retention; efficacy; adverse drug reactions; drug response; seizure freedom
Abstract :
[en] 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.
Wereport 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.
Disciplines :
Human health sciences: Multidisciplinary, general & others
Author, co-author :
Androsova, Ganna ✱; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB)
Krause, Roland ✱; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB)
Borghei, Mojgansadat; Université Libre de Bruxelles, Brussels, Belgium > Laboratory of Experimental Neurology
Wassenaar, Merel; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
Auce, Pauls; Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom > Department of Molecular and Clinical Pharmacology ; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
Avbersek, Andreja; UCL Institute of Neurology, London, United Kingdom > Department of Clinical and Experimental Epilepsy
Becker, Felicitas; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
Berghuis, Bianca; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
Campbell, Ellen; Belfast Health and Social Care Trust, Belfast, United Kingdom
Coppola, Antonietta; University of Genoa, Genoa, Italy > Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health
Francis, Ben; University of Liverpool, Liverpool, United Kingdom > Department of Biostatistics
Wolking, Stefan; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
Cavalleri, Gianpiero L.; Royal College of Surgeons in Ireland, Dublin, Ireland > Molecular and Cellular Therapeutics
Craig, John; Belfast Health and Social Care Trust, Belfast, United Kingdom
Delanty, Norman; Royal College of Surgeons in Ireland, Dublin, Ireland > Molecular and Cellular Therapeutics ; Beaumont Hospital, Dublin, Ireland > Department of Neurology
Koeleman, Bobby P. C.; University Medical Center Utrecht, Utrecht, Netherlands > Department of Genetics
Kunz, Wolfram S.; University of Bonn, Bonn, Germany > Department of Epileptology
Lerche, Holger; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
Marson, Anthony G.; Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom > Department of Molecular and Clinical Pharmacology ; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
Sander, Josemir W.; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, 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, Graeme J.; Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom > Department of Molecular and Clinical Pharmacology
Striano, Pasquale; University of Genoa, Genoa, Italy > Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health
Zara, Federico; Laboratory of Neurogenetics and Neuroscience, Institute G. Gaslini, Genoa, Italy
Sisodiya, Sanjay M.; UCL Institute of Neurology, London, United Kingdom > Department of Clinical and Experimental Epilepsy ; The Chalfont Centre for Epilepsy, Chalfont St. Peters, United Kingdom
Depondt, Chantal; Université Libre de Bruxelles, Brussels, Belgium > Laboratory of Experimental Neurology ; Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium > Department of Neurology
FP7 - 602461 - BIOCOG - Biomarker Development for Postoperative Cognitive Impairment in the Elderly
Funders :
European Commission. Grant Number: 279062 Framework of the EU-funded FP7 research program BioCog Department of Health's NIHR Biomedical Research Centre's funding scheme Christelijke Vereniging voor de Verpleging van Lijders aan Epilepsie University of Liverpool [GB] Italian League Against Epilepsy (LICE) German Society for Epileptology Foundation no epilep Dr. Marvin Weil Epilepsy Research Fund Ministero della Salute [IT] European Community Sixth Telethon Foundation Italian League Against Epilepsy CE - Commission Européenne [BE]
