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 Italian League Against Epilepsy (LICE) German Society for Epileptology Foundation no epilep Dr. Marvin Weil Epilepsy Research Fund Ministero della Salute European Community Sixth Telethon Foundation Italian League Against Epilepsy CE - Commission Européenne European Union
