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Comparative effectiveness of antiepileptic drugs in patients with mesial temporal lobe epilepsy with hippocampal sclerosis
- Source :
- EPILEPSIA, Epilepsia, 1-8. Malden, MA: Blackwell Science (2017).
- Publication Year :
- 2017
-
Abstract
- SummaryObjective Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a common epilepsy syndrome that is often poorly controlled by antiepileptic drug (AED) treatment. Comparative AED effectiveness studies in this condition are lacking. We report retention, efficacy, and tolerability in a cohort of patients with MTLE-HS. Methods Clinical data were collected from a European database of patients with epilepsy. We estimated retention, 12-month seizure freedom, and adverse drug reaction (ADR) rates for the 10 most commonly used AEDs in patients with MTLE-HS. Results Seven hundred sixty-seven patients with a total of 3,249 AED trials were included. The highest 12-month retention rates were observed with carbamazepine (85.9%), valproate (85%), and clobazam (79%). Twelve-month seizure freedom rates varied from 1.2% for gabapentin and vigabatrin to 11% for carbamazepine. Response rates were highest for AEDs that were prescribed as initial treatment and lowest for AEDs that were used in a third or higher instance. ADRs were reported in 47.6% of patients, with the highest rates observed with oxcarbazepine (35.7%), topiramate (30.9%), and pregabalin (27.4%), and the lowest rates with clobazam (6.5%), gabapentin (8.9%), and lamotrigine (16.6%). The most commonly reported ADRs were lethargy and drowsiness, dizziness, vertigo and ataxia, and blurred vision and diplopia. Significance Our results did not demonstrate any clear advantage of newer versus older AEDs. Our results provide useful insights into AED retention, efficacy, and ADR rates in patients with MTLE-HS.
- Subjects :
- Male
0301 basic medicine
Cyclohexanecarboxylic Acids
Databases, Factual
efficacy
drug response
Pregabalin
Hippocampus
Benzodiazepines
Epilepsy
0302 clinical medicine
seizure freedom
Amines
Oxcarbazepine
Multidisciplinary, general & others [D99] [Human health sciences]
gamma-Aminobutyric Acid
adverse drug reactions
Triazines
Middle Aged
Seizure freedom
3. Good health
Carbamazepine
Treatment Outcome
Retention
Neurology
Tolerability
Anesthesia
Vertigo
Anticonvulsants
Female
Gabapentin
medicine.drug
Adult
Lethargy
retention
medicine.medical_specialty
Multidisciplinaire, généralités & autres [D99] [Sciences de la santé humaine]
Efficacy
Adolescent
Drug response
Vision Disorders
Adverse drug reactions
Fructose
Lamotrigine
Dizziness
Vigabatrin
Young Adult
03 medical and health sciences
Topiramate
Internal medicine
Diplopia
medicine
Humans
Aged
Retrospective Studies
Hippocampal sclerosis
Sclerosis
business.industry
Valproic Acid
medicine.disease
030104 developmental biology
Epilepsy, Temporal Lobe
Epilepsy syndromes
Clobazam
Ataxia
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- EPILEPSIA, Epilepsia, 1-8. Malden, MA: Blackwell Science (2017).
- Accession number :
- edsair.doi.dedup.....ce5d69a4306b2c17599bdc1213b50d08