EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)

In spite of the significant progress achieved in epileptology, resistant forms of epilepsy comprise about 30 % of all cases of epilepsy. The articles reviews modern concepts and basic mechanisms of pharmacoresistance, as well as the ways to overcome them. The authors presented a detailed review of m...

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Main Authors: O. A. Pylaeva, K. Yu. Mukhin, M. B. Mironov
Format: Article
Language:Russian
Published: ABV-press 2015-04-01
Series:Русский журнал детской неврологии
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Online Access:https://rjdn.abvpress.ru/jour/article/view/40
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author O. A. Pylaeva
K. Yu. Mukhin
M. B. Mironov
author_facet O. A. Pylaeva
K. Yu. Mukhin
M. B. Mironov
author_sort O. A. Pylaeva
collection DOAJ
description In spite of the significant progress achieved in epileptology, resistant forms of epilepsy comprise about 30 % of all cases of epilepsy. The articles reviews modern concepts and basic mechanisms of pharmacoresistance, as well as the ways to overcome them. The authors presented a detailed review of modern literature devoted to studies of efficacy, safety, and tolerability of the new antiepileptic drug (AED) lacosamide (Vimpat®) with uncontrolled epilepsy. Lacosamidе is registered in Russia for additional therapy of patients of 16 y.o. and older with focal seizures with or without secondary generalization. The drug is a functionalized amino acid. The assumed action mechanism differs from that of other AEDs: this drug selectively lowers the pathological hyperactivity of neurons without affecting their physiological activity, decreases abnormal epileptogenic neuronal excitability, selectively enhances slow inactivation of sodium channels without affecting rapid inactivation. Lacosamidе has the following pharmacokinetic advantages: linear kinetics; the drug is a weak inducer of liver enzymes (CYP) and, therefore, does not alter the metabolism of other AEDs and is only slightly bound to plasma proteins (< 15 %). Clinical studies have shown the efficacy and good tolerability of lacosamidе by patients with focal seizures; the dosage of the drug of 400 mg/day was assessedto be optimal. Efficacy and good tolerability of lacosamidе has been confirmed by postmarketing studies after beginning of its broad use in clinical practice. Frequent side effects associated with the therapy ( 15 %) include dizziness, headache, drowsiness, nausea, and diplopia. Concurrent intake of other AEDs that block sodium channels statistically significantly increased the risk of arising of side effects associated with the therapy. Pharmacoeconomic analysis of several studies showed favorable indicator of lacosamidе regarding the cost/efficacy criterion for treatment of focal epileptic seizures resistant to therapy.
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spelling doaj-art-6bf2984a9b9c4bf6a16e44b7922833d82025-08-04T14:12:10ZrusABV-pressРусский журнал детской неврологии2073-88032412-91782015-04-0194596810.17650/2073-8803-2014-9-4-59-6834EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)O. A. Pylaeva0K. Yu. Mukhin1M. B. Mironov2Svt. Luka's Institute of Child Neurology and Epilepsy, 6 Svetlaya St., Puchkovo Settlement, Troitsk, Moscow, 143396, RussiaSvt. Luka's Institute of Child Neurology and Epilepsy, 6 Svetlaya St., Puchkovo Settlement, Troitsk, Moscow, 143396, RussiaSvt. Luka's Institute of Child Neurology and Epilepsy, 6 Svetlaya St., Puchkovo Settlement, Troitsk, Moscow, 143396, RussiaIn spite of the significant progress achieved in epileptology, resistant forms of epilepsy comprise about 30 % of all cases of epilepsy. The articles reviews modern concepts and basic mechanisms of pharmacoresistance, as well as the ways to overcome them. The authors presented a detailed review of modern literature devoted to studies of efficacy, safety, and tolerability of the new antiepileptic drug (AED) lacosamide (Vimpat®) with uncontrolled epilepsy. Lacosamidе is registered in Russia for additional therapy of patients of 16 y.o. and older with focal seizures with or without secondary generalization. The drug is a functionalized amino acid. The assumed action mechanism differs from that of other AEDs: this drug selectively lowers the pathological hyperactivity of neurons without affecting their physiological activity, decreases abnormal epileptogenic neuronal excitability, selectively enhances slow inactivation of sodium channels without affecting rapid inactivation. Lacosamidе has the following pharmacokinetic advantages: linear kinetics; the drug is a weak inducer of liver enzymes (CYP) and, therefore, does not alter the metabolism of other AEDs and is only slightly bound to plasma proteins (< 15 %). Clinical studies have shown the efficacy and good tolerability of lacosamidе by patients with focal seizures; the dosage of the drug of 400 mg/day was assessedto be optimal. Efficacy and good tolerability of lacosamidе has been confirmed by postmarketing studies after beginning of its broad use in clinical practice. Frequent side effects associated with the therapy ( 15 %) include dizziness, headache, drowsiness, nausea, and diplopia. Concurrent intake of other AEDs that block sodium channels statistically significantly increased the risk of arising of side effects associated with the therapy. Pharmacoeconomic analysis of several studies showed favorable indicator of lacosamidе regarding the cost/efficacy criterion for treatment of focal epileptic seizures resistant to therapy.https://rjdn.abvpress.ru/jour/article/view/40epilepsyepilepsy resistant to therapyfocal seizuresadult patientslacosamidеaction mechanismpharmacokineticspharmacodynamicsefficacytolerability
spellingShingle O. A. Pylaeva
K. Yu. Mukhin
M. B. Mironov
EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)
Русский журнал детской неврологии
epilepsy
epilepsy resistant to therapy
focal seizures
adult patients
lacosamidе
action mechanism
pharmacokinetics
pharmacodynamics
efficacy
tolerability
title EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)
title_full EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)
title_fullStr EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)
title_full_unstemmed EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)
title_short EFFICACY AND TOLERABILITY OF LACOSAMIDE (VIMPAT) FOR TREATMENT OF EPILEPSY IN ADULTS (A REVIEW)
title_sort efficacy and tolerability of lacosamide vimpat for treatment of epilepsy in adults a review
topic epilepsy
epilepsy resistant to therapy
focal seizures
adult patients
lacosamidе
action mechanism
pharmacokinetics
pharmacodynamics
efficacy
tolerability
url https://rjdn.abvpress.ru/jour/article/view/40
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AT kyumukhin efficacyandtolerabilityoflacosamidevimpatfortreatmentofepilepsyinadultsareview
AT mbmironov efficacyandtolerabilityoflacosamidevimpatfortreatmentofepilepsyinadultsareview