Summary

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• This summary is based on the review of 12 systematic review(s)/meta-analysis(es). ^[1-12]
• Adjunctive Treatment for Seizures: Lacosamide demonstrated effectiveness as an adjunctive treatment for drug-resistant focal-onset and partial-onset seizures, with a pooled 50% responder rate of 48% overall (38% in randomized controlled trials and 53% in observational studies) and a pooled seizure-free rate of 9% (4% in randomized controlled trials and 13% in observational studies).
• Elderly Population: Lacosamide achieved a high probability of seizure freedom at both 6 and 12 months in elderly patients with new-onset epilepsy, making it a top-ranking choice in this demographic.
• Post-Traumatic Epilepsy: Lacosamide did not affect mortality rates or treatment-related adverse effects among patients with post-traumatic epilepsy, indicating a neutral impact on these specific outcomes.
• Lennox-Gastaut Syndrome (LGS): Evidence was insufficient to confirm Lacosamide’s effectiveness in LGS; however, 35.2% of patients reported a greater than 50% reduction in seizure frequency.
• Adverse Events (AEs): Lacosamide's most commonly reported adverse events were somnolence, behavioral abnormalities (e.g., irritability and aggressiveness), nausea, tremor, memory issues, dizziness, gastrointestinal discomfort, vomiting, and weight loss, affecting 36% of patients; no serious adverse events were noted.
• Withdrawal Rates: The withdrawal rate due to adverse events for Lacosamide was 13% in both randomized controlled trials and real-world studies.
• Comparative Safety: Compared to Cenobamate, Lacosamide had lower rates of treatment-emergent adverse events and adverse events leading to discontinuation, though differences were not statistically significant; Brivaracetam showed fewer treatment-emergent adverse events than Lacosamide, suggesting better tolerability.
• There is no population type or subgroup information available in the reviewed studies.