Introduction
Conventional anti‑epileptic first‑line drugs can control the seizures of most patients with epilepsy, but persistent seizures occur in more than 30% of patients. Lacosamide, an antiepileptic drug, has been used as an adjuvant treatment for partial or systemic epilepsy.
Objective
To evaluate the therapeutic effect of levetiracetam combined with Lacosamide in patients with epilepsy.
Patients and Methods
252 patients with refractory partial seizures were randomized into
Group A: Levetiracetam tablets [120 patients, the control group
Group B: Levetiracetam tablets combined with Lacosamide [132 patients, the joint group.
Outcome measures
The measures were recorded at 6 months before and after treatment:
- The treatment efficacy in the two groups was assessed.
- A marked response indicated a complete remission of clinical symptoms, great improvements in vital signs, and a decrease in seizure frequency by >70%.
- A moderate response indicated a partial remission of clinical symptoms, moderate improvements in vital signs, and a decrease in seizure frequency by 30‑70%.
- No response indicated no improvements in the clinical symptoms or vital signs and a decrease in seizure frequency by <30% or even no decrease.
Results
- The total response rate was markedly higher in the joint group than in the control group.
- The joint group and control group were not different in the frequency of seizures before treatment (P>0.05).
- After 6 months of treatment, the frequency of seizures decreased in both groups, with a slightly higher frequency in the control group than in the joint group.
- The expression levels of NSE, S-100β, and GFAP significantly decreased in the two groups after treatment (P<0.05).
- The BMD of the femoral neck decreased in both groups after a period of treatment (P>0.05).
- In the joint group, the ALP level after treatment was higher than that before treatment, but the difference was not statistically significant.
- In the control group, the ALP level after treatment was lower than that before treatment, but the difference was not statistically significant (P>0.05).
- The Ca level decreased in both groups after treatment (P>0.05).
- The QOLIE‑31 score significantly increased in the two groups, with a slightly higher QOLIE‑31 score in the joint group than in the CG.
- The 1‑year drug retention rate was 74.24% in the joint group, with 34 cases of drug withdrawal.
- The 1‑year drug retention rate was 66.67% in the control group, with 40 cases of drug withdrawal.
- Slight adverse effects on BMD and bone metabolism.
Conclusion
Levetiracetam combined with Lacosamide significantly enhances the therapeutic effect and improves neural function in patients with refractory partial seizures.