Fig. 4
From: Saliva-based lacosamide monitoring paves the way toward personalized epilepsy pharmacotherapy
Subgroup analysis in the high seizure burden group assessing the impact of lacosamide dosage increments on seizure control. (A) Saliva concentrations of lacosamide (spot, Cmax, and trough) in the high seizure burden group exhibited significant trends in the Jonckheere-Terpstra test, with the highest levels in patients having more than one seizure event per day and the lowest in those with one event every two weeks (spot level: P = 0.033; Cmax: P = 0.041; Trough: P = 0.033). (B) A longitudinal analysis comparing the severe (n = 9) and less-severe (n = 19) seizure burden groups showed a significantly faster decline in seizure frequency in the severe group (β = − 0.234, 95% CI, − 0.376 to − 0.090, P = 0.002). (C) In the same comparison, the lacosamide dose increased more rapidly in the severe group (β = 2.043, 95% CI, 0.315 to 3.816, P = 0.023). (D) There was no significant time-dependent difference in the number of ASM prescribed between the two groups (β = − 0.009, 95% CI, − 0.020 to 0.002, P = 0.126). The solid lines of (B), (C), and (D) represent corresponding LOESS regression lines, with shaded areas indicating 95% CIs. (E) The heatmaps illustrate the time-dependent changes in lacosamide dose and ASM number, highlighting a more intense augmentation of lacosamide dose in the severe seizure burden group compared to the less-severe group, without significant differences in ASM number. ASM antiseizure medication; CI confidence interval; LOESS locally estimated scatterplot smoothing.
