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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(11): 1090-1096
DOI: 10.1055/s-0042-1758366
Original Article

Use of lacosamide in children: experience of a tertiary medical care center in Brazil

Utilização da lacosamida em crianças: experiência de um centro terciário no Brasil
Tayla Taynan Romão 
1   Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Neurologia, Niterói RJ, Brazil.
,
Abraão Iuri Medeiros Angelim 
2   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Epilepsia, Rio de Janeiro RJ, Brazil.
,
Henrique Jannuzzelli Pires do Prado 
2   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Epilepsia, Rio de Janeiro RJ, Brazil.
,
Fernanda Veiga de Goes 
3   Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Departamento de Neurologia, Rio de Janeiro RJ, Brazil.
,
Maria Elisa Paiva Pires 
2   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Epilepsia, Rio de Janeiro RJ, Brazil.
,
Rosiane da Silva Fontana 
2   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Epilepsia, Rio de Janeiro RJ, Brazil.
,
Lais de Carvalho Pires 
3   Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Departamento de Neurologia, Rio de Janeiro RJ, Brazil.
,
Alexandre Ribeiro Fernandes 
1   Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Neurologia, Niterói RJ, Brazil.
,
Isabella D'Andrea-Meira 
1   Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Neurologia, Niterói RJ, Brazil.
2   Instituto Estadual do Cérebro Paulo Niemeyer, Departamento de Epilepsia, Rio de Janeiro RJ, Brazil.
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Abstract

Background Lacosamide (LCM) is a third-generation anti-seizure drug approved in Europe and the United States, either as a monotherapy or adjunctive therapy, to treat partial-onset seizures in adults, adolescents, and children. In Brazil, LCM is licensed for treatment only in patients older than 16 years of age.

Objective To evaluate a cohort of children presenting with refractory epilepsy who received LCM as an add-on therapy and observe the response and tolerability to the LCM treatment.

Methods A retrospective cohort study conducted in a tertiary health care facility, which included 26 children, aged up to 16 years, who presented with refractory epilepsy and received LCM as an add-on treatment. The follow-up visits were scheduled every 3 months until 9 months of treatment with LCM.

Results After 3 months of LCM administration, in 73.1% of the children, there was a reduction of > 50% in the frequency of seizures, and this clinical improvement was maintained in most patients (73.9%) for the following 9 months. Mild (such as, somnolence and behavioral changes) or severe (seizure worsening) adverse effects were observed in two and three children respectively. Among responders to LCM, there was a higher prevalence of males, fewer concomitant anti-seizure drugs, and lower percentage of patients using sodium channel blockers.

Conclusions Lacosamide should be considered as an early treatment option in pediatric patients with refractory epilepsy, mainly focal seizures.

Resumo

Antecedentes Lacosamida (LCM) é um fármaco anticrise de terceira geração aprovado na Europa e nos Estados Unidos, utilizado como monoterapia ou terapia adjuvante para tratar crises epilépticas focais em adultos, adolescentes e crianças. No Brasil, a LCM só é aprovada para tratamento em pacientes com mais de 16 anos de idade.

Objetivo Avaliar uma coorte de crianças com epilepsia refratária que receberam LCM como terapia adjuvante e observar a resposta e tolerabilidade ao tratamento.

Métodos Um estudo de coorte retrospectivo conduzido em uma unidade terciária de saúde, que incluiu 26 crianças de até 16 anos de idade que apresentavam epilepsia refratária e receberam um tratamento complementar com LCM. As visitas de acompanhamento foram agendadas a cada 3 meses, até 9 meses de tratamento com LCM.

Resultados Após 3 meses de administração de LCM, em 73,1% das crianças, a frequência das crises teve uma redução maior do que 50%, e essa melhora clínica foi mantida na maioria dos pacientes (73,9%) pelos 9 meses seguintes. Efeitos adversos leves (como, sonolência e alterações comportamentais) ou graves (agravamento das crises) foram observados em duas e três crianças, respectivamente. Entre as crianças que responderam ao tratamento com LCM, houve uma maior prevalência do sexo masculino, o uso de um menor número de medicações anticrise associadas e o uso de bloqueadores dos canais de sódio.

Conclusões A LCM deve ser considerada uma opção de tratamento precoce em pacientes pediátricos com epilepsia refratária, principalmente aqueles que apresentam crises focais.

Keywords

Epilepsy - Lacosamide - Child - Drug Resistant Epilepsy - Pediatric Assistants

Palavras-chave

Epilepsia - Lacosamida - Criança - Epilepsia Resistente a Medicamentos - Assistentes de Pediatria

Authors' Contributions

TTR, IDM: study design, acquisition of data, data analysis, and writing of the manuscript; AIMA, HJPP, FG, MEPP, RSF, LP, ARF: acquisition of data, data analysis, and review of the manuscript.




Publication History

Received: 17 September 2021

Accepted: 25 January 2022

Article published online:
28 December 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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