Initial monotherapy with eslicarbazepine acetate for the management of adult patients with focal epilepsy in clinical practice: a meta-analysis of observational studies.

Abstract

AIM OF THE STUDY:

To assess the effectiveness, overall tolerability of eslicarbazepine acetate (ESL) as an initial or early monotherapy treatment of adult patients with focal epilepsy under real-world practice conditions.

MATERIALS AND METHODS:

We focused on real-world longitudinal studies that included or separately reported the results of at least one of the efficacy outcomes of interest. A DerSimonian-Laird random effects model was used with the presentation of the 95% confidence intervals of the estimate.

RESULTS:

5 studies met our selection criteria and were included in the quantitative synthesis. All studies were observational and uncontrolled studies, and all but one were retrospective studies. The pooled proportion of patients who were seizure-free for the entire study period was 64.6% (95% CI, 45.7 to 79.8) at month 6 and 56.6% (95% CI, 50.2 to 62.8) at month 12. Pooled retention rates were 95.0% (95% CI, 90.3 to 97.5) at 6 months and 83.6% (95% CI, 73.9 to 90.1) at 12 months. The pooled proportion of patients who reported at least one adverse event was 27.2% (95% CI, 21.7 to 33.6), and the pooled proportion of patients who discontinued ESL due to adverse events was 8.9% (95% CI 6.2 to 12.6).

CONCLUSIONS:

Our results suggest that initial or early monotherapy with ESL is effective and well-tolerated for the management of adult patients with focal epilepsy in clinical practice, with results that are at least similar to those reported in the pivotal randomized clinical trial of ESL monotherapy. No new safety signals with ESL have been identified in this systematic review.

• Authors: Silvia Fernández-Anaya, Vicente Villanueva, José M Serratosa, Fernando Rico-Villademoros, Rosa Rojo, Pilar Sarasa
• Journal: The International journal of neuroscience (Int J Neurosci) Vol. 133 Issue 4 Pg. 430-440 (Apr 2023) ISSN: 1563-5279 [Electronic] England
• PMID: 33993841 (Publication Type: Meta-Analysis, Systematic Review, Journal Article)

Chemical References

• eslicarbazepine acetate
• Anticonvulsants
• Dibenzazepines

Topics

• Humans
• Adult
• Anticonvulsants (adverse effects)
• Retrospective Studies
• Epilepsies, Partial (drug therapy)
• Dibenzazepines (adverse effects)
• Treatment Outcome
• Randomized Controlled Trials as Topic