According to results of an exploratory pooled analysis of the Euro-Esli study presented at the AES Annual Meeting 2017, eslicarbazepine acetate (ESL) is a useful antiepileptic agent for patients transitioning from carbamazepine or oxcarbazepine, as ESL was found to be both efficacious as well as generally well tolerated.

To investigate the efficacy and safety of ESL in clinical practice, the study authors analyzed data obtained from the Euro-Esli study, which itself pooled results from 14 European clinical practice studies. Efficacy analysis included responder rate (seizure frequency reduction of ≥50%) as well as seizure freedom rate (no seizure activity at least since prior visit), which was analyzed 3, 6, and 12 months after ESL treatment as well as at the last visit. Safety analysis evaluated both adverse events (AEs) throughout follow-up as well as treatment discontinuation caused by AEs.

The study authors explained, “Euro-Esli included 2058 patients (52.1% male; mean age, 44 years; mean duration of epilepsy, 20.9 years), of whom 233 (11.3%) transitioned from carbamazepine to ESL and 134 (6.5%) transitioned from oxcarbazepine to ESL.”

The study had a 70.0% responder rate and a 30.9% seizure freedom rate after 12 months of ESL treatment for patients transitioning from carbamazepine due to lack of efficacy (n=163).  A 57.1% responder rate and a 25.0% seizure freedom rate were reported for patients transitioning from oxcarbazepine to ESL because of a lack of efficacy (n=90).

Of the patients who transitioned from carbamazepine, 11.6% discontinued ESL due to lack of efficacy, while the discontinuation number for those who transitioned from oxcarbazepine was 10.5% .

Of the patients who transitioned from carbamazepine due to poor tolerability (n=64), 26.6% experienced AEs and 8.3% discontinued ESL because of AEs. For patients who transitioned from oxcarbazepine due to poor tolerability (n=61), 39.5% experienced AEs and 6.8% discontinued ESL because of AEs.

ESL was efficacious and well tolerated in patients transitioning from carbamazepine or oxcarbazepine in clinical practice. The authors concluded, ”That it may be a useful treatment option for patients who either do not achieve adequate control or experience intolerable AEs with these agents.”

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Peltola J, McMurray R, Villanueva V. Efficacy, Safety and Tolerability of Eslicarbazepine Acetate in Patients Transitioning from Carbamazepine or Oxcarbazepine in Everyday Clinical Practice. Presented at AES annual meeting in Washington, DC. Abstract 1.319.