M Ley1, A Principe2, J Jiménez-Conde3, R Rocamora4. 1. Epilepsy Monitoring Unit, Department of Neurology, IMIM-Hospital del Mar, Passeig Maritim 25-29, Barcelona 08003, Spain. Electronic address: mley@parcdesalutmar.cat. 2. Epilepsy Monitoring Unit, Department of Neurology, IMIM-Hospital del Mar, Passeig Maritim 25-29, Barcelona 08003, Spain. Electronic address: aprincipe@parcdesalutmar.cat. 3. Neurovascular Unit, Department of Neurology, IMIM-Hospital del Mar, Passeig Maritim 25-29, Barcelona 08003, Spain. Electronic address: jjimenez@IMIM.es. 4. Epilepsy Monitoring Unit, Department of Neurology, IMIM-Hospital del Mar, Passeig Maritim 25-29, Barcelona 08003, Spain. Electronic address: rrocamora@parcdesalutmar.cat.
Abstract
INTRODUCTION: Older dibenzazepines with a carboxamide substitution have been demonstrated to cause deleterious effects on lipid metabolism profile, as well as frequent hyponatremia. The aim of our study is to assess the effects of eslicarbazepine acetate, a novel AED, on lipid metabolism profile, sodium values and liver function tests, as well as to compare them with previous effects of carbamazepine and oxcarbazepine. METHODS: This report describes a retrospective cohort study of 108 patients who were treated with eslicarbazepine. Of these patients, 52% had switched to eslicarbazepine from prior treatment with carbamazepine or oxcarbazepine. Laboratory values concerning lipid metabolism profile, liver function tests and sodium were assessed before and after beginning/switching treatment. Patients who began treatment or whose treatment for dyslipidemia was modified during the study period were excluded from the analysis. Co-medications that could impact lipid metabolism profile, sodium or hepatic function were kept stable during the study period. RESULTS: The mean total cholesterol of the entire group decreased significantly from prior pathological to normal values after beginning/switching treatment. The percentage of patients with pathological values decreased. Patients switching from prior carboxamides also showed significant reductions in mean LDL and triglycerides. Patients beginning treatment without prior carboxamides did not develop dyslipidemia after titration. A tendency for an increased percentage of patients with hyponatremia was detected in both groups. CONCLUSIONS: Compared with older carboxamides, eslicarbazepine acetate exhibits a safer profile related to lipid metabolism. No relevant changes were detected in liver function tests. Consequently, a vascular risk factor could be avoided in patients with chronic epilepsy, while hyponatremia still needs to be ruled out. Prospective studies are still needed.
INTRODUCTION: Older dibenzazepines with a carboxamide substitution have been demonstrated to cause deleterious effects on lipid metabolism profile, as well as frequent hyponatremia. The aim of our study is to assess the effects of eslicarbazepine acetate, a novel AED, on lipid metabolism profile, sodium values and liver function tests, as well as to compare them with previous effects of carbamazepine and oxcarbazepine. METHODS: This report describes a retrospective cohort study of 108 patients who were treated with eslicarbazepine. Of these patients, 52% had switched to eslicarbazepine from prior treatment with carbamazepine or oxcarbazepine. Laboratory values concerning lipid metabolism profile, liver function tests and sodium were assessed before and after beginning/switching treatment. Patients who began treatment or whose treatment for dyslipidemia was modified during the study period were excluded from the analysis. Co-medications that could impact lipid metabolism profile, sodium or hepatic function were kept stable during the study period. RESULTS: The mean total cholesterol of the entire group decreased significantly from prior pathological to normal values after beginning/switching treatment. The percentage of patients with pathological values decreased. Patients switching from prior carboxamides also showed significant reductions in mean LDL and triglycerides. Patients beginning treatment without prior carboxamides did not develop dyslipidemia after titration. A tendency for an increased percentage of patients with hyponatremia was detected in both groups. CONCLUSIONS: Compared with older carboxamides, eslicarbazepine acetate exhibits a safer profile related to lipid metabolism. No relevant changes were detected in liver function tests. Consequently, a vascular risk factor could be avoided in patients with chronic epilepsy, while hyponatremia still needs to be ruled out. Prospective studies are still needed.
Authors: Robert T Wechsler; Rodney A Radtke; Michael Smith; David G Vossler; Laura Strom; Eugen Trinka; Hailong Cheng; Todd Grinnell; David Blum; Mariana Vieira; Joana Moreira; Francisco Rocha Journal: Epilepsia Date: 2019-07-01 Impact factor: 5.864