拉考沙胺与卡马西平治疗成人新诊癫痫的有效性和安全性对比

郭夏青; 李郭飞; 孙玉华; 郑东琳

doi:10.6039/j.issn.1001-0408.2024.04.15

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拉考沙胺与卡马西平治疗成人新诊癫痫的有效性和安全性对比

药物与临床 | 更新时间：2024-02-23

- 拉考沙胺与卡马西平治疗成人新诊癫痫的有效性和安全性对比
- Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with newly diagnosed epilepsy
- 中国药房 2024年35卷第4期页码：464-467
- 作者机构：
  
  河南大学淮河医院神经内科一病区，河南开封　475000
- 作者简介：
  
  主治医师，硕士。研究方向：脑血管病、帕金森病。 E-mail：guoxiaqing2002@163.com
  副主任医师。研究方向：癫痫的诊治。E-mail：96299736223@qq.com
- 基金信息：
  
  河南省科技发展计划(212102310830)
- DOI：10.6039/j.issn.1001-0408.2024.04.15
  中图分类号： R742.1;R969.4
- 纸质出版日期：2024-02-29，
  
  收稿日期：2023-07-19，
  
  修回日期：2023-12-22，
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郭夏青,李郭飞,孙玉华等.拉考沙胺与卡马西平治疗成人新诊癫痫的有效性和安全性对比 ^Δ[J].中国药房,2024,35(04):464-467.

GUO Xiaqing,LI Guofei,SUN Yuhua,et al.Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with newly diagnosed epilepsy[J].ZHONGGUO YAOFANG,2024,35(04):464-467.
郭夏青,李郭飞,孙玉华等.拉考沙胺与卡马西平治疗成人新诊癫痫的有效性和安全性对比 ^Δ[J].中国药房,2024,35(04):464-467. DOI： 10.6039/j.issn.1001-0408.2024.04.15.

GUO Xiaqing,LI Guofei,SUN Yuhua,et al.Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with newly diagnosed epilepsy[J].ZHONGGUO YAOFANG,2024,35(04):464-467. DOI： 10.6039/j.issn.1001-0408.2024.04.15.

摘要

目的

比较拉考沙胺（LCM）与卡马西平（CAR）单药治疗成人新诊癫痫患者的有效性和安全性。

方法

采用回顾性分析方法，根据用药方案的不同，将2020年9月－2022年6月河南大学淮河医院神经内科收治的新诊癫痫患者（84例）分为对照组（40例，接受CAR治疗）和观察组（44例，接受LCM治疗），比较两组患者的总有效率、癫痫发作频率、血脂水平和不良事件（AEs）发生情况。

结果

治疗后第1个月，观察组患者的总有效率（63.64%）与对照组（55.00%）比较，差异无统计学意义（

＞0.05）；两组患者的癫痫发作频率均较治疗前显著减少（

＜0.05），但组间比较差异无统计学意义（

＞0.05）。治疗后第3个月，观察组患者的总有效率（90.91%）显著高于对照组（67.50%，

＜0.05）；两组患者的癫痫发作频率亦较治疗前显著减少，且观察组显著少于对照组（

＜0.05）。治疗后第3个月，对照组患者的TC、TG、LDL-C水平以及观察组患者的LDL-C水平均较同组治疗前显著升高，且观察组患者的TC、TG、LDL-C水平均显著低于对照组（

＜0.05）。观察组患者的AEs发生率（15.91%）与对照组（17.50%）比较，差异无统计学意义（

＞0.05）。

结论

LCM和CAR在成人新诊癫痫患者的治疗中均具有一定效果，均可降低患者的癫痫发作频率，且安全性相当。同时，LCM的长期疗效优于CAR，对患者血脂水平的影响小于CAR。

Abstract

OBJECTIVE

To compare the efficacy and safety of lacosamide （LCM） and carbamazepine （CAR） as monotherapy in the treatment of adult patients with newly diagnosed epilepsy.

METHODS

By methods of retrospective analysis， 84 adult patients with newly diagnosed epilepsy， were admitted to the Department of Neurology， Huaihe Hospital of Henan University during Sept. 2020-Jun. 2022， were divided into the control group （40 cases， receiving CAR treatment） and the observation group （44 cases， receiving LCM treatment） according to different medication regimens. Total response rate， epilepsy seizure frequency， blood lipid levels， and the occurrence of adverse events （AEs） of patients were compared between the 2 groups.

RESULTS

In the first month after treatment， there was no statistically significant difference in the total response rate between the observation group （63.64%） and the control group （55.00%，

＞0.05）； the frequency of epilepsy seizure in both groups was significantly reduced compared to before treatment （

＜0.05）， but there was no statistically significant difference between 2 groups （

＞0.05）. In the third month after treatment， the total response rate of the observation group （90.91%） was significantly higher than control group （67.50%，

＜0.05）； the frequencies of epilepsy seizure in both groups were significantly reduced compared to before treatment， and the observation group was significantly lower than the control group （

＜0.05）. In the third month after treatment， the levels of total cholesterol （TC）， triglyceride （TG） and low-density lipoprotein cholestrol （LDL-C） in the control group and the level of LDL-C in the observation group were significantly higher than before treatment， and the levels of TC， TG and LDL-C in the observation group were significantly lower than those in the control group （

＜0.05）. There was no statistically significant difference in the incidence of AEs between the observation group （15.91%） and the control group （17.50%，

＞0.05）.

