September 24, 2019

Study Finds No Clear Genomic or Clinical Predictors of Lacosamide Response in Refractory Epilepsies

Objective: Clinical and genetic predictors of response to antiepileptic drugs (AEDs) are largely unknown. This study examined predictors of lacosamide response in a real world clinical setting.

Methods: This research team tested the association of clinical predictors with treatment response using regression modelling in a cohort of people with refractory epilepsy. Genetic assessment for lacosamide response was conducted via genome-wide association studies and exome studies, comprising 281 candidate genes.

Results: Most patients (479/483) were treated with LCM in addition to other AEDs. The results corroborate previous findings that patients with refractory genetic generalized epilepsy (GGE) may respond to treatment with LCM. No clear clinical predictors were identified. The research team then compared 73 lacosamide responders, defined as those experiencing greater than 75% seizure reduction or seizure freedom, to 495 non-responders (less than 25% seizure reduction). No variants reached the genome-wide significance threshold in our case-control analysis.

Significance: No genetic predictor of lacosamide response was identified. Patients with refractory genetic generalized epilepsy might benefit from treatment with lacosamide.

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