Lakozamid podawany dożylnie w leczeniu epilepsji u dzieci: doświadczenia ośrodka wysokospecjalistycznego w Bogotá, Kolumbia
Intravenous Lacosamide in Pediatric Epilepsy: Experience From a High-Complexity Center in Bogotá, Colombia
W skrócie
Badacze ocenili skuteczność i bezpieczeństwo lakozamidu podawanego dożylnie u 140 dzieci z epilepsją. Okazało się, że u ponad 68% pacjentów zmniejszyła się liczba napadów, a lek był bezpieczny - powikłania pojawiły się tylko u 2,9% dzieci. Naukowcy zatem rekomendują lakozamid dożylny jako bezpieczną opcję dla dzieci z epilepsją, które nie mogą tymczasowo przyjmować leków doustnie lub których epilepsja nie reaguje na inne leki.
Oryginalny abstract (angielski)
BACKGROUND: To evaluate the efficacy and safety of intravenous lacosamide (IV LCM) in pediatric patients with epilepsy. METHODS: A retrospective descriptive cohort study was conducted in patients younger than 18 years hospitalized at HOMI Fundación Hospital Pediátrico La Misericordia (Bogotá, Colombia) between November 2018 and January 2023. Patients treated with IV LCM were included, excluding those with status epilepticus or seizure clusters (subject of a separate study and analysis). Sociodemographic variables, epilepsy characteristics, medication use, seizure control, and adverse effects were analyzed descriptively. RESULTS: A total of 140 patients were included (median age: 10.9 years; 53.6% male). Most patients had focal epilepsy (89.3%), with structural etiology being the most common cause (44.3%). A total of 68.6% of patients showed a greater than 50% reduction in seizure frequency, 30% had no change in seizure frequency, and 1.4% experienced worsening. Favorable responses were observed in focal epilepsy (71.2%) and in structural etiology (43/62; 69.4%). Adverse effects occurred in 2.9% of cases, mainly sinus bradycardia and nausea. No significant changes were observed in hemodynamic, renal, or hepatic parameters after treatment. CONCLUSIONS: This study suggests that IV LCM is an effective and safe option for the management of uncontrolled or drug-resistant epilepsy in patients who were temporarily unable to take oral medications and were already receiving the medication, as well as an add-on therapy in patients with uncontrolled epilepsy.