Lacosamide has an innovative mode of action and a unique binding site. It is thought to exert its anti-epileptic effect by selectively enhancing slow inactivation of sodium channels and binding to collapsin response mediator protein-2 (CRMP-2).1,2 The precise mechanism of action remains to be fully elucidated.
Pooled trial data show that lacosamide improved seizure control compared to, and regardless of, current or prior anti-epileptic therapy.3
These trials, involving 1308 patients, were designed to evaluate the efficacy and safety of lacosamide when administered concomitantly with one to three anti-epileptic drugs in patients with uncontrolled partial-onset seizures, with or without secondary generalisation.
Overall, the proportion of subjects with a 50% reduction in seizure frequency was 23%, 34%, and 40% for placebo, lacosamide 200mg daily and lacosamide 400mg daily, respectively.1,3
Data from an ongoing study suggest that long-term treatment with lacosamide (currently up to 5.5 years) has high long-term retention rates (77% after one year),4 and is generally well tolerated.1,3
1. Vimpat Summary of Product Characteristics.
2. Beyreuther BK, Freitag J, Heers C et al. Lacosamide: a review of preclinical properties. CNS Drug Reviews 2007; 13:21-42.
3. UCB Pharma Ltd. Data on file.
4. Rosenfeld W, Fountain NB, Kaubrys G et al. Lacosamide: an interim evaluation of long-term safety and efficacy as oral adjunctive therapy in subjects with partial-onset seizures. Presented at the 61st Annual American Epilepsy Society Meeting, 2007, Philadelphia.
Further information: UCB Pharma