Abstracts

Rationale: Background and Purpose: Eslicarbazepine acetate (ESL) is widely used newer antiepileptic drug (AED) in focal epilepsy. It has a favorable safety profile that supports its use in elderly. Whether this drug is as effective and well-tolerated in elderly as in younger adults has not been fully examined yet. Our aim was to evaluate the effect and side effects of ESL in younger adults compared to elderly.Methods: Methods: The data of 73 patients treated with ESL for focal epilepsy was retrospectively evaluated by reviewing the patients’ clinical files. ESL was withdrawn in 30% of all the patients because of side effects, i.e. gastrointestinal disturbance, vertigo/dizziness and tiredness. Only patients with at least 6 months follow-up were included in the final analysis (N=59). The patients were divided into 2 groups by age; younger adults (YA) above 20 y (N=46) and elderly (E) above 60 y (N=13). The effect and tolerability of ESL were compared in the two groups. The demographic data and characteristics of epilepsy in both groups were described.Results: Results: The mean age in YA was 46 y (21-59 y), and 70 y (60-82 y) in group E. Sex distribution was similar in the 2 groups. There were no major differences concerning the etiology of epilepsy between groups. 35 % of the selected patients (N=59) did not have any epileptogenic brain lesion. Cerebrovascular lesion was the underlying pathology in only 3/46 YA and 1/13 E patients. Tumor cerebri caused epilepsy in 7/13 E patients and only 3/46 YA. ESL was introduced due to lack of seizure control or side effects to previous AEDs. Patients with uncontrolled epilepsy in both groups demonstrated improved seizure control (Table 1.) with ESL add-on without significant difference between YA (27%) and E (28 %) (p=0.9). 36% of all the patients changed to ESL from OXC (38% in E) and the doses of ESL in these patients varied between 1200-2400 mg/day. In general, lower doses of ESL compared to OXC were required to achieve seizure control in these patients for both groups. ESL was in general well-tolerated without any side effects in 33/46 younger and 6/13 elderly patients, and even patients (N=5) on supratherapeutic doses, 2400 mg in the E and 3000 mg in YA, did not complained about any side effects. The most common adverse effect was tiredness in over 20 % of patients in both groups (Table 2.).Conclusions: Conclusion: Our results confirm previous data that ESL has an advantageous profile according to seizure control and it is well-tolerated both in younger adults and elderly patients. Although, dose adjustment was not needed in our elderly patients, the limited number of subjects does not allow any significant conclusions on that. Special focus is needed in future prospective studies on elderly using ESL, as age is the major influencing factor on the pharmacokinetic profile of AEDs. Supported by Eisai AB