Intravenous lacosamide in status epilepticus: Correlation between loading dose, serum levels, and clinical response.

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Serval ID
serval:BIB_4B7DEF70D1C9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intravenous lacosamide in status epilepticus: Correlation between loading dose, serum levels, and clinical response.
Journal
Epilepsy Research
Author(s)
Perrenoud M., André P., Alvarez V., Stähli C., Decosterd L.A., Rossetti A.O., Novy J.
ISSN
1872-6844 (Electronic)
ISSN-L
0920-1211
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
135
Pages
38-42
Language
english
Abstract
Intravenous lacosamide (LCM) is increasingly used in the treatment of status epilepticus (SE), but optimal loading dose and target serum levels are unclear. We analysed the correlation between LCM serum levels after intravenous loading dose and clinical response.
Retrospective study in two centres from December 2014 to May 2016 including consecutive SE patients treated with LCM, in which trough serum levels after intravenous loading dose were available. Trough levels were correlated with the loading dose and the clinical response, defined as LCM introduction terminating SE without the need of further treatment. Correlations were adjusted for other SE characteristics.
Among 40 patients, 16 (40%) responded to LCM. LCM serum concentrations within the reference interval (10-20mg/l) were associated with loading doses of >9mg/kg (p=0.003; χ2). However, we observed no difference between LCM serum levels in responders (median 10.4mg/l) versus non-responders (median 9.5mg/l; p=0.36; U test), even after adjusting for other predictors of clinical outcome (SE severity, aetiology, and number of previous treatment).
High intravenous LCM loading doses (>9mg/kg) were associated with serum levels within the reference interval, there was however no correlation with the clinical response. Prospective studies are needed to evaluate the benefit of increasing the LCM loading dose in SE.

Keywords
Acetamides/administration & dosage, Acetamides/blood, Administration, Intravenous, Adult, Aged, Aged, 80 and over, Anticonvulsants/administration & dosage, Anticonvulsants/blood, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Retrospective Studies, Status Epilepticus/blood, Status Epilepticus/drug therapy, Status Epilepticus/mortality, Treatment Outcome, Critical care, Outcome, Retrospective, Therapeutic drug monitoring
Pubmed
Web of science
Create date
27/06/2017 17:25
Last modification date
17/09/2020 9:17
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