Response to treatment schedules after the first antiepileptic drug failed

Autor: Xiao-Ting Hao, Rui Li, Xin Tong, Jiani Chen, Xiao-Sa Chi, Weixi Xiong, Yazhou He, Hao Xu, Xin-Yue Jiang, Hui Gao, Dong Zhou, Wenyu Liu, Le Zhang
Rok vydání: 2018
Předmět:
Zdroj: Epilepsia. 59:2118-2124
ISSN: 1528-1167
0013-9580
Popis: OBJECTIVE After the failure of the first antiepileptic drug (AED) at doses > 50% defined daily dose (DDD), there are three options for patients with epilepsy: combination therapy, alternative therapy, and increased dosage of the first AED. However, present studies have not provided evidence for which option is best. Therefore, we conducted this retrospective observational cohort study to compare the effects of three treatment schedules. METHODS Patients diagnosed with newly diagnosed epilepsy at the epilepsy clinic of West China Hospital between August 2006 and February 2016 were evaluated for eligibility for this study. Patients who failed to respond to the first AED at doses > 50% DDD were included, and divided into three cohorts: increased dosage, combination therapy, and alternative therapy. Cumulative incidence curves for time to seizure freedom were compared for different cohorts by Gray test. Competing risk regression was conducted to evaluate the association of clinical predictors with seizure freedom. RESULTS Altogether, 502 patients (277 male, 55.2%) were included for further analysis, and the median duration of follow-up was 32 months (range = 8-127). The probability of seizure freedom was significantly higher in patients receiving combination therapy (n = 323) compared to the alternative therapy cohort (n = 76, P
Databáze: OpenAIRE
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