Lacosamide

(Vimpat®)

Lacosamide

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Drug updated on 5/17/2024

Dosage FormTablet (oral; 50 mg, 100 mg, 150 mg, 200 mg); Injection (intravenous; 200 mg/20 mL); Solution (oral; 10 mg/mL)
Drug ClassFunctionalized amino acids
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of partial-onset seizures in patients 1 month of age and older.
  • Indicated for the treatment of adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older.

Summary
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  • Lacosamide (Vimpat) is indicated for the treatment of partial-onset seizures in patients 1 month of age and older, and as an adjunctive therapy in treating primary generalized tonic-clonic seizures in patients aged 4 years and above.
  • Eleven studies were reviewed to gather information about Vimpat's efficacy, safety, tolerability, and comparison with other anti-seizure medications (ASMs).
  • Lacosamide showed significant efficacy in lowering seizure frequency compared to placebo. It was particularly effective alongside Cenobamate (CNB) and Eslicarbazepine Acetate (ESL), which are also third-generation ASMs.
  • Lacosamide demonstrated safety and effectiveness among special populations such as those suffering from Lennox-Gastaut syndrome, a difficult-to-manage condition. However, some reports noted worsening seizures among these patients.
  • Compared to other ASMs like Brivaracetam (BRV), ESL, CNB, and Perampanel (PER), lacosamide and BRV had fewer participants experiencing treatment-emergent adverse events (TEAEs), indicating it may be better tolerated than some alternatives.
  • For pediatric populations, lacosamide was deemed safe concerning movement disorders. The specific adverse events did not significantly differ from those observed in adult populations, indicating similar tolerance levels across different ages.
  • Among adults with drug-resistant focal-onset seizures, lacosamide proved effective as an adjunctive therapy. It showed comparable rates of seizure control to phenytoin (PHT) but resulted in fewer serious adverse events, making it a safer alternative.
  • Limited evidence suggests a potential role for lacosamide in the treatment of Lennox-Gastaut Syndrome (LGS). However, caution is advised due to the possibility of an increase in seizure frequency among this patient group.

Product Monograph / Prescribing Information

Document TitleYearSource
Vimpat (lacosamide) Prescribing Information.2023UCB, Inc., Smyrna, GA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study.2024Frontiers in Neurology
A comparison of cenobamate with other newer antiseizure medications for adjunctive treatment of focal-onset seizures: a systematic review and network meta-analysis.2024Seizure
Efficacy and tolerability of lacosamide in lennox–gastaut syndrome: a systematic review and meta-analysis.2022Journal of Neurosciences in Rural Practice
Indirect treatment comparison of cenobamate to other ASMs for the treatment of uncontrolled focal seizures.2022Epilepsy and Behavior
Third-generation antiseizure medications for adjunctive treatment of focal-onset seizures in adults: a systematic review and network meta-analysis.2022Drugs
Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data.2022The Cochrane Database of Systematic Reviews
Movement disorders secondary to novel antiseizure medications in pediatric populations: a systematic review and meta-analysis of risk.2022Journal of Child Neurology
Efficacy of lacosamide and phenytoin in status epilepticus: a systematic review.2021Acta Neurologica Scandinavica
Lacosamide add-on therapy for focal epilepsy.2021The Cochrane Database of Systematic Reviews
Clinical efficacy and safety of lacosamide as an adjunctive treatment in adults with refractory epilepsy.2021Frontiers in Neurology
Anti-seizure medications and efficacy against focal to bilateral tonic-clonic seizures: a systematic review with relevance for SUDEP prevention.2021Epilepsy and Behavior

Clinical Practice Guidelines

Document TitleYearSource
Evidence-based anti-seizure monotherapy in newly diagnosed epilepsy: a new approach.2020Acta Neurologica Scandinavica