Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients： A 7-year Study in an Epilepsy Center in China  

作　　者：Fei Zhu Sen-Yang Lang Xiang-Qing Wang Xiao-Bing Shi Yun-Feng Ma Xu Zhang Ya-Nan Chen Jia-Tang Zhang 

机构地区：[1]Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing 100853, China [2]Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

出　　处：《Chinese Medical Journal》2015年第22期3015-3022,共8页中华医学杂志（英文版）

摘　　要：Background： It is important to choose an appropriate antiepileptic drug （AED） to manage partial epilepsy. Traditional AEDs, such as carbamazepine （CBZ） and valproate （VPA）, have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods： This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate （TPM）, oxcarbazepine （OXC）, lamotrigine （LTG）, or levetiracetam （LEV）, were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results： A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months （95% confidential interval： 30.64~4.07）. CBZ exhibited the highest 12-month remission rate （85.55%）, which was significantly higher than those of TPM （69.38%, P = 0.006）, LTG （70.79%, P= 0.001）, LEV （72.54%, P = 0.005）, and VPA （73.33%, P = 0.002）. CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems （8.09%）, rashes （7.76%）, abnormal hepatic function （6.24%）, and drowsiness （6.24%）. Conclusion： This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing tbcal epilepsy as measuredBackground： It is important to choose an appropriate antiepileptic drug （AED） to manage partial epilepsy. Traditional AEDs, such as carbamazepine （CBZ） and valproate （VPA）, have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are areas in need of further research. Accordingly, this study investigated the long-term effectiveness of six AEDs used as monotherapy in patients with partial epilepsy. Methods： This is a retrospective, long-term observational study. Patients with partial epilepsy who received monotherapy with one of six AEDs, namely, CBZ, VPA, topiramate （TPM）, oxcarbazepine （OXC）, lamotrigine （LTG）, or levetiracetam （LEV）, were identified and followed up from May 2007 to October 2014, and time to first seizure after treatment, 12-month remission rate, retention rate, reasons for treatment discontinuation, and adverse effects were evaluated. Results： A total of 789 patients were enrolled. The median time of follow-up was 56.95 months. CBZ exhibited the best time to first seizure, with a median time to first seizure of 36.06 months （95% confidential interval： 30.64~4.07）. CBZ exhibited the highest 12-month remission rate （85.55%）, which was significantly higher than those of TPM （69.38%, P = 0.006）, LTG （70.79%, P= 0.001）, LEV （72.54%, P = 0.005）, and VPA （73.33%, P = 0.002）. CBZ, OXC, and LEV had the best retention rate, followed by LTG, TPM, and VPA. Overall, adverse effects occurred in 45.87% of patients, and the most common adverse effects were memory problems （8.09%）, rashes （7.76%）, abnormal hepatic function （6.24%）, and drowsiness （6.24%）. Conclusion： This study demonstrated that CBZ, OXC, and LEV are relatively effective in managing tbcal epilepsy as measured

关 键 词：12-month Remission Rate Antiepileptic Drug Partial Epilepsy Retention Rate 

分 类 号：TQ463[化学工程—制药化工] TQ460.4