The Efficacy and Safety of Lamotrigine Versus Carbamazepine in Focal Epilepsy
Status:
Enrolling by invitation
Trial end date:
2023-10-01
Target enrollment:
Participant gender:
Summary
Epilepsy is a serious chronic brain disorder that has a tendency towards recurrent seizures.
This affects millions of people throughout the world and brings a heavy socioeconomic burden.
The treatment of focal epilepsy is more challenging. Selecting an appropriate antiepileptic
drug (AED) remains difficult because the chosen drug must be effective, safe and tolerable.
It is important to consider the safety and efficacy of an AED for monotherapy separately. The
goal of AED therapy is to achieve seizure control with little or no adverse efects, improve
the patient's quality of life and ensure patient satisfaction. Different AEDs can be used to
treat focal seizures in adults. First line medication for treating focal seizures is
carbamazepine (CBZ), but it has drawbacks such as adverse effects including Steven Johnson
syndrome, drug interactions and blood dyscrasia. There is also genetic linkage that
Steven-Johnson syndrome and toxic epidermal necrolysis with carbamazepine are more common in
individuals of Asian descent who carry the HLA-B 1502 allele. Another 1st line drug is
lamotrigine (LTG) , it has favourable side effect profile including less sedative effect,
less cognitive impairment, less drug interactions and blood dyscrasia. It has an elimination
half- life longer than 24 hour, so once daily dosing is possible and it is associated with
good drug compliance. Because of its favorable pharmacokinetics and side effect profile, LTG
may be preferred to CBZ for focal epileptic seizures. In a study showed that the seizure
freedom rate at the end of 6 months was 65% in LTG group compared to 73% in CBZ group. 41% in
CBZ group and 32% in LTG group had at least one adverse effects.
Few trials have compared the effectiveness and safety of LTG with CBZ as monotherapy for
focal seizures worldwide. By far, no study has yet been conducted addressing the issue of
efficacy and safety between lamotrigine and carbamazepine among focal epilepsy patients in
the context of Bangladeshi population. Since the usage of LTG is less common in Bangladesh,
comparative study of efficacy and safety of LTG versus CBZ will be expected to give more
confidence for the use of the drug. Considering this, the study aims to assess the safety and
efficacy of carbamazepine and lamotrigine among focal epilepsy patients. This study finding
have an implication in the treatment protocol which will be beneficial for the patients and
physicians as well.