Lacosamide use does not increase lipid levels, finds study

Researchers analyzed data from a Phase 3, international, randomized, double‐blind trial of LCM vs CBZ for the initial treatment of focal epilepsy. They analyzed serum lipid profiles of 271 patients who were not taking lipid‐lowering agents and providing blood samples under fasting conditions before treatment and following 3 or 12 months of treatment with LCM or CBZ at various doses.

Key findings of the study:

♦ By the end of 12 months, researchers observed no difference in LCM‐treated patients for total cholesterol, cholesterol fractions, or triglycerides.

♦ They observed an increase of 21.1 mg/dL in total cholesterol, 12.6 mg/dL in low‐density lipoprotein (LDL) cholesterol, 12.5 mg/dL in non–high density lipoprotein (non‐HDL) cholesterol, and 8.5 mg/dL in HDL cholesterol among patients who were treated with CBZ. However, they observed no changes in the triglycerides levels.

♦ They reported that the proportion of patients with elevated total cholesterol levels did not change in the LCM treatment group (37.0% at Baseline; 34.8% at 12 months) but increased from 30.8% (at Baseline) to 49.6% (at 12 months) in the CBZ treatment group.

The authors concluded, "We have demonstrated two important outcomes from our analysis using data from a randomized clinical trial: first, that CBZ unequivocally produces increases in serum lipids; and second, that LCM does not increase lipid levels. These data add to the body of literature suggesting that noninducing anticonvulsants should be strongly preferred for treatment of focal seizures".

For further information:

https://onlinelibrary.wiley.com/doi/10.1111/epi.16745