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Outcomes following exposure to lacosamide monotherapy during pregnancy and breastfeeding — a prospective case series
, 1, 1, 1
Affiliations- Collegium Medicum, Jagiellonian University of Krakow, Krakow, Poland
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Abstract
Aim of the study. To evaluate the safety of lacosamide (LCM) monotherapy during pregnancy and breastfeeding.
Material and methods. Patients taking LCM monotherapy treated at the university epilepsy clinic were prospectively followed up during pregnancy, delivery, and breastfeeding. Data on seizure frequency, LCM dosage, pregnancy course, delivery and breastfeeding, birth outcome, congenital malformation, and development of newborns was collected.
Results. Four pregnancies in three patients with refractory focal epilepsy treated with LCM monotherapy were reported. One of these pregnancies ended in a miscarriage during the seventh week of gestation. The average daily LCM dose at the time of conception was 300 mg. Treatment with LCM was continued throughout pregnancy and breastfeeding. The dose of LCM was increased in two pregnancies: in one case following a seizure relapse, and in the other case as a preventive measure to avoid an increase in seizure frequency. Seizure frequency remained stable during pregnancy in two cases. All deliveries were carried out via caesarean section, with an average gestational age at birth of 37.6 weeks. The Apgar score was 10 in all newborns, and no congenital malformations were detected. At the age of 12 months, normal developmental milestones were reached. Infants were breastfed without any complications.
Conclusions and clinical implications. This case series adds to a growing body of evidence suggesting the relative safety of LCM monotherapy throughout pregnancy and breastfeeding.
Abstract
Aim of the study. To evaluate the safety of lacosamide (LCM) monotherapy during pregnancy and breastfeeding.
Material and methods. Patients taking LCM monotherapy treated at the university epilepsy clinic were prospectively followed up during pregnancy, delivery, and breastfeeding. Data on seizure frequency, LCM dosage, pregnancy course, delivery and breastfeeding, birth outcome, congenital malformation, and development of newborns was collected.
Results. Four pregnancies in three patients with refractory focal epilepsy treated with LCM monotherapy were reported. One of these pregnancies ended in a miscarriage during the seventh week of gestation. The average daily LCM dose at the time of conception was 300 mg. Treatment with LCM was continued throughout pregnancy and breastfeeding. The dose of LCM was increased in two pregnancies: in one case following a seizure relapse, and in the other case as a preventive measure to avoid an increase in seizure frequency. Seizure frequency remained stable during pregnancy in two cases. All deliveries were carried out via caesarean section, with an average gestational age at birth of 37.6 weeks. The Apgar score was 10 in all newborns, and no congenital malformations were detected. At the age of 12 months, normal developmental milestones were reached. Infants were breastfed without any complications.
Conclusions and clinical implications. This case series adds to a growing body of evidence suggesting the relative safety of LCM monotherapy throughout pregnancy and breastfeeding.
Keywords
lacosamide, pregnancy, breastfeeding, malformations
About this articleTitle
Outcomes following exposure to lacosamide monotherapy during pregnancy and breastfeeding — a prospective case series
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Short Communication
Pages
203-206
Published online
2024-02-02
Page views
325
Article views/downloads
303
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2024;58(2):203-206.
Keywords
lacosamide
pregnancy
breastfeeding
malformations
Authors
Magdalena Bosak
Radosław Dziedzic
Katarzyna Matwiej
Agnieszka Słowik
References (12)- Tomson T, Battino D, Bromley R, et al. Management of epilepsy in pregnancy: a report from the International League Against Epilepsy Task Force on Women and Pregnancy. Epileptic Disord. 2019; 21(6): 497–517.
- Bosak M, Song BH, Dewerenda-Sikora M, et al. Obstetric and neonatal outcomes in women with epilepsy in Poland — a two-centre study. Neurol Neurochir Pol. 2020; 54(1): 62–65.
- Wężyk K, Słowik A, Bosak M. Predictors of remission in patients with epilepsy. Neurol Neurochir Pol. 2020; 54(5): 434–439.
- https://eurapinternational.org/wp-content/uploads/2023/06/EurapReport_May2023.pdf (1.07.2023).
- Fukushima Y, Yamamoto Y, Yamazaki E, et al. Change in the pharmacokinetics of lacosamide before, during, and after pregnancy. Seizure. 2021; 88: 12–14.
- Landmark CJ, Rektorli L, Burns ML, et al. Pharmacokinetic data on brivaracetam, lacosamide and perampanel during pregnancy and lactation. Epileptic Disord. 2021; 23(2): 426–431.
- Ylikotila P, Ketola RA, Timonen S, et al. Early pregnancy cerebral venous thrombosis and status epilepticus treated with levetiracetam and lacosamide throughout pregnancy. Reprod Toxicol. 2015; 57: 204–206.
- Zutshi D, Millis SR, Basha MM, et al. Lacosamide serum concentrations during pregnancy. Epilepsy Behav. 2021; 123: 108253.
- Golembesky A, Cooney M, Craig J, et al. Outcomes following exposure to the antiepileptic drug lacosamide during pregnancy — results from a global safety database (P5.231). Neurology. 2017; 88(16_supplement).
- https://www.aedpregnancyregistry.org/latest-data/ (31.07.2023).
- Lattanzi S, Cagnetti C, Foschi N, et al. Lacosamide during pregnancy and breastfeeding. Neurol Neurochir Pol. 2017; 51(3): 266–269.
- Hoeltzenbein M, Slimi S, Fietz AK, et al. Increasing use of newer antiseizure medication during pregnancy: An observational study with special focus on lacosamide. Seizure. 2023; 107: 107–113.
