Intravenous lacosamide (LCM) in status epilepticus (SE): Weight-adjusted dose and efficacy

Santamarina, Estevo; González-Cuevas, Montserrat; Toledo, Manuel; Jiménez, Marta; Becerra, Juan Luís; Quílez, Alex; Suller, Ana; Mauri, J.A.; Fernández, Ángel; Marinas, Ainhoa; Quintana, Manuel; Puig, Xavier Salas

doi:10.1016/j.yebeh.2018.04.025

Cited by 24 publications

(12 citation statements)

References 24 publications

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“…Previous studies on newer generation AEDs in SE suggested a ceiling effect in terms of response. Regarding lacosamide, a loading dose greater than 5mg/kg (Santamarina et al 2018) was useful whereas no benefits were found when increasing higher than 9mg/kg (Perrenoud et al 2017). These data suggest that there may not be a benefit of increasing indiscriminately loading dose in SE even if the treatment is well tolerated.…”

Section: Discussionmentioning

confidence: 89%

Intravenous brivaracetam in status epilepticus: Correlation between loading dose, plasma levels and clinical response

et al. 2019

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Section: Discussionmentioning

confidence: 89%

Intravenous brivaracetam in status epilepticus: Correlation between loading dose, plasma levels and clinical response

et al. 2019

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“…Although LCM is not FDA approved for SE, it has been evaluated in this setting in multiple case series, case reports, and retrospective reviews . The populations studied varied in the types of SE encountered: generalized, convulsive, absence, focal, complex partial, nonconvulsive, refractory, and super refractory (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…No difference was seen in seizure control or mortality, but this study was underpowered because the authors did not recruit the calculated sample size needed to achieve a power of 90%. The largest investigation of LCM in SE retrospectively evaluated 165 patients with SE (mean age 64 yrs; 40% female). Lacosamide was given as the third AED in 46.1% of patients with seizure control reported in 64% after a median IV loading dose of 400 mg. Seizure cessation occurred within 12 hours for 55% of patients.…”

Section: Discussionmentioning

confidence: 99%

Use of Newer Anticonvulsants for the Treatment of Status Epilepticus

et al. 2019

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Status epilepticus (SE) has a high mortality rate and is one of the most common neurologic emergencies. Fast progression of this neurologic emergency and lack of response to traditional antiepileptic drugs (AEDs) in most cases has challenged clinicians to use new agents. This article evaluates the efficacy and safety of AEDs released to the market after 2000 for SE, refractory status epilepticus (RSE), and super‐refractory status epilepticus (SRSE). The PubMed database was searched for clinical trials published between January 2000 and July 2018 using the search terms status epilepticus, refractory status epilepticus, super refractory status epilepticus, brivaracetam, clobazam, cannabidiol, eslicarbazepine, lacosamide, perampanel, rufinamide, stiripentol, and zonisamide. Trials that evaluated these agents in adults with SE, RSE, and SRSE were included. Brivaracetam use was identified in two retrospective reviews with success rates of 27% and 57%. One unsuccessful case report of cannabidiol use in SE was found. Four clobazam studies were identified in SE and RSE with success rates ranging from 25–100%. No evidence for the use of eslicarbazepine and zonisamide was found. Using the search terms for lacosamide identified 38 articles: 1 systematic review, 5 prospective studies, 15 retrospective reviews, and 17 case reports. Success rates and dosing varied, but studies that included focal or partial types of SE showed higher success rates. Five articles were identified regarding perampanel use in this setting. Three were retrospective reviews with success rates ranging from 17–60%, and two were case reports. Only one case report regarding the use of rufinamide was found; rufinamide titrated up to 4.4 mg/day allowed discontinuation of barbiturate and clobazam. One case report and two case series of stiripentol were found with reported efficacy between 60% and 100% in SRSE. Evidence is currently insufficient to support the use of these agents in this setting.

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“…6 Lacosamide (5 mg/kg, or 400 mg for an adult patient) has been shown to be effective in treating status epilepticus in retrospective studies; a prospective study comparing lacosamide to fosphenytoin for the treatment of nonconvulsive status epilepticus is ongoing. 38,39 If the patient continues to have seizures after treatment with a benzodiazepine and an IV AED, he or she now has refractory status epilepticus, and third-line treatment should be initiated within the first hour. 29 If the patient is still breathing well, a second IVAED can be given.…”

Section: In-hospital Management Of Status Epilepticusmentioning

confidence: 99%

Emergency Management of Epilepsy and Seizures

Bank

Bazil

2019

Semin Neurol

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Seizure- and epilepsy-related complications are a common cause of emergency medical evaluation, accounting for 5% of 911 calls and 1% of emergency department visits. Emergency physicians and neurologists must be able to recognize and treat seizure- and epilepsy-related emergencies. This review describes the emergency evaluation and management of new onset seizures, breakthrough seizures in patients with known epilepsy, status epilepticus, acute symptomatic seizures, and acute adverse effects of antiepileptic drugs.

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Intravenous lacosamide (LCM) in status epilepticus (SE): Weight-adjusted dose and efficacy

Cited by 24 publications

References 24 publications

Intravenous brivaracetam in status epilepticus: Correlation between loading dose, plasma levels and clinical response

Intravenous brivaracetam in status epilepticus: Correlation between loading dose, plasma levels and clinical response

Use of Newer Anticonvulsants for the Treatment of Status Epilepticus

Emergency Management of Epilepsy and Seizures

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