Intravenous lacosamide (LCM) in status epilepticus (SE): Weight-adjusted dose and efficacy
| Autor: | Alex Quílez, Ana Suller, Montserrat González-Cuevas, Juan Luis Becerra, Manuel Toledo, Ainhoa Marinas, Marta Jiménez, Estevo Santamarina, Ángel Fernández, José Ángel Mauri, Xavier Salas Puig, Manuel Quintana |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Lacosamide Status epilepticus 030226 pharmacology & pharmacy Loading dose 03 medical and health sciences Behavioral Neuroscience Epilepsy Benzodiazepines Young Adult 0302 clinical medicine Status Epilepticus Medicine Humans Aged Retrospective Studies Response rate (survey) Aged 80 and over business.industry Middle Aged medicine.disease Clonazepam Treatment Outcome Neurology Spain Concomitant Anesthesia Etiology Administration Intravenous Anticonvulsants Drug Therapy Combination Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | EPILEPSY & BEHAVIOR r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname |
| ISSN: | 1525-5069 1525-5050 |
| Popis: | Background: Some studies suggest higher efficacy of lacosamide (LCM) in status epilepticus (SE) with higher loading doses; however, this weight-adjusted dose has not been evaluated. Objective: The objective was to evaluate the relationship between loading weight-adjusted dose and efficacy of LCM in SE. Methods: A group of patients with SE treated with LCM from Spanish hospitals was examined retrospectively. Demographic data, type of SE, etiology, response rate, last antiepileptic drug (AED) used, treatment line in which LCM was used, total loading dose, and weight-adjusted dose were collected. Results: One hundred sixty-five cases of SE were collected; 87 (52.7%) patients had nonconvulsive SE. Mean age was 64.2 +/- 17.2 and 60.6% (n = 100) were men. Regarding etiology, SE was considered as acute symptomatic in 85 (51.5%), remote symptomatic in 51 (30.9%), progressive symptomatic in 10 (6.1%), and cryptogenic in 19 (11.5%). Lacosamide was used as the third drug in 46.1%, and as a second option in 28%. In 115 patients, clonazepam had been used as the first option, and no benzodiazepines had been administered in the remaining 50. The median loading dose was 400 mg (100-600 mg), and the weight-adjusted dose was 5 mg/kg (3-6 mg/kg). The response rate was 63.3%, and 55.1% responded within the first 12 h. Efficacy was significantly higher in patients who had taken benzodiazepines at LCM loading doses >5.3 mg/kg (p = 0.006). This relationship was maintained independent of using other concomitant AEDs. However, if benzodiazepines were not taken, this relationship was not found. Conclusions: In adults with benzodiazepine-resistant SE, the response rate to LCM was higher, with weight-adjusted doses above 5.3 mg/kg. (C) 2018 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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