title: Control of seizures in different stages of partial epilepsy: LACO-EXP, a Spanish retrospective study of lacosamide.
abstract: Lacosamide is approved as adjunctive therapy for focal epilepsies. The number of antiepileptic drugs (AEDs) tried is associated with prognosis. This multicenter, retrospective, observational study (LACO-EXP) in Spain in 500 adult patients with focal epilepsies examined the efficacy and tolerability of add-on lacosamide. Factors associated with better efficacy/tolerability were analyzed. After 12months, the responder rate (≥50% reduction in seizure frequency) was 57.1%, and the seizure-free rate was 14.9%. Efficacy was better when lacosamide was the first or second add-on AED, although there was a small chance to be seizure-free even for patients who had received ≤10 prior AEDs. The mechanism of action of concomitant AEDs is important in all the stages, but differences are smaller in the early stages. Lacosamide was generally well tolerated. A slower dosage-titration schedule was associated with a lower adverse event rate. Further investigation of the timing of initiation of lacosamide add-on therapy and ideal combinations of AEDs is required.
authors.affiliation: Hospital Universitario y Politécnico La Fe Valencia, Bulevard Sur, s/n, Carretera de Malilla, 46026 Valencia, Spain. Electronic address: villanueva_vichab@gva.es.
authors.forename: Vicente
authors.initials: V
authors.lastname: Villanueva
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: López
authors.forename: José María
authors.initials: JM
authors.lastname: Serratosa
authors.forename: Beatriz
authors.initials: B
authors.lastname: González-Giraldez
authors.forename: Dulce
authors.initials: D
authors.lastname: Campos
authors.forename: Albert
authors.initials: A
authors.lastname: Molins
authors.forename: Juan
authors.initials: J
authors.lastname: Rodriguez Uranga
authors.forename: José Angel
authors.initials: JA
authors.lastname: Mauri
authors.forename: Javier
authors.initials: J
authors.lastname: Salas-Puig
authors.forename: Manuel
authors.initials: M
authors.lastname: Toledo
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Sánchez-Alvarez
authors.forename: Antonio
authors.initials: A
authors.lastname: Moreno
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Serrano-Castro
authors.forename: Rosa Ana
authors.initials: RA
authors.lastname: Saiz-Diaz
authors.forename: Jesús
authors.initials: J
authors.lastname: González de la Aleja
authors.forename: Pilar
authors.initials: P
authors.lastname: de la Peña
authors.forename: Montserrat
authors.initials: M
authors.lastname: Asensio
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000078334:Lacosamide; D008297:Male; D008875:Middle Aged; D019370:Observation; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: Antiepileptic drugs; Focal epilepsy; Lacosamide; Retrospective study; Seizure-free