Abstracts

Rationale: Many patients with epilepsy need a second antiepileptic drug (AED), due either to inefficacy or side effects of the first tried one. We evaluated the efficacy and security of lacosamide (LCM) as first add-on therapy in the real-life setting. Methods: LACONORTE is a multicenter, retrospective, one-year study. Patients with focal-onset epilepsy on monotherapy with another AED who were started on lacosamide as first add-on therapy were included. Clinical data was obtained at 3, 6 and 12 months and then analyzed. Results: Ninety-eight patients (50% men) with a mean age of 50 and a median duration of the epilepsy of 3 years (range 0 to 65) were included. LCM had been started due to lack of seizure control (74%), adverse events (16%) or both (8%). At 1 year, 85% were responders (with at least 50% reduction in the number of seizures) and 68% of all patients and 76% of those with secondary generalization were seizure-free. Twenty-one patients (21%) had adverse events, 71% were light and they were transient in the 65% of the patients who continued on LCM. It was withdrawn in 3 patients due to intolerance and 1 more because of inefficacy. Neither side effects nor withdrawal seemed to be related to total dose or to escalating regimes. Adverse events were more frequent when LCM was combined with another sodium channel blocker. Among the 82 patients who completed the year, 78 (95%) continued on LCM (median dose 200 mg/day, ranging 100 to 400). Twenty-two (28%) had been converted to monotherapy, 82% of them remaining seizure-free. Conclusions: These results of real-life setting show LCM to be efficacious and safe when used as first add-on therapy for focal-onset epilepsy. Most adverse events were light and/or transient. Funding: None