Abstracts

Rationale: Lacosamide, is one of the newer antiepileptic drug approved for focal drug-resistant epilepsy as an add-on treatment in patients older than 16 years. However there is growing evidence of its use, safety and efficacy in pediatric population. We aim to evaluate efficacy and tolerability of lacosamide in focal and generalized epilepsies and status epilepticus on pediatric population Methods: We conducted a systematic review on MEDLINE, EMBASE, COCHRANE, Google Scholar and Scielo from January 2008 to January 2017. Using a standardized assessment, efficacy, and adverse events attributed to lacosamide were extracted from each publication and systematically reported. Three reviewers independently screened full-text papers for observational studies. The primary outcome was efficacy of lacosamide. We considered all outcomes in children. Children were classified as those under 21 years old. We performed no meta-analyses due to the limited available data Results: Of 175 abstracts identified by the search, 82 were reviewed as full-text. Twenty-six articles fulfilled eligibility criteria and described outcomes in 797 patients (57% male). Most of the studies were of retrospective nature with a small sample size. The success seizure free rate in drug-resistant epilepsy is around 24%; on average 51% of patients had 50% or greater seizure reduction. Adverse effects occur in 18-59% of patients. The main events were dizziness, sedation, gastrointestinal upset, and mood and behavioral change Conclusions: Current evidence shows lacosamide as a good option in pediatric patients with focal drug-resistant epilepsies as an add-on therapy given its efficacy on seizure control, safety profile and low to moderate rate of adverse effects. The use of lacosamide in generalized epilepsies and refractory status epilepticus shows conflicting data. Larger prospective multicenter randomized controlled studies in pediatric patients are necessary to substantiate the findings Funding: This study did not recieved any funding