Fig. 3
From: Saliva-based lacosamide monitoring paves the way toward personalized epilepsy pharmacotherapy
Determination and validation of optimal cutoff values for saliva lacosamide concentration in the high seizure burden group. (A) In this group (n = 28), the optimal cutoff for peak saliva lacosamide concentration (Cmax) for achieving well-controlled seizure status was 15.94 mg/L, with a sensitivity of 72% and specificity of 88.2%. (B) The longitudinal analysis revealed a temporal correlation between achieving well-controlled seizure status and instances where Cmax exceeded 15.9 mg/L. The solid lines represent corresponding LOESS regression lines, with shaded areas indicating 95% CIs. The various colored spaghetti plots represent the longitudinal data for individual patients, tracking the changes in their lacosamide levels over time. (C) Comparison of estimated peak saliva concentrations before and after achieving seizure control showed significant differences (pre-4 months: 13.72 mg/L, at achievement: 16.51 mg/L, post-4 months: 15.87 mg/L, multiple comparison correction by Tukey’s method). (D) The optimal trough level cutoff was 9.056 mg/L, with the same sensitivity and specificity. (E) Well-controlled seizure status achievement times corresponded with trough levels above 9.06 mg/L. The solid lines represent corresponding LOESS regression lines, with shaded areas indicating 95% CIs. The various colored spaghetti plots represent the longitudinal data for individual patients, tracking the changes in their lacosamide levels over time. (F) Notable differences were observed in trough concentrations before and after seizure control (pre-4 months: 8.65 mg/L, at achievement: 10.32 mg/L, post-4 months: 9.92 mg/L, multiple comparison correction by Tukey’s method). CI confidence interval; LOESS locally estimated scatterplot smoothing.
