Premium
Outcome of cancer‐related seizures in patients treated with lacosamide
Author(s) -
Toledo M.,
Molins A.,
Quintana M.,
Santamarina E.,
MartinezRicarte F.,
MartínezSaez E.,
SalasPuig J.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12809
Subject(s) - lacosamide , medicine , status epilepticus , adverse effect , epilepsy , concomitant , anesthesia , psychiatry
Objectives Lacosamide is an antiepileptic drug ( AED ), which has proven to be effective to control seizures, including acute conditions such as status epilepticus. The aim of this study is to describe the clinical experience with lacosamide in neuro‐oncological patients. Materials and methods Multicenter retrospective study in patients with cancer‐related seizures, who received lacosamide as an add‐on therapy. Results Forty‐eight patients with benign and malignant tumors, including primary brain tumors, lymphomas, systemic cancer with central nervous system involvement, or paraneoplastic encephalitis, were included. Lacosamide was effective in the control of chronic seizures in patients with either benign or malignant tumors. The success rate was greater in malignant tumors, and drug‐resistant epilepsies were more likely associated with benign tumors. Adverse events occurred in nearly 70% of patients, particularly in acute conditions and associated with the concomitant use of radio‐/chemotherapy. Lacosamide‐related adverse events were more likely somnolence and dizziness, which usually resolved after dose adjustment. After starting lacosamide, nearly half of the patients discontinued one of the baseline AED s and decreased or discontinued dexamethasone. Fifteen patients with status epilepticus were treated with intravenous lacosamide, and 73% of them had their condition resolved without serious drug‐related adverse events. Conclusion Lacosamide is an AED to consider in cases of cancer‐related seizures. Lacosamide pharmacodynamics and pharmacokinetics allow the achievement of responder rates over 50% with no serious adverse effects, amelioration of side effects from other AED s or radio‐/chemotherapy, and no significant drug interactions. Furthermore, the intravenous formulation shows clear benefits in acute conditions such as status epilepticus.