LACO-IV STUDY: INTRAVENOUS LACOSAMIDE EXPERIENCE IN CLINICAL PRACTICE
Abstract number :
2.136
Submission category :
7. Antiepileptic Drugs
Year :
2013
Submission ID :
1749173
Source :
www.aesnet.org
Presentation date :
12/7/2013 12:00:00 AM
Published date :
Dec 5, 2013, 06:00 AM
Authors :
M. Garces, F. L pez, A. Castillo, P. Giner, N. Torres, I. Escalza, A. Del Villar Igea, M. Bonet, E. No , V. Villanueva Haba
Rationale: Lacosamide (LCM) is a novel antiepileptic drug (AED) available as intravenous (IV) solution, approved as replacement when oral administration is not possible. Based on experimental evidence as well as retrospective case series, IV-LCM may be a useful alternative in emergency treatment of seizure cluster (SC) and status epilepticus (SE) The purpose of this study is to describe the IV-LCM use, efficacy and security profile in our clinical practice.Methods: We conducted a retrospective multicenter study involving 8 Spanish centers. Medical records were reviewed of all patients receiving IV-LCM (any indication) from November 2011 to May 2013. Demographic data, indication for use, preexisting epilepsy, type and etiology of SC and SE, time interval of IV-LCM administration, time interval to SC/SE resolution and adverse events were collected. Successful IV-LCM therapy was defined when LCM was the last AED administered and cessation of SE/SC occurred before 24 hours.Results: Fifty patients (28 female, mean age 58.1 years) were identified. IV-LCM was used as replacement of oral administration in 4 patients, treatment of SC in 17 patients and treatment of SE in 29 patients. Twenty-two patients (44%) had a previous diagnosis of epilepsy. Complex partial seizure cluster (57%) and nonconvulsive SE (44.8%) were the most frequent clinical presentations. The most frequent reason of IV-LCM use was failure and/or contraindication of standard drugs (82% of patients). IV-LCM was introduced as a second and third drug in 65.5% of patients, with a mean interval from SC/SE onset of 78/117 hours. IV-LCM was effective in 52,2% of patients (64.7% SC, 44.8% SE), with a mean interval from first administration of IV-LCM to SC/SE cessation of 8.1/15.2 hours. No serious adverse events attributed to LCM were documented.Conclusions: In our patients sample, the main use of IV-LCM is related to standard drugs failure or contraindication in emergency situations (SC or SE). IV-LCM appears to be a fast, effective and safe alternative in emergency situations.
Antiepileptic Drugs