{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:54:18Z","timestamp":1783947258139,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,2]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Status epilepticus (SE) is a neurological emergency requiring immediate treatment. Although intravenous lacosamide (LCM) is used for the management of epilepsy, its effectiveness in treating SE remains unclear. We aimed to compare the in\u2010hospital outcomes between intravenous LCM and levetiracetam (LEV) as an early adjunctive therapy for SE using a nationwide inpatient Japanese database.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted an observational study using data extracted from the Japanese Diagnosis Procedure Combination database. Patients admitted for SE who received intravenous diazepam or lorazepam on the day of admission and were discharged between April 2019 and March 2023 were enrolled. Patients were categorized into those who received intravenous LCM or LEV on the day of admission. We compared the in\u2010hospital outcomes (in\u2010hospital mortality, length of hospital stay, total hospitalization costs, and proportion of patients with a Glasgow Coma Scale score [GCS] \u22649 at discharge) between the groups using propensity score overlap weighting.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 4605 eligible patients, 227 received\n LCM<\/jats:styled-content>\n and 4378 received\n LEV<\/jats:styled-content>\n . In the propensity score overlap\u2010weighted cohort, in\u2010hospital mortality (4.0% vs. 4.6%, adjusted risk difference [\n aRD<\/jats:styled-content>\n ], \u22120.28%; 95% confidence interval [\n CI<\/jats:styled-content>\n ], \u22123.3% to 2.7%), length of hospital stay (22.4 vs. 22.3\u2009days; difference, 0.011; 95%\n CI<\/jats:styled-content>\n , \u22123.9 to 3.9), and total hospitalization costs (1\u2009167\u2009798\n JPY<\/jats:styled-content>\n vs. 1\u2009177\u2009497\n JPY<\/jats:styled-content>\n ; difference, 9699\n JPY<\/jats:styled-content>\n ; 95%\n CI<\/jats:styled-content>\n , \u2212196\u2009269 to 176\u2009872\n JPY<\/jats:styled-content>\n ) did not differ significantly between the\n LCM<\/jats:styled-content>\n and\n LEV<\/jats:styled-content>\n groups. The proportion of patients with\n GCS<\/jats:styled-content>\n scores \u22649 at discharge was lower in the\n LCM<\/jats:styled-content>\n group than in the\n LEV<\/jats:styled-content>\n group (0.6% and 2.4%;\n aRD<\/jats:styled-content>\n , \u22122.1%; 95%\n CI<\/jats:styled-content>\n , \u22123.3% to \u22120.9%).\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n LCM and LEV did not yield significantly different in\u2010hospital mortality rates when used for early adjunctive treatment of SE. However, LCM may reduce poor neurological status at discharge. These results highlight the potential utility of LCM in the early management of SE.<\/jats:p>\n <\/jats:sec>\n \n Plain Language Summary<\/jats:title>\n This study compared two intravenous antiseizure medications, levetiracetam (LEV) and lacosamide (LCM), as early add\u2010on therapy for status epilepticus (SE), using data from a large Japanese inpatient database. The in\u2010hospital mortality, length of hospital stay, or total medical costs did not differ significantly between the groups. However, patients treated with LCM had a lower chance of having a poor neurological status at discharge. While LEV is a well\u2010established treatment for SE, this study suggests that LCM may be similarly effective and could offer an advantage, although more research is needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi4.70182","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:19:18Z","timestamp":1762957158000},"page":"162-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In\u2010hospital outcomes of lacosamide versus levetiracetam for early adjunctive treatment of status epilepticus: A Nationwide Japanese retrospective cohort study"],"prefix":"10.1002","volume":"11","author":[{"given":"Yumiko","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Aso","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Shirota","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine The University of Tokyo Tokyo Japan"},{"name":"Department of Clinical Laboratory Medicine, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Institute of Science Tokyo Graduate School Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsushi","family":"Toda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine The University of Tokyo Tokyo Japan"},{"name":"National Center Hospital, National Center of Neurology and Psychiatry Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-1859","authenticated-orcid":false,"given":"Satoshi","family":"Kodama","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine The University of Tokyo Tokyo Japan"},{"name":"Department of Neurology University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2016.11.001"},{"key":"e_1_2_9_3_1","volume-title":"Clinical practice guidelines for epilepsy 2018 (in Japanese)","author":"The Japanese Society of 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