Severity of Epilepsy and Response to Antiseizure Medications in Individuals With Multiple Sclerosis: Analysis of a Real-World Dataset.

Autor:	Villamar MF; The Warren Alpert Medical School of Brown University, Providence, RI (MFV); Department of Neurology, Brigham and Women's Hospital, Boston, MA (MFV, RAS, PP, BKB-J); Department of Neurology, University of Pittsburgh Medical Center, PA (PP); and Department of Biomedical Informatics (IK, BKB-J), Harvard Medical School, Boston, MA., Sarkis RA; The Warren Alpert Medical School of Brown University, Providence, RI (MFV); Department of Neurology, Brigham and Women's Hospital, Boston, MA (MFV, RAS, PP, BKB-J); Department of Neurology, University of Pittsburgh Medical Center, PA (PP); and Department of Biomedical Informatics (IK, BKB-J), Harvard Medical School, Boston, MA., Pennell P; The Warren Alpert Medical School of Brown University, Providence, RI (MFV); Department of Neurology, Brigham and Women's Hospital, Boston, MA (MFV, RAS, PP, BKB-J); Department of Neurology, University of Pittsburgh Medical Center, PA (PP); and Department of Biomedical Informatics (IK, BKB-J), Harvard Medical School, Boston, MA., Kohane I; The Warren Alpert Medical School of Brown University, Providence, RI (MFV); Department of Neurology, Brigham and Women's Hospital, Boston, MA (MFV, RAS, PP, BKB-J); Department of Neurology, University of Pittsburgh Medical Center, PA (PP); and Department of Biomedical Informatics (IK, BKB-J), Harvard Medical School, Boston, MA., Beaulieu-Jones BK; The Warren Alpert Medical School of Brown University, Providence, RI (MFV); Department of Neurology, Brigham and Women's Hospital, Boston, MA (MFV, RAS, PP, BKB-J); Department of Neurology, University of Pittsburgh Medical Center, PA (PP); and Department of Biomedical Informatics (IK, BKB-J), Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	Neurology. Clinical practice [Neurol Clin Pract] 2022 Aug; Vol. 12 (4), pp. e49-e57.
DOI:	10.1212/CPJ.0000000000001178
Abstrakt:	Background and Objectives: Epilepsy is an important comorbidity that affects outcomes for people with multiple sclerosis (MS). However, it is unclear whether seizure severity among individuals with coexistence of MS and epilepsy (MS + E) is higher than in those with other focal epilepsies. Our goal was to compare the overall severity of epilepsy in individuals with MS + E vs those with focal epilepsy without MS (E - MS), as defined by seizure-related health care utilization, frequency and duration of status epilepticus, and frequency of antiseizure medication (ASM) regimen changes. Methods: In this hypothesis-generating study, we analyzed a US commercial nationwide deidentified claims data set with >86 million individuals between January 1, 2008, and August 31, 2019. Using validated algorithms, we identified adults with E - MS and those with MS + E. We compared the number and length of seizure-related hospital admissions, the number of claims and unique days with claims for status epilepticus, and the rates of ASM regimen changes between the MS + E and E - MS groups. Results: During the study period, 66,708 individuals with E - MS and 537 with MS + E had ≥2 years of coverage after their initial diagnosis of epilepsy. There was no difference between the MS + E and E - MS groups in the percentage of individuals admitted for seizures and/or status epilepticus. However, MS + E with seizure-related admissions had more admissions and longer hospital stays than those with E - MS. MS + E who experienced status epilepticus had more unique days with status epilepticus claims compared with E - MS. MS + E were more likely to have ASM regimen changes in 2 years after the initial diagnosis of epilepsy and had more ASM changes during 2 years compared with E - MS. Among individuals with MS + E, there were no differences in our measures of seizure severity for those treated with sodium channel blockers/modulators vs other ASM classes. Discussion: This study supports the notion that individuals with MS + E can have more severe epilepsy than those with E - MS. Seizure severity among individuals with MS + E treated with sodium channel blockers/modulators vs other ASM classes shows no significant differences. Classification of Evidence: This study provides Class III evidence that individuals with MS + E can have more severe epilepsy than those with E - MS. (© 2022 American Academy of Neurology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu