拉考沙胺治疗儿童癫痫发作的精准用药专家共识(2026)OA

Epilepsy is one of the most prevalent chronic neurological disorders in the pediatric population.As a third-generation antiseizure medication with a unique pharmacological mechanism and good safety,lacosamide(LCM)has provided a new option for pediatric epilepsy management.However,the pharmacokinetics(PK)profile of LCM in children exhibits substantial inter-individual variability because of the fact that children are at the stage of rapid growth and development,highlighting an urgent need for standardized clinical guidance.Initiated by the Division of Therapeutic Drug Monitoring,Chinese Pharmacological Society,and led by the Children's Hospital of Nanjing Medical University,this consensus has strictly followed the 2022 Edition of the Guideline for the Development and Revision of Clinical Practice Guidelines in China,and registered in the PREPARE registry(PREPARE-2026CN141).The consensus development group systematically retrieved relevant clinical evidence published from 2005 to 2026 across major Chinese and English academic databases.Based on the evidence grading and recomendation strength criteria made by Oxford Centre for Evidence-Based Medicine(2009),and after Delphi expert consultations and anonymous voting,a total of 21 recommendations were finally formulated,covering the clinical application,PK characteristics,pharmacogenomics,therapeutic drug monitoring(TDM),and model-informed precision dosing(MIPD)of LCM in children with epilepsy.This consensus establishes a preliminary TDM target concentration range of 2-10 μ g/mL for LCM in Chinese pediatric patients,and proposes a standardized MIPD workflow.The aim is to provide clinicians and pharmacists with scientific and standardized guidance for individualized medication and improve the safety and efficacy of LCM treatment for pediatric epilepsy.