Lacosamide for the treatment of partial-onset seizures

Abstract

Lacosamide (LCM) is an antiepileptic drug approved as adjunctive therapy for partial-onset seizures in adults. It has a mechanism of action that differs from other antiepileptic drugs in that it selectively enhances sodium channel slow inactivation, which is in contrast to ‘traditional’ sodium channel blockers (e.g., carbamazepine, oxcarbazepine, lamotrigine and phenytoin) that primarily affect fast inactivation. The pharmacokinetic profile of LCM is well characterized and includes a fast rate of absorption, little or no interaction with cytochrome P450 isoenzymes, limited effect of age and gender on plasma levels, and low potential for drug–drug interactions. Safety and efficacy data from three double-blind, placebo-controlled trials, as well as pooled and post hoc analyses of these three trials, have been published, and demonstrate the safety and rapid-onset efficacy of LCM in adults with treatment-refractory partial-onset seizures. LCM is available in tablets and an intravenous formulation when oral administration is temporarily not feasible.

Keywords::

• antiepileptic drug
• epilepsy
• intravenous
• lacosamide
• partial-onset seizures

Financial & competing interests disclosure

V Biton has received honoraria for speaking engagements and research grants from UCB Pharma and has conducted multiple clinical trials with UCB Pharma. He is currently an investigator for Eisai, Janssen, King, Medivation, Pfizer, Sepracor/Sunovion, UCB/Schwarz, Xenoport, Lundbeck, Schering-Plough/Merck, Upsher-Smith, SK Life Sciences and Wyeth. Previously, V Biton has been an investigator for Dainippon, GSK, Genzyme, Astellas/Fujisawa, Myriad, RWJPRI, Insmed, Ortho McNeil, Jazz, Carter Wallace/MedPointe, Parke-Davis, HMR/Sanofi-Aventis, Novartis, IVAX, Abbott, AstraZeneca, Cyberonics, Schwabe, SkyePharma, NPS, Saegis, Eunoe, Genentech, J&J, Marinus, Intranasal/Ikano, Ovation/Lundbeck, Schwarz/UCB, Valeant, Depomed, XTL, Forest, Elan, Vertex, Icagen, Impax and Vernalis. The author has 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.

Editorial assistance for this article was provided by Jennifer Hepker, PhD, of Prescott Medical Communications Group (Chicago, IL, USA) and was funded by UCB Pharma. Publication management in the form of publication coordination was provided by Elizabeth Hackler, employee of UCB.