Publication: EPICON consensus: recommendations for proper management of switching to eslicarbazepine acetate in epilepsy.
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Date
2016-06-24
Authors
Villanueva, V
Ojeda, J
Rocamora, R A
Serrano-Castro, P J
Parra, J
Rodríguez-Uranga, J J
Bathal, H
Viteri, C
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Abstract
The objective of the EPICON Project is to develop a set of recommendations on how to adequately switch from carbamazepine (CBZ) and oxcarbazepine (OXC) to eslicarbazepine acetate (ESL) in some patients with epilepsy. A steering committee drafted a questionnaire of 56 questions regarding the transition from CBZ or OXC to ESL in clinical practice (methodology and change situation). The questionnaire was then distributed to 54 epilepsy experts in 2 rounds using the Delphi method. An agreement/disagreement consensus was defined when a median ≥ 7 points or ≤ 3 was achieved, respectively, and a relative interquartile range ≤ 0.40. We analysed the results obtained to reach our conclusions. Our main recommendations were the following: switching from CBZ to ESL must be carried out over a period of 1 to 3 weeks with a CBZ:ESL dose ratio of 1:1.3 and is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, subjects with cognitive problems, severe osteoporosis-osteopaenia, dyslipidaemia, or liver disease other than acute liver failure, as well as for men with erectile dysfunction caused by CBZ. The transition from OXC to ESL can take place overnight with an OXC:ESL dose ratio of 1:1 and it is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, or those with cognitive problems. The transition was not recommended for patients with prior rash due to CBZ or OXC use. The EPICON Project offers a set of recommendations about the clinical management of switching from CBZ or OXC to ESL, using the Delphi method.
Description
MeSH Terms
Anticonvulsants
Carbamazepine
Consensus
Delphi Technique
Dibenzazepines
Drug Substitution
Epilepsy
Guidelines as Topic
Humans
Neurologists
Oxcarbazepine
Surveys and Questionnaires
Voltage-Gated Sodium Channel Blockers
Carbamazepine
Consensus
Delphi Technique
Dibenzazepines
Drug Substitution
Epilepsy
Guidelines as Topic
Humans
Neurologists
Oxcarbazepine
Surveys and Questionnaires
Voltage-Gated Sodium Channel Blockers
DeCS Terms
CIE Terms
Keywords
Acetato de eslicarbazepina, Cambio, Carbamazepina, Carbamazepine, Drug switching, Eslicarbazepine acetate, Methodology, Metodología, Oxcarbazepina, Oxcarbazepine, Situaciones, Situations