CONCLUSIONS

Both LCM and CAR have certain effects in the treatment of newly diagnosed epilepsy in adults， which can reduce the frequency of epilepsy seizure in patients and have comparable safety. Meanwhile， LCM has better long-term efficacy than CAR in treating newly diagnosed epilepsy in adults， and its impact on the patient’s blood lipid is smaller than CAR.

关键词

拉考沙胺卡马西平新诊癫痫成人患者有效性安全性

Keywords

carbamazepinenewly diagnosed epilepsyadult patientefficacysafety

references

HU T T，ZHANG J F，WANG J X，et al. Advances in epilepsy：mechanisms，clinical trials，and drug therapies[J]. J Med Chem，2023，66（7）：4434-4467.

PONG A W，XU K J，KLEIN P. Recent advances in pharmacotherapy for epilepsy[J]. Curr Opin Neurol，2023，36（2）：77-85.

BERNABEI J M，LI A，REVELL A Y，et al. Quantitative approaches to guide epilepsy surgery from intracranial EEG[J]. Brain，2023，146（6）：2248-2258.

高敏，片莹，张敬军. 抗癫痫药物性脑病研究进展[J]. 中国神经精神疾病杂志，2023，49（3）：184-188.

GAO M，PIAN Y，ZHANG J J. Progress in antiepileptic drug-induced encephalopathy[J]. Chin J Nerv Ment Dis，2023，49（3）：184-188.

KANNER A M，BICCHI M M. Antiseizure medications for adults with epilepsy：a review[J]. JAMA，2022，327（13）：1269-1281.

XIA L，OU S C，PAN S Q. Initial response to antiepileptic drugs in patients with newly diagnosed epilepsy as a predictor of long-term outcome[J]. Front Neurol，2017，8：658.

BIASE S D，VALENTE M，GIGLI G L，et al. Pharmacokinetic drug evaluation of lacosamide for the treatment of partial-onset seizures[J]. Expert Opin Drug Metab Toxicol，2017，13（9）：997-1005.

FISHER R S，ACEVEDO C，ARZIMANOGLOU A，et al. ILAE official report：a practical clinical definition of epilepsy[J]. Epilepsia，2014，55（4）：475-482.

CHEN Y，NAGIB M M，YASMEN N，et al. Neuroinflammatory mediators in acquired epilepsy：an update[J]. Inflamm Res，2023，72（4）：683-701.

KNOWLES J K，HELBIG I，METCALF C S，et al. Precision medicine for genetic epilepsy on the horizon：recent advances，present challenges，and suggestions for con-tinued progress[J]. Epilepsia，2022，63（10）：2461-2475.

BAULAC M，ROSENOW F，TOLEDO M，et al. Efficacy，safety，and tolerability of lacosamide monotherapy versus controlled-release carbamazepine in patients with newly diagnosed epilepsy：a phase 3，randomised，double-blind，non-inferiority trial[J]. Lancet Neurol，2017，16（1）：43-54.

SCHMITZ B，DIMOVA S，ZHANG Y，et al. Tolerability and efficacy of lacosamide and controlled-release carba-mazepine monotherapy in patients with newly diagnosed epilepsy and concomitant psychiatric conditions：post hoc analysis of a prospective，randomized，double-blind trial[J]. Epilepsy Res，2020，159：106220.

BEN-MENACHEM E，GREBE H P，TERADA K，et al. Loerm safety and efficacy of lacosamide and controlled-release carbamazepine monotherapy in patients with newly diagnosed epilepsy[J]. Epilepsia，2019，60（12）：2437-2447.

张鹤声，张恩惠，刘文钰，等. 拉考沙胺单药治疗癫痫发作的研究进展[J]. 中国新药与临床杂志，2022，41（2）：79-84.

ZHANG H S，ZHANG E H，LIU W Y，et al. Research progress of lacosamide monotherapy in treatment of epilepsy[J]. Chin J N Drugs Clin Remedies，2022，41（2）：79-84.

CHUNG S，SPERLING M R，BITON V，et al. Laco-samide as adjunctive therapy for partial-onset seizures：a randomized controlled trial[J]. Epilepsia，2010，51（6）：958-967.

VOSSLER D G，KNAKE S，O’BRIEN T J，et al. Efficacy and safety of adjunctive lacosamide in the treatment of primary generalised tonic-clonic seizures：a double-blind，randomised，placebo-controlled trial[J]. J Neurol Neurosurg Psychiatry，2020，91（10）：1067-1075.

MINTZER S，DIMOVA S，ZHANG Y，et al. Effects of lacosamide and carbamazepine on lipids in a randomized trial[J]. Epilepsia，2020，61（12）：2696-2704.

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