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Once-Daily Eslicarbazepine May Prevent Seizures as Well as Twice-Daily Carbamazepine



VANCOUVER—Taking eslicarbazepine acetate once daily may control partial seizures as well as taking carbamazepine twice daily, according to research presented at the 68th Annual Meeting of the American Academy of Neurology.

"Seizure control is crucial," said Elinor Ben-Menachem, MD, Guest Professor of Neurology at Gothenburg University in Sweden. "A once-a-day drug may help people stick to their medication schedule."

Elinor Ben-Menachem, MD

Dr. Ben-Menachem and colleagues randomized 815 people with newly diagnosed partial seizures to receive eslicarbazepine or carbamazepine for about six months. At the beginning of the study, participants received 800 mg of eslicarbazepine once daily or 200 mg of carbamazepine twice daily. Participants who had a seizure during a 26-week evaluation period had their dose increased to 1,200 mg of eslicarbazepine once daily or 400 mg of carbamazepine twice daily. If participants had seizures at this dose during a second 26-week evaluation period, their dose was increased to 1,600 mg of eslicarbazepine once daily or 600 mg of carbamazepine twice daily.

Participants who were seizure-free at any dose continued their dose through subsequent periods.

The primary end point was the proportion of patients with 26-week seizure freedom. According to the study design, eslicarbazepine would be considered noninferior to carbamazepine if the difference in seizure-freedom rate between the two drugs was 12% or less.

Approximately 71% of participants taking eslicarbazepine and 76% of those taking carbamazepine were seizure-free for six or more months at the last evaluated dose. After one year, about 65% of participants taking eslicarbazepine were seizure-free, compared with 70% of those taking carbamazepine. The difference in seizure-freedom rate between the drugs was approximately 4% at six months and about 5% at one year.

Incidence rates of adverse events were similar for the two drugs, but slightly higher for carbamazepine. The most frequently reported adverse events were headache, dizziness, nausea, fatigue, and somnolence. Most adverse events were mild. The researchers observed no new or unexpected safety findings.

"Memory issues, fatigue, or a complicated medication schedule can all interfere with a person taking their seizure-control medications on a regular basis, so having a once-daily option for patients, especially when they are newly diagnosed and still learning to manage the disease, may be beneficial," said Dr. Ben-Menachem. "The hope is that these results may also give doctors more options to better tailor treatments for people with epilepsy."

Erik Greb

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