The Initial Experience of Eslicarbazepine in Children at Three Canadian Tertiary Pediatric Care Centers

• Published in: Journal of child neurology 2025-01, Vol.40 (1), p.39-48
• Main Authors: Nyakeri, Yvonne, Xu, Qi, Nouri, Maryam, Haile, Denait, Datta, Anita N.
• Format: Article
• Language: English
• Subjects: Adolescent; Anticonvulsants - adverse effects; Anticonvulsants - therapeutic use; Canada; Child; Child, Preschool; Dibenzazepines - adverse effects; Dibenzazepines - therapeutic use; Drug Resistant Epilepsy - drug therapy; Female; Humans; Male; Original; Retrospective Studies; Tertiary Care Centers; Treatment Outcome; Young Adult
• ISSN: 0883-0738; 1708-8283; 1708-8283
• DOI: 10.1177/08830738241282903

Introduction Eslicarbazepine (ESL) is a once-daily, third-generation antiseizure medication for focal-onset seizures. The primary mechanism of action is enhancing the slow inactivation of voltage-gated sodium channels. The study objective was to review real-world experience regarding retention rate, efficacy, and tolerability of eslicarbazepine, soon after it became available for children in Canada. Methods A retrospective review was performed on all patients prescribed eslicarbazepine from September 2017 to June 2020, with at least 3 years of follow-up data, at 3 Canadian tertiary care pediatric centers. Results Fifty patients were identified, and the mean age of eslicarbazepine initiation was 12.4 years (range 3-19 years). Most patients had drug-resistant epilepsy, trying a mean of 5.04 (range 0-14) antiseizure medications before the initiation of eslicarbazepine. Twenty-four patients (48.0%) experienced adverse effects, including dizziness (n = 10), drowsiness (n = 6), dizziness and drowsiness (n = 1), nausea and abdominal pain (n = 4), transient unsteadiness and diplopia (n = 1), and negative mood changes (n = 2). None had serious adverse effects, including rash. The retention rate of eslicarbazepine at last follow-up was 70%. Fifteen (30%) had ≥50% seizure reduction, with 2 of these patients becoming seizure free. Ten (20%) had 25% to 50% reduction, 2 (4%) had worsening of seizures, and 17 (34%) had no change in seizure frequency. Conclusion The study results support the long-term effectiveness and tolerability of eslicarbazepine in a cohort of children with predominantly drug-resistant epilepsy in a real-life setting from 3 Canadian centers with initial use after approval. Adverse effects were nonserious, infrequently leading to eslicarbazepine discontinuation.