Tolerability of lacosamide rapid dose titration: A randomized, multicenter, prospective, open-label study.
Epilepsy Behav
; 115: 107663, 2021 02.
Article
en En
| MEDLINE
| ID: mdl-33342710
ABSTRACT
OBJECTIVE:
Currently recommended dosing of lacosamide often necessitates long titration periods. However, the use of a regimen consisting of initial loading dose of 200â¯mg followed by a maintenance dose of 200â¯mg/day in practice suggests tolerability of more rapid titration schedules. We aimed to clarify whether the shortened titration schedule affects tolerability of lacosamide.METHODS:
We evaluated the safety of two rapid titration protocols designed to reach the target dose of 400â¯mg/day within 1â¯week, and the conventional weekly titration protocol (reaching the target dose of 400â¯mg/day in three weeks). The ≥50% responder rate and steady-state plasma concentration of lacosamide were also analyzed. Adverse events were assessed at 1â¯week and 5â¯weeks after reaching the target dose.RESULTS:
Seventy-five patients with epilepsy were enrolled and evenly distributed to three titration protocols, from which 5 patients were lost to follow-up and excluded from the safety analysis. Discontinuation of lacosamide or dose reductions due to adverse events occurred in 32 patients (46%), of whom a large majority (74%) had experienced adverse events after reaching 400â¯mg/day, demonstrating apparent dose-dependency. There was no difference in safety outcomes among the three titration groups. Concomitant use of sodium channel blockers significantly increased the risk of adverse events.CONCLUSION:
Rapid titration protocols for lacosamide were not associated with an increased risk of adverse events compared to the conventional weekly titration protocol. Uptitration of lacosamide at shorter intervals to an effective target dosage may be feasible in appropriate clinical situations.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Epilepsias Parciales
Tipo de estudio:
Clinical_trials
/
Guideline
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Observational_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Epilepsy Behav
Asunto de la revista:
CIENCIAS DO COMPORTAMENTO
/
NEUROLOGIA
Año:
2021
Tipo del documento:
Article