Abstracts

Rationale: The objective of this study was to investigate the efficacy and side effects of lacosamide (LCM) monotherapy in patients with partial epilepsy in our Epilepsy Unit.Methods: We reviewed the clinical charts of all patients with partial epilepsy who received at least a single dose of LCM in monotherapy (Group 1=initial monotherapy, Group 2= add-on and conversion to monotherapy). Efficacy was assessed at months 6 and 12 by comparing pre-LCM monthly seizure frequency with post-LCM monotherapy treatment seizure frequency. Pre-LCM monthly seizure frequency was assessed during a 12-month retrospective baseline prior to the introduction of LCM. Response was defined as a >50% reduction in seizure frequency, including seizure freedom.Results: Thirty-five patients were included in this study (Group 1=11, Group 2=24). All patients presented partial epilepsy: 57% symptomatic, 40% cryptogenic, and 3% unclassified. Mean pre-LCM monthly seizure frequency was 5,6 (Group 1=0,18, Group 2=8,1). Patients in group 2 were on a mean of 1,1 AEDs (range 1-2) when LCM was added and 35% (9/24) had previously tried 2 or more AEDs. Mean dose of LCM was 270 mg/daily. Mean follow-up in LCM monotherapy was 10 months (range 0,5-26). Reasons to cease LCM monotherapy were lack of efficacy (2/35) and intolerable side effects (1/35). At 6 months, 20/23 patients (87%) were responders (Group 1=86%, Group 2=87%), including 14/23 (61%) who were seizure-free. At 12 months, 9/11 patients (82%) were responders (Group 1=75%, Group 2=86%), including 6/11 (55%) who were seizure-free. Adverse events were recorded in 8 patients (23%) and lead to withdrawal of LCM in only one (3%). Conclusions: In this retrospective study of LCM monotherapy in partial epilepsies, LCM showed a high and sustained efficacy, whether used as an initial option or after add-on and subsequent conversion to monotherapy. Side effects were mild and rare. Lacosamide promises to be an effective and safe AED in monotherapy for patients with partial epilepsy.