AI Article Synopsis
- The study aimed to compare the effectiveness of two antiepileptic drugs, lamotrigine and lacosamide, in treating seizures in brain tumor patients after initial treatments failed.
- Researchers analyzed data from 139 patients with diffuse glioma who received either drug and assessed treatment failure rates, uncontrolled seizures, and toxicity levels.
- Results indicated no significant difference between the two medications in terms of treatment failure or seizure control, suggesting both are equally effective for this patient group.
Article Abstract
Purpose: Optimal treatment with antiepileptic drugs (AEDs) is an important part of care for brain tumor patients with epileptic seizures. Lamotrigine and lacosamide are both examples of frequently used non-enzyme inducing AEDs with limited to no drug-drug interactions, reducing the risk of unfavorable side effects. This study aimed to compare the effectiveness of lamotrigine versus lacosamide.
Methods: In this multicenter study we retrospectively analyzed data of patients with diffuse grade 2-4 glioma with epileptic seizures. All patients received either lamotrigine or lacosamide during the course of their disease after treatment failure of first-line monotherapy with levetiracetam or valproic acid. Primary outcome was the cumulative incidence of treatment failure, from initiation of lamotrigine or lacosamide, with death as competing event, for which a competing risk model was used. Secondary outcomes were uncontrolled seizures after AED initiation and level of toxicity.
Results: We included a total of 139 patients of whom 61 (44%) used lamotrigine and 78 (56%) used lacosamide. At 12 months, there was no statistically significant difference in the cumulative incidence of treatment failure for any reason between lamotrigine and lacosamide: 38% (95%CI 26-51%) versus 30% (95%CI 20-41%), respectively. The adjusted hazard ratio for treatment failure of lacosamide compared to lamotrigine was 0.84 (95%CI 0.46-1.56). The cumulative incidences of treatment failure due to uncontrolled seizures (18% versus 11%) and due to adverse events (17% versus 19%) did not differ significantly between lamotrigine and lacosamide.
Conclusion: Lamotrigine and lacosamide show similar effectiveness in diffuse glioma patients with epilepsy.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8367894 | PMC |
| http://dx.doi.org/10.1007/s11060-021-03800-z | DOI Listing |
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