Lacosamide: pharmacology, mechanisms of action and pooled efficacy and safety data in partial-onset seizures

Abstract

Lacosamide is an antiepileptic drug approved in the USA and Europe as adjunctive therapy for partial-onset seizures. Studies suggest that lacosamide selectively enhances slow inactivation of voltage-gated sodium channels and possibly interacts with collapsin response mediator protein-2. The efficacy of lacosamide has been shown in animal models of epilepsy and Phase II/III clinical trials. Pharmacokinetic studies show that it is renally excreted, minimally bound to plasma proteins and has no known clinically relevant drug–drug interactions. Clinical trials show that lacosamide is well tolerated; the most common adverse events were dizziness, nausea and vomiting. In a Phase II/III pooled analysis, lacosamide 200 and 400 mg/day significantly reduced partial-onset seizure frequency and improved the 50% responder rate compared with placebo.

Keywords::

• antiepileptic
• clinical trial
• lacosamide
• partial-onset seizure
• pooled analysis

Acknowledgements

The authors would like to thank Dirk Thomas, Schwarz Biosciences GmbH, Niels Krebsfaenger, Schwarz Biosciences GmbH, Christian Wolff, UCB Pharma SA and Alain Matagne UCB Pharma SA for their contributions and suggestions regarding the preclinical sections of this manuscript.

Financial & competing interests disclosure

A Beydoun works as a consultant for UCB Pharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.