title: Eslicarbazepine acetate: its effectiveness as adjunctive therapy in clinical trials and open studies.
abstract: Eslicarbazepine acetate (ESL) is a once-daily antiepileptic drug that is approved as adjunctive therapy in adults with focal-onset seizures. Following oral administration, ESL is rapidly metabolized to its active metabolite, eslicarbazepine, which acts primarily by enhancing slow inactivation of voltage-gated sodium channels. The efficacy and safety/tolerability of ESL in the adjunctive setting were established in a comprehensive Phase III program (n = 1702 randomized patients) and this evidence has been supported by several open studies (n = 864). ESL treatment has demonstrated improvements in health-related quality of life, in both randomized clinical trials and open studies. ESL has also been shown to be usually well tolerated and efficacious when used in the adjunctive setting in elderly patients. The effectiveness of ESL as the only add-on to antiepileptic drug monotherapy has been demonstrated in a multinational study (n = 219), subgroup analyses of which have also shown it to be efficacious and generally well tolerated in patients who had previously not responded to carbamazepine therapy. Open studies have also demonstrated improvements in tolerability in patients switched overnight from oxcarbazepine to ESL. Due to differences in pharmacokinetics, pharmacodynamics, and metabolism, there may be clinical situations in which it is appropriate to consider switching patients from oxcarbazepine or carbamazepine to ESL.
authors.affiliation: UCL Institute of Neurology, Box 5, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK. s.shorvon@ucl.ac.uk.
authors.forename: S D
authors.initials: SD
authors.lastname: Shorvon
authors.affiliation: Department of Neurology and Neuroscience Institute at Christian Doppler Klinik, Paracelsus Medical University Salzburg, Ignaz Harrerstrasse 79, 5020, Salzburg, Austria.|Centre for Cognitive Neuroscience, 5020, Salzburg, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Trinka
authors.affiliation: Epilepsiezentrum Kork, Landstraße 1, 77694, Kehl-Kork, Germany.
authors.forename: B J
authors.initials: BJ
authors.lastname: Steinhoff
authors.affiliation: Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Holtkamp
authors.affiliation: Multidisciplinary Epilepsy Unit, Neurology Service, Hospital Universitario y Polotécnico La Fe, Avda Fernando Abril Martorell 106, 46026, Valencia, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Villanueva
authors.affiliation: Department of Neurology, Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Peltola
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Göteborg, Box 430, SE-405 30, Göteborg, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Ben-Menachem
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D003984:Dibenzazepines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D057915:Drug Substitution; D004828:Epilepsies, Partial / Q000188:drug therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012640:Seizures / Q000188:drug therapy
chemical_list: D000927:Anticonvulsants; D003984:Dibenzazepines; C416835:eslicarbazepine acetate
keywords: Adjunctive therapy; Antiepileptic drug; Clinical practice; Epilepsy; Eslicarbazepine acetate; Focal-onset seizures