title: Rational polytherapy with lacosamide in clinical practice: results of a Spanish cohort analysis RELACOVA.
abstract: There has been little long-term success with polytherapy for patients with refractory partial-onset epilepsy. The rational combination of antiepileptic drugs based on their mechanism of action may help improve treatment efficacy and tolerability. Lacosamide, a novel sodium channel blocker (SCB), was investigated in 158 patients with partial-onset epilepsy in the prospective, multicenter, observational, RELACOVA cohort study conducted in Spain. After 12 months' treatment with lacosamide, 47% of patients were responders (≥50% reduction in seizure frequency) and 24% were seizure free. Lacosamide was well tolerated; dizziness was the most frequent adverse event. Efficacy was better (responder rate, 65% vs 38%; seizure free rate, 35% vs 17%) and there was a lower adverse event rate (33% vs 58%) in patients receiving non-SCBs (n=49) versus those receiving SCBs (n=104) as concomitant therapy at baseline. Further investigation of lacosamide combination therapy is warranted.
authors.affiliation: Hospital Universitario y Politécnico La Fe Valencia, Valencia, Spain. villanueva_vichab@gva.es
authors.forename: Vicente
authors.initials: V
authors.lastname: Villanueva
authors.forename: Elena
authors.initials: E
authors.lastname: López-Gomáriz
authors.forename: Javier
authors.initials: J
authors.lastname: López-Trigo
authors.forename: Juan
authors.initials: J
authors.lastname: Palau
authors.forename: Manuel
authors.initials: M
authors.lastname: García
authors.forename: Teresa
authors.initials: T
authors.lastname: Villarroya
authors.forename: Macarena
authors.initials: M
authors.lastname: Bonet
authors.forename: Consuelo
authors.initials: C
authors.lastname: Santafé
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008297:Male; D008875:Middle Aged; D019370:Observation; D026941:Sodium Channel Blockers / Q000627:therapeutic use*; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D026941:Sodium Channel Blockers; D000078334:Lacosamide