Cargando…
Effects of lacosamide and carbamazepine on lipids in a randomized trial
OBJECTIVE: The effects of anticonvulsants on lipids are the subject of considerable concern and investigation, but there are almost no data on this issue from randomized trials. We evaluated serum lipid profiles in adults with newly diagnosed epilepsy, following randomization to lacosamide (LCM) or...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756649/ https://www.ncbi.nlm.nih.gov/pubmed/33200428 http://dx.doi.org/10.1111/epi.16745 |
_version_ | 1783626589926326272 |
---|---|
author | Mintzer, Scott Dimova, Svetlana Zhang, Ying Steiniger‐Brach, Björn De Backer, Marc Chellun, Daya Roebling, Robert |
author_facet | Mintzer, Scott Dimova, Svetlana Zhang, Ying Steiniger‐Brach, Björn De Backer, Marc Chellun, Daya Roebling, Robert |
author_sort | Mintzer, Scott |
collection | PubMed |
description | OBJECTIVE: The effects of anticonvulsants on lipids are the subject of considerable concern and investigation, but there are almost no data on this issue from randomized trials. We evaluated serum lipid profiles in adults with newly diagnosed epilepsy, following randomization to lacosamide (LCM) or carbamazepine (CBZ) monotherapy. METHODS: We analyzed data from a Phase 3, international, randomized, double‐blind trial of LCM vs CBZ for the initial treatment of focal epilepsy. Serum lipid profiles in patients 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 were analyzed. RESULTS: At 12 months, 271 patients satisfied the inclusion criteria for the analysis. No change was observed in LCM‐treated patients for total cholesterol, cholesterol fractions, or triglycerides. CBZ‐treated patients showed 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; triglycerides remained unchanged. The proportion of patients with elevated total cholesterol levels (above the upper limit of the reference range) 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. SIGNIFICANCE: This study provides Class II evidence that CBZ elevates serum lipids, whereas LCM has no effect on lipids. It supports LCM as an appropriate choice for new‐onset focal epilepsy. |
format | Online Article Text |
id | pubmed-7756649 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77566492020-12-28 Effects of lacosamide and carbamazepine on lipids in a randomized trial Mintzer, Scott Dimova, Svetlana Zhang, Ying Steiniger‐Brach, Björn De Backer, Marc Chellun, Daya Roebling, Robert Epilepsia Full‐length Original Research OBJECTIVE: The effects of anticonvulsants on lipids are the subject of considerable concern and investigation, but there are almost no data on this issue from randomized trials. We evaluated serum lipid profiles in adults with newly diagnosed epilepsy, following randomization to lacosamide (LCM) or carbamazepine (CBZ) monotherapy. METHODS: We analyzed data from a Phase 3, international, randomized, double‐blind trial of LCM vs CBZ for the initial treatment of focal epilepsy. Serum lipid profiles in patients 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 were analyzed. RESULTS: At 12 months, 271 patients satisfied the inclusion criteria for the analysis. No change was observed in LCM‐treated patients for total cholesterol, cholesterol fractions, or triglycerides. CBZ‐treated patients showed 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; triglycerides remained unchanged. The proportion of patients with elevated total cholesterol levels (above the upper limit of the reference range) 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. SIGNIFICANCE: This study provides Class II evidence that CBZ elevates serum lipids, whereas LCM has no effect on lipids. It supports LCM as an appropriate choice for new‐onset focal epilepsy. John Wiley and Sons Inc. 2020-11-17 2020-12 /pmc/articles/PMC7756649/ /pubmed/33200428 http://dx.doi.org/10.1111/epi.16745 Text en © 2020 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Full‐length Original Research Mintzer, Scott Dimova, Svetlana Zhang, Ying Steiniger‐Brach, Björn De Backer, Marc Chellun, Daya Roebling, Robert Effects of lacosamide and carbamazepine on lipids in a randomized trial |
title | Effects of lacosamide and carbamazepine on lipids in a randomized trial |
title_full | Effects of lacosamide and carbamazepine on lipids in a randomized trial |
title_fullStr | Effects of lacosamide and carbamazepine on lipids in a randomized trial |
title_full_unstemmed | Effects of lacosamide and carbamazepine on lipids in a randomized trial |
title_short | Effects of lacosamide and carbamazepine on lipids in a randomized trial |
title_sort | effects of lacosamide and carbamazepine on lipids in a randomized trial |
topic | Full‐length Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756649/ https://www.ncbi.nlm.nih.gov/pubmed/33200428 http://dx.doi.org/10.1111/epi.16745 |
work_keys_str_mv | AT mintzerscott effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial AT dimovasvetlana effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial AT zhangying effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial AT steinigerbrachbjorn effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial AT debackermarc effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial AT chellundaya effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial AT roeblingrobert effectsoflacosamideandcarbamazepineonlipidsinarandomizedtrial |