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Influence of new versus traditional antiepileptic drugs on course and outcome of status epilepticus.
- Source :
-
Seizure [Seizure] 2020 Jan; Vol. 74, pp. 20-25. Date of Electronic Publication: 2019 Nov 06. - Publication Year :
- 2020
-
Abstract
- Purpose: New antiepileptic drugs (AEDs) are increasingly applied in second-line therapy of status epilepticus (SE). In our study, we analyzed the impact of the choice of second-line AEDs on the course and prognosis of SE.<br />Methods: This retrospective single- center study used data of an 8 year cohort of SE in adults from 2007 to 2014. Based on the year of market introduction with a cutoff at 1990, we classified AEDs as traditional or new. Prescription pattern associated differences in prognosis were measured through univariate and multivariable analysis of 3 endpoints: occurrence of refractory SE (RSE), functional outcome in survivors to discharge (good: mRS at discharge <3 or identical to admission mRS; otherwise poor), and in-hospital mortality.<br />Results: From 362 SE episodes during the study period, 222 episodes were included into the study, among those 150 episodes treated with new and 72 with traditional AEDs. Use of new AEDs increased during the study period. After adjustment for confounders, treatment with new AEDs was on the one hand associated with higher rate of RSE occurrence (OR 1.95, 95 % CI 1.05-3.62, p = 0.03), but, on the other hand, also with better functional outcome at discharge (OR 2.64, 95 % CI 1.16-6.00, p = 0.02), while it was not an independent predictor of in- hospital mortality (OR 0.88, 95 % CI 0.33-2.33, p = 0.80).<br />Conclusion: Our observation that new AEDs may be associated with a higher rate of RSE development and relatively better functional outcome when adjusted for the premorbid mRS needs confirmation in prospective studies.<br /> (Copyright © 2019 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Cohort Studies
Female
Humans
Levetiracetam therapeutic use
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Valproic Acid therapeutic use
Anticonvulsants therapeutic use
Drug Prescriptions
Drug Resistant Epilepsy diagnosis
Drug Resistant Epilepsy drug therapy
Status Epilepticus diagnosis
Status Epilepticus drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2688
- Volume :
- 74
- Database :
- MEDLINE
- Journal :
- Seizure
- Publication Type :
- Academic Journal
- Accession number :
- 31790940
- Full Text :
- https://doi.org/10.1016/j.seizure.2019.11.003