Bottcher S, et al. – This long–term study was performed to examine the retention rate of lacosamide (LCM) in patients with epilepsy and intellectual disabilities (IDs), to identify factors influencing retention rate, and to investigate the LCM retention rate with and without concomitant sodium channel blocker (SCB), also test the hypothesis that the retention rate of LCM with concomitant SCB would be lower than without SCB. The physicians concluded that the high rate of drug resistance was one of the major challenges in medically caring for patients with epilepsy and IDs. However, regarding the efficacy and tolerability of antiepileptic drugs (AEDs), there was a lack of evidence–based information in this population. In children with epilepsy, it had been shown that concomitant SCB use was a key factor in increasing the risk of LCM failure. This finding had not been replicated in their predominantly adult sample of patients with IDs.

• The physicians conducted a monocentric, retrospective, observational, open-label study to evaluate LCM retention rates in patients with IDs and drug-resistant epilepsy using the Kaplan-Meier estimator.
• They also evaluated the effect of therapy-related variables on the long-term retention of LCM.

• The physicians included 136 subjects with IDs and drug-resistant epilepsy (age 2–66 years); most patients had focal epilepsy.
• At 1 year, long-term retention rates were 62.0%, 43.7% at 2 years, and 29.1% at 3 and 4 years.
• Insufficient therapeutic benefits (69%), adverse events (11%), or a combination of both factors (8%) were included as reasons for LCM discontinuation.
• The LCM retention rate was influenced by the number of background antiepileptic drugs (AEDs).
• As per the outcomes, an additional and independent impact of concomitant therapy with SCB on retention rate could not be affirmed.