拉科酰胺在癫痫持续状态中的应用——针对现有证据的系统评价
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摘要
拉科酰胺(Lacosamide,LCM)的静脉制剂具有良好的耐受性和安全性,促使其在癫痫持续状态(Status Epilepticus,SE)中得到应用。本项系统评价的目的是确定和评估LCM在SE中的使用情况。在电子数据库中用联合检索方式对2008年—2016年10月的文献进行了系统检索,并使用标准化的评估表格从各项研究中将有关研究设计、方法框架、数据源、有效性和LCM引起的不良反应的信息进行提取并系统地报告。研究共评估了522次SE发作,其中包括486例成人和36例儿童及青少年发作,女性占51.7%。LCM的总体效力为57%。LCM对非惊厥性(57%,82/145)和全面痉挛性(61%,30/49,P=0.68)SE的效力相似,但对局灶运动性SE的总体有效率更高(92%,34/39,P<0.001)。而LCM在用药次序靠后时其疗效从100%下降到20%。治疗期间的主要不良反应是眩晕,视力异常,复视和共济失调。总体而言,LCM具有良好的耐受性,并且没有具临床意义的药物相互作用。现有数据表明LCM在SE中的使用是有前景的,有效率为57%。LCM的优势在于没有潜在的药物相互作用,并且在紧急情况需迅速增加剂量时可静脉使用。
        
引文
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