Twelve-Month Efficacy of Lacosamide Monotherapy at Maximal Dose and Tolerability for Epilepsy Treatment in Pediatric Patients: Real-World Clinical Experience

Background: The efficacy and safety of lacosamide (LCM) monotherapy in Chinese pediatric patients with epilepsy have not been established. Therefore, this real-world retrospective study aimed to assess the efficacy of 12 months after achievement the maximal dose and tolerability of LCM as monotherapy for epilepsy treatment in pediatric patients. Methods: Pediatric patients were administered LCM monotherapy in two ways: primary or conversion monotherapy. Seizure frequency was recorded as an average per month for the preceding three months at baseline and then at each follow-up period for three, six, and 12 months. Results: Primary monotherapy with LCM was administered to 37 (33.0%) pediatric patients, whereas conversion to monotherapy was achieved in 75 (67.0%) pediatric patients. The responder rates of pediatric patients receiving primary monotherapy with LCM at three, six, and 12 months were 75.7% (28 of 37), 67.6% (23 of 34), and 58.6% (17 of 29), respectively. The responder rates of pediatric patients receiving conversion to monotherapy with LCM at three, six, and 12 months were 80.0% (60 of 75), 74.3% (55 of 74), and 68.1% (49 of 72), respectively. The incidence of adverse reactions with conversion to LCM monotherapy and primary monotherapy was 32.0% (24 of 75) and 40.5% (15 of 37), respectively. Conclusion: LCM is an effective and well-tolerated treatment option as monotherapy for the treatment of epilepsy.