Abstracts

Rationale: Though big effort was done in last 20 years in developping new drugs, 20-30% of patients with epilepsy still remain refractory to medical treatment. The need of new antiepileptic drugs (AEDs) is still declared es actuall, efficacy and tolerability data about the newest AEDs are still incomplete. Lacosamide (LCS) was introduced into the clinical praxis in Slovakia in April 2009. Methods: We analysed data in clinical cohort of 70 outpatients (29 men and 41 women) with refractory partial epilepsy visiting tertiary epilepsy centres in University Hospitals in Bratislava and Kosice in Slovakia after 12 month treatment with LCS as add-on therapy. Mean age in this group of patients was 35,6years (20-84y), mean duration of epilepsy 18,4 years(2-47y). 42/70 patients (60%) used before LCS 5 or more AEDs, which is known risk factor for farmacoresistance. The mean used therapeutic dose in our patients was 280,6mg of LCS per day. The efficacy was calculated as RR (responder rate , at minimum 50% reduction in seizure frequency), the portion of seizure free (SF) patients was also calculated. Results: RR in our group of 70 patients was 51,42% (36/70), SF patients in that 7,14% (5/70). SF patients were treated before LCS with less than 4 AEDs, in the patients treated with more than 5 AEDs before LCS none become seizure free. In 20% (14/70) of patients LCS was withdrawn due to intolerable side effects or lack of efficacy. The most often seen adverse events were dizziness and instabile gate in 10%, seizure aggravation, diplopia and headache -each 5,7%. Less than 3% of patients complained about fatigue, tremor, diarrhoe, depression, one patient with suicidal ideations. Conclusions: LCS showed efficacy and adverse event profile comparable with other new antiepileptic drugs, still seizure freedom was achieved only in patients treated with less than 4 antiepileptics before LCS administration. The results in our cohort of patients are in aggreement with other preclinical and clinical studies, which have been published yet.