Eslicarbazepine 200mg tablets

Persistent sodium current (INaP) is an important activity-dependent regulator of neuronal excitability. It is involved in a variety of physiological and pathological processes, including pacemaking, prolongation of sensory potentials, neuronal injury, chronic pain and diseases such as epilepsy and amyotrophic lateral sclerosis. Despite its importance, neither the molecular basis nor the regulation of INaP are sufficiently understood. Of particular significance is a solid knowledge and widely accepted consensus about pharmacological tools for analysing the function of INaP and for developing new therapeutic strategies. However, the literature on INaP is heterogeneous, with varying definitions and methodologies used across studies. To address these issues, we provide a systematic review of the current state of knowledge on INaP, with focus on mechanisms and effects of this current in the central nervous system. We provide an overview of the specificity and efficacy of the most widely used INaP blockers: amiodarone, cannabidiol, carbamazepine, cenobamate, eslicarbazepine, ethosuximide, gabapentin, GS967, lacosamide, lamotrigine, lidocaine, NBI-921352, oxcarbazepine, phenytoine, PRAX-562, propofol, ranolazine, riluzole, rufinamide, topiramate, valproaic acid and zonisamide. We conclude that there is strong variance in the pharmacological effects of these drugs, and in the available information. At present, GS967 and riluzole can be regarded bona fide INaP blockers, while phenytoin and lacosamide are blockers that only act on the slowly inactivating component of sodium currents.

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PurposeTo investigate the placebo effect in the treatment of children and adolescents with epilepsy.MethodsWe conducted a systematic review of studies comparing anti-seizure medication (ASM) to placebo in children and adolescents with epilepsy. Eligible studies were identified through the database PubMed following PRISMA guidelines resulting in the identification of 1173 articles. Screening and inclusion were assessed by two independent reviewers and 17 studies met inclusion criteria.ResultsSeventeen studies involving children and adolescents with epilepsy were included in this review. Compared to levetiracetam (LEV) and perampanel (PER), the placebo did not show a significant reduction in seizures. However, compared to pregabalin (PGB) the placebo was significant in reducing seizures at lower doses. Results for eslicarbazepine (ESL) were contradictory. Placebo-treated patients generally had lower Child Behavior checklist (CBCL) problem scores than those on LEV, which was associated with higher Total Problem Scores and worse Aggressive Behavior scores. Adverse event (AE) rates in the placebo groups varied widely, from 14 % to 91.8 %.ConclusionThis systematic review examined the effect of placebo treatment compared to ASMs in childhood epilepsy across 17 studies. The effectiveness of placebos was not significant compared to LEV and PER. However, there was a significant placebo effect compared to PGB, which was higher compared to low PGB doses than compared to high PGB doses. AE rates varied widely. Assessing long-term cognitive and behavioral outcomes was challenging due to short study durations and potential biases. Future research could play a critical role in preventing AEs in children undergoing ASM treatment by providing a deeper understanding of the placebo effect associated with these medications.

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This study conducts a cost-effectiveness analysis of brivaracetam (BRV) compared to other 3rd-generation antiseizure medications (AEDs) for the treatment of pharmacoresistant focal-onset seizures in Jordan. A Markov model was constructed over a 2-years' time horizon for a hypothetical cohort of focal-onset seizures patients. A cycle of 3-months was adopted in our economic evaluation (total cycles of 8 cycles). Four health states were defined: seizure free, partial responders (≥50% reduction in seizure frequency), non-responders, and discontinuation. In addition to BRV, 3 treatment comparators were included in this economic evaluation: eslicarbazepine (ESL), lacosamide (LCM), and perampanel (PER). Clinical data were retired from a previously published network meta-analysis of 65 randomized controlled trials. Cost inputs were obtained from the Jordan Food and Drug Administration and local healthcare providers. Incremental Cost-Effectiveness Ratio (ICER) was calculated using the percentage of complete response (CR) in the denominator. Probabilistic sensitivity analysis was conducted to assess the robustness of the study findings. BRV was associated with the highest gains in CR over all AEDs included in this economic evaluation. The 2-year cost of ESL is JOD 4139; LCM is JOD 3078; PER is JOD 5541; BRV is JOD 3925. The incremental gain in CR with BRV was higher by 29.0%, 30.9%, and 26.4% compared to ESL, LCM, and PER, respectively. Despite these higher gains in CR with BRV versus all other AEDs in this economic evaluation, it was associated with lower cost when compared to ESL and PER at saving ICER of -JOD 737 per 1% CR achieved and -JOD 6113 per 1% CR achieved, respectively. However, BRV was associated with the ICER of JOD 2744 per 1% of CR achieved compared with LCM. These estimates were confirmed by the probabilistic sensitivity analysis. Compared to ESL and PER, BRV was associated with cost-savings. Compared to LCM, the BRV was cost-effective at the World Health Organization recommended willingness-to-pay threshold of 3× of Jordanian gross domestic product per capita.

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Background The efficacy and tolerability of eslicarbazepine acetate (ESL) in adults and children with focal-onset epilepsy (FOE) according to the dose remain to be validated. A meta-analysis based on randomized controlled trials (RCTs) was therefore conducted as a summary. Methods Relevant RCTs were collected by systematic searching the electronic databases of PubMed, Cochrane's Library, Embase, Wanfang and CNKI from inception to May 16, 2022. The random-effect model was adopted to pool the results by incorporating the possible heterogeneity. Efficacy outcomes including responsive rate and effective rate, defined as cases with 50 and ≥75% reduction in seizure frequency compared to baseline, were determined, respectively. Incidence of severe adverse events (AE) leading to drug discontinuation was also evaluated. Results Ten studies including 2,565 people with epilepsy contributed to the meta-analysis. For adults, ESL 400 mg/d did not improve the response rate or the effective rate; ESL 800 mg/d was associated with improved response rate (odds ratio [OR] 2.16, 95% confidence interval [CI]: 1.65–2.83, p < 0.001) and effective rate (OR 2.16, 95% CI: 1.41–3.30, p < 0.001) without significantly increased severe AE (OR 1.58, 95% CI: 0.90–2.78, p = 0.11); ESL 1,200 mg/d improved response rate (OR 2.49, p < 0.001) and effective rate (OR 3.09, p = 0.04), but significantly increased severe AE (OR 3.72, p < 0.001). For children, ESL also did not significantly improve the response rate (OR 1.76, p = 0.22) or the effective rate (OR 2.17, p = 0.13). Conclusion ESL 800 mg/d is effective and well-tolerated as adjuvants for adults with FOE. Efficacy of ESL in children with FOE should be further evaluated.

Abstract licence: CC BY 4.0