Licarbazepine

Epilepsy is a prevalent neurological disorder in children and adolescents aged 0-16 years. Oxcarbazepine is commonly prescribed for its favorable pharmacological profile, yet its metabolism, efficacy, and safety vary widely among individuals. The active metabolite, 10-monohydroxy derivative (MHD), is key to its therapeutic effects, but factors influencing its blood concentration remain unclear. Identifying these determinants is crucial for optimizing personalized treatment. This study analyzed 417 epilepsy patients aged 0-16 years who received oxcarbazepine treatment between January 2023 and October 2024. Steady-state blood concentrations of MHD were measured using immunoassay, and clinical data were collected. Multiple regression models and correlation analyses were applied to determine key factors affecting MHD levels. Daily dose and daily dose per kilogram of body weight showed significant positive correlations with MHD blood concentration (r = 0.606, P < 0.001; r = 0.591, P < 0.001, respectively). Age-related differences were observed, with adolescents exhibiting higher MHD levels than younger children, likely due to differences in metabolic maturation. Gender differences indicated that female patients required higher doses to achieve comparable MHD concentrations as male patients. Renal and hepatic functions (e.g., creatinine and total bilirubin levels) significantly influenced MHD blood concentrations, highlighting the need for careful dose adjustments in patients with physiological impairments. This study provides a comprehensive analysis of MHD blood concentration determinants in pediatric epilepsy patients, emphasizing the importance of personalized treatment approaches. These findings offer a valuable reference for optimizing oxcarbazepine therapy, improving therapeutic outcomes, and minimizing adverse effects in children and adolescents with epilepsy.