Evidence map›Paper›PMID 40450138›Full record

ArticleScientific reports2025

Saliva-based lacosamide monitoring paves the way toward personalized epilepsy pharmacotherapy.

Yoonhyuk Jang, Seon-Jae Ahn, Soyoung Lee, Yongmoo Kim, Han Sang Lee, Yoon-Kyung Lee, Yong Woo Shin, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park and 7 more

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In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Yoonhyuk Jang *Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Seon-Jae Ahn *Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Soyoung Lee *College of Pharmacy, Chungnam National University, Daejeon, South Korea.
Yongmoo KimLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Han Sang LeeLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Yoon-Kyung LeeDepartment of Neurology, College of Medicine, Dong-A University, Busan, South Korea.
Yong Woo ShinDepartment of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
Soon-Tae LeeLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Keun-Hwa JungLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Kyung-Il ParkLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Ki-Young JungLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Joo-Youn ChoDepartment of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
SeungHwan LeeDepartment of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Kyung-Sang YuDepartment of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Kon ChuLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. stemcell.snu@gmail.com.
In-Jin JangDepartment of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. ijjang@snu.ac.kr.
Sang Kun LeeLaboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. sangkun2923@gmail.com.

Funding

SK Chemicals Pharmaceuticals 0620213640
6 · The paper itself

Abstract

Saliva, known for better patient compliance and simpler collection, is ideal for monitoring antiseizure medication (ASM) levels. This study aimed to validate saliva for measuring lacosamide, develop a pharmacokinetic (PK) model, and determine the optimal saliva concentration for seizure control in epilepsy patients. In our prospective study at Seoul National University Hospital from August 2021 to November 2022, we enrolled lacosamide-prescribed epilepsy patients, collecting their saliva and blood samples. We developed a population PK model with nonlinear mixed-effects modeling, incorporating a saliva compartment and plasma-to-saliva distribution scaling factor. The model, factoring in CYP2C19 genotypes, demographics, and concurrent ASM use, estimated optimal saliva lacosamide concentration cutoffs for well-controlled seizures in high seizure burden patients. These values were validated through a two-year longitudinal analysis. In our study, 123 epilepsy patients prescribed lacosamide were finally analyzed. We identified 74 matched pairs of blood and saliva samples, finding a linear relationship between their lacosamide concentrations (R = 0.62, P < 0.001). Using our PK model, we estimated individual peak (C

Indexed as

AnticonvulsantsDrug MonitoringEpilepsyLacosamidePrecision MedicineSalivaAdultAgedCytochrome P-450 CYP2C19FemaleHumansMaleMiddle AgedProspective StudiesYoung AdultAnticonvulsantsCYP2C19 protein, humanCytochrome P-450 CYP2C19LacosamideLacosamideLacosamide pharmacokineticsPersonalized medicineSaliva-based TDM

Identifiers

PMID40450138
PMCPMC12126552

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.