive switching from carbamazepine to oxcarbazepine in patients with epilepsy. Funct. Neurol. 22(2), 111–115 (2007).
- 22 . [Ad hoc change from carbamazepine to oxcarbazepine – effectiveness and tolerance. A retrospective analysis]. Nervenarzt. 72(12), 918–923 (2001).
- 23 . Post-authorisation study of eslicarbazepine as treatment for drug-resistant epilepsy: preliminary results. Neurologia 29(2), 94–101 (2014).
- 24 Relationship between serum mono-hydroxy-carbazepine concentrations and adverse effects in patients with epilepsy on high-dose oxcarbazepine therapy. Epilepsy Res. 69(2), 170–176 (2006).
