Switching from oxcarbazepine to eslicarbazepine in pediatric patients with focal epilepsy is safe and well-tolerated

초록

Objective: To assess the safety and tolerability of overnight switching from twice-daily oxcarbazepine to once-daily eslicarbazepine acetate (eslicarbazepine) in pediatric patients with focal epilepsy. Methods: Pediatric patients with focal epilepsy (<19 years old) who were switched from oxcarbazepine to eslicarbazepine were recruited through a retrospective review of medical records at three tertiary hospitals. Patient outcomes were evaluated for retention rate, changes in seizure burden, and treatment-emergent adverse effects. Results: A total of 60 patients (median age, 15 years; range, 6-18 years) had been switched from oxcarbazepine to eslicarbazepine during the study period. The median initial eslicarbaepine dosage was 13.7 mg/kg/day (range, 7-34 mg/kg/day), with a median oxcarbazepin-to-eslicarbazepine conversion ratio of 0.89 (range, 0.33-1.33). The treatment retention rates for eslicarbazepine were 86.7 % at 3 months, 84.2 % at 6 months, and 78.3 % at 12 months. No significant difference in retention rate was observed when patients were divided into two age groups (<12 years and 12-18 years). During the 1-year follow-up, 10 (16.7 %) patients discontinued eslicarbazepine. Among theses patients, 8 (80 %) reverted to oxcarbazepine-mostly at the first follow-up visit after the transition (median, 2 months). All 13 patients (21.7 %) who transitioned from oxcarbazepine to eslicarbazepine because of oxcarbazepine-related side effects reported resolution of symptoms after the switch. Conclusion: Overnight switching from oxcarbazepine to eslicarbazepine is well tolerated in pediatric patients with focal epilepsy. Switching to eslicarbazepine is particularly beneficial for patients experiencing oxcarbazepine-related adverse effects.

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