Ganna Androsova1, Roland Krause1, Mojgansadat Borghei2, Merel Wassenaar3, Pauls Auce4,5, Andreja Avbersek6, Felicitas Becker7, Bianca Berghuis3, Ellen Campbell8, Antonietta Coppola9, Ben Francis10, Stefan Wolking7, Gianpiero L Cavalleri11, John Craig8, Norman Delanty11,12, Bobby P C Koeleman13, Wolfram S Kunz14, Holger Lerche7, Anthony G Marson4,5, Josemir W Sander3,15,16, Graeme J Sills4, Pasquale Striano9, Federico Zara17, Sanjay M Sisodiya6,16, Chantal Depondt2,18. 1. Luxembourg Center for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg. 2. Laboratory of Experimental Neurology, Université Libre de Bruxelles, Brussels, Belgium. 3. Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands. 4. Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom. 5. The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom. 6. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom. 7. Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. 8. Belfast Health and Social Care Trust, Belfast, United Kingdom. 9. Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy. 10. Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom. 11. Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland. 12. Department of Neurology, Beaumont Hospital, Dublin, Ireland. 13. Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. 14. Department of Epileptology, University of Bonn, Bonn, Germany. 15. NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, United Kingdom. 16. The Chalfont Centre for Epilepsy, Chalfont St. Peters, United Kingdom. 17. Laboratory of Neurogenetics and Neuroscience, Institute G. Gaslini, Genoa, Italy. 18. Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Abstract
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. We report 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. Wiley Periodicals, Inc.
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. We report 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. Wiley Periodicals, Inc.
Authors: Bianca Berghuis; Caragh Stapleton; Anja C M Sonsma; Janic Hulst; Gerrit-Jan de Haan; Dick Lindhout; Rita Demurtas; Roland Krause; Chantal Depondt; Wolfram S Kunz; Federico Zara; Pasquale Striano; John Craig; Pauls Auce; Anthony G Marson; Hreinn Stefansson; Terence J O'Brien; Michael R Johnson; Graeme J Sills; Stefan Wolking; Holger Lerche; Sanjay M Sisodiya; Josemir W Sander; Gianpiero L Cavalleri; Bobby P C Koeleman; Mark McCormack Journal: Epilepsia Open Date: 2019-01-17
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Authors: Stefan Wolking; Ciarán Campbell; Caragh Stapleton; Mark McCormack; Norman Delanty; Chantal Depondt; Michael R Johnson; Bobby P C Koeleman; Roland Krause; Wolfram S Kunz; Anthony G Marson; Josemir W Sander; Graeme J Sills; Pasquale Striano; Federico Zara; Sanjay M Sisodiya; Gianpiero L Cavalleri; Holger Lerche Journal: Front Pharmacol Date: 2021-06-09 Impact factor: 5.810