title: Dose effects of lacosamide as add-on therapy for partial-onset seizure in adult.
abstract: The objective of the study was to evaluate the dose effects of lacosamide on the efficacy and safety as adjunctive therapy for partial-onset seizure in adults. We searched online databases such as Pubmed, Embase, Cochrane Online Library, and Clinicaltrial.gov for randomized control trials. A meta-analysis was performed on RevMan 5.3 software. Four randomized control trials with 1855 patients out of 310 citations and 30 registered trials were identified. 400 mg/d was more effective than 200 mg/d [RR 1.23 (95 % CI 1.05-1.45), P = 0.01], but the 600 mg/d didn't show more benefit than 400 mg/d [RR 1.01 (95 % CI 0.81-1.27), P = 0.90]. Increasing the dosage led to higher incidence of quitting the medication because of adverse events [400 vs. 200 mg/d RR 2.17 (95 % CI 1.15-4.11), P = 0.02; 600 vs. 400 mg/d RR 1.55 (95 % CI 1.12-2.15), P = 0.009]. Incidence of serious adverse events did not occur with the increase of dose [400 vs. 200 mg/d RR 1.26 (95 % CI 0.50-3.20), P = 0.62], [600 vs. 400 mg/d RR 0.52 (95 % CI 0.21-1.30), P = 0.16]. A dose of 400 mg/d resulted in a higher chance of dizziness [RR 1.50 (95 % CI 1.02-2.20), P = 0.04], vomiting [RR 1.73 (95 % CI 1.03-2.90), P = 0.04], and diplopia [RR 1.98 (95 % CI 1.19-3.30), P = 0.008] than that of 200 mg/d. 400 mg/d is the optimal dose for efficacy. The dose of 200 mg/d has the best safety for less occurrence of adverse events and less quitting. Current evidence suggests that a dose of 600 mg/d is unnecessary, except for particular reasons.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Deng
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Neurology, East Ward of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, No. 589# Honghe Road, Chengdu, 610101, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Si
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Wen-Wu
authors.initials: WW
authors.lastname: Zhang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China.
authors.forename: Da
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, 610041, China. zjllxx1968@163.com.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D016208:Databases, Factual / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: Antiepileptic drug; Epilepsy; Lacosamide; Partial-onset seizure; Therapeutics