2023 Volume 55 Issue 4 Pages 268-273
Objective: This study aimed to compare the efficacy and safety of lacosamide (LCM) and levetiracetam (LEV) in children with focal epilepsy. Methods: We retrospectively analyzed the efficacy and safety of LCM and LEV monotherapy in children aged ≧4 and ＜16 years old with newly diagnosed focal epilepsy at Hiroshima City Funairi Citizens Hospital. The main outcome was seizure frequency during 12 months from the day of uptitration to the target dose, which was categorized as complete response (seizure-free), response (≧50% reduction), no response (＜50% reduction), or aggravation. Results: We enrolled 23 patients (14 boys) taking LCM (age at starting monotherapy, 4.1−13.6 years; median, 7.8 years) and 33 patients (18 boys) taking LEV (age at starting monotherapy, 4.0−15.8 years ; median, 8.8 years). The number of patients showing a complete response and response was 15 (65.2%) and 6 (26.1%), respectively, in the LCM group, and 21 (63.6%) and 8 (24.2%), respectively, in the LEV group. Efficacy was not significantly different, and no patients had aggravation in either group. Treatment-emergent adverse events (TEAEs) were reported in 6 patients (26.1%) taking LCM and 7 (21.2%) taking LEV. However, the number of TEAEs was not significantly different, and no patients discontinued therapy because of TEAEs. The TEAEs included somnolence in 5 patients, attention deficit in 1, headache in 1, and nasopharyngitis in 1 in the LCM group, and irritability and aggression in 3, somnolence in 3, headache in 1, feeling sick in 1, and vomiting in 1 in the LEV group. Conclusions: Monotherapy using LCM or LEV had equivalent efficacy and safety in children with focal epilepsy.
