Real-World Efficacy and Tolerability of Switching from Oxcarbazepine to Eslicarbazepine Therapy in Children Aged 6 years or Older with Focal Epilepsy

Purpose: This study investigated the influence of prior use of oxcarbazepine (OXC) and other anti-seizure medications (ASMs) on seizure outcomes and tolerability when switching from OXC to eslicarbazepine acetate (ESL) or when adding adjunctive ESL therapy.Additionally, we aimed to evaluate other prognostic factors associated with ESL therapy in pediatric focal epilepsy.Methods: ESL adjunctive or switching therapy was initiated in children aged 6 years with focal epilepsy.Patients were classified into those who received baseline ASMs including OXC (OXC-P group, switching from OXC) and those who received other ASMs excluding OXC (OXC-N group, adjunctive therapy).Reduction in seizure frequency and adverse events (AEs) were evaluated during follow-up.Results: Seventy-two patients (mean age, 10.95.2 years) were included.The mean duration of ESL therapy was 6.13.7 months, and the mean maintenance dose was 16.35.6mg/kg/day.The proportion of responders (50% reduction in seizure frequency) was 40.3% (29/72), without a significant difference between the OXC-P and OXC-N groups (17/50 [34.0%] vs. 12/22 [54.5%],P=0.169).Moreover, no significant between-group differences were noted in overall AEs (30.0% vs. 27.3%,P=0.981) or the retention rate (82.0% vs. 77.3%,P=0.886).Significant factors associated with a favorable response to ESL treatment were a higher ESL dose, shorter epilepsy duration, and fewer concomitant ASMs.Conclusion: Switching from OXC to ESL or using adjunctive ESL therapy was effective and well-tolerated in children aged 6 years with focal epilepsy, irrespective of prior use of OXC in the baseline ASM regimen before initiating ESL therapy.