Comparative effectiveness of antiepileptic drugs in patients with mesial temporal lobe epilepsy with hippocampal sclerosis.

Autor: Androsova G; Luxembourg Center for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg., Krause R; Luxembourg Center for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg., Borghei M; Laboratory of Experimental Neurology, Université Libre de Bruxelles, Brussels, Belgium., Wassenaar M; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands., Auce P; Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Avbersek A; Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom., Becker F; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany., Berghuis B; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands., Campbell E; Belfast Health and Social Care Trust, Belfast, United Kingdom., Coppola A; Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy., Francis B; Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom., Wolking S; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany., Cavalleri GL; Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland., Craig J; Belfast Health and Social Care Trust, Belfast, United Kingdom., Delanty N; Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.; Department of Neurology, Beaumont Hospital, Dublin, Ireland., Koeleman BPC; Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands., Kunz WS; Department of Epileptology, University of Bonn, Bonn, Germany., Lerche H; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany., Marson AG; Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Sander JW; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, United Kingdom.; The Chalfont Centre for Epilepsy, Chalfont St. Peters, United Kingdom., Sills GJ; Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom., Striano P; Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy., Zara F; Laboratory of Neurogenetics and Neuroscience, Institute G. Gaslini, Genoa, Italy., Sisodiya SM; Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom.; The Chalfont Centre for Epilepsy, Chalfont St. Peters, United Kingdom., Depondt C; Laboratory of Experimental Neurology, Université Libre de Bruxelles, Brussels, Belgium.; Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2017 Oct; Vol. 58 (10), pp. 1734-1741. Date of Electronic Publication: 2017 Aug 31.
DOI: 10.1111/epi.13871
Abstrakt: Objective: 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.
(Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.)
Databáze: MEDLINE
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