BACKGROUND: Kaiser Permanente advocates using single-source generics for brand-name drugs. We compared the effectiveness of 3 different-generation generic antiepileptic drugs (AEDs) in patients with focal epilepsies. OBJECTIVE: To compare the effectiveness of the 3 most commonly used AEDs (carbamazepine [CBZ], lamotrigine [LTG], and levetiracetam [LEV]) after 24-month monotherapy. METHODS: This is a retrospective data analysis of 646 consecutive AED-naive patients aged 1-88 years treated with CBZ, LTG, or LEV between 2006 and 2012 with dosing adjustments permitted during the first 6 months. Chi-squared test with p < 0.05 was used to calculate seizure-freedom and tolerability rates. RESULTS: At the end of the 24-month study period, 65.69% patients in the CBZ group continued to remain seizure free, 25.98% were drug failures, and 8.33% dropped out due to adverse events, with the corresponding numbers being 66.49%, 23.94%, and 9.57% in the LTG group and 72.44%, 12.99%, and 14.57% in the LEV group. Rash was the most common adverse event for CBZ (3.43%) and LTG (6.38%), and mood changes were the most commen adverse event for LEV (7.87%). Among the 3 groups (n = 646), AED tolerance rates and AED retention rates showed no significant difference (p = 0.08 and p = 0.23, respectively). Seizure-freedom rate difference among the 3 groups (n = 574) was significant (p = 0.003), and seizure-freedom rate for LEV was superior to CBZ (p = 0.001) and to LTG (p = 0.006). CONCLUSION: At the end of the 24-month study period, in a head-to-head comparison of single-source bioequivalent generic formulations, superior seizure-freedom rate and comparable tolerability and retention rates for LEV were observed when compared with CBZ and LTG.
BACKGROUND: Kaiser Permanente advocates using single-source generics for brand-name drugs. We compared the effectiveness of 3 different-generation generic antiepileptic drugs (AEDs) in patients with focal epilepsies. OBJECTIVE: To compare the effectiveness of the 3 most commonly used AEDs (carbamazepine [CBZ], lamotrigine [LTG], and levetiracetam [LEV]) after 24-month monotherapy. METHODS: This is a retrospective data analysis of 646 consecutive AED-naive patients aged 1-88 years treated with CBZ, LTG, or LEV between 2006 and 2012 with dosing adjustments permitted during the first 6 months. Chi-squared test with p < 0.05 was used to calculate seizure-freedom and tolerability rates. RESULTS: At the end of the 24-month study period, 65.69% patients in the CBZ group continued to remain seizure free, 25.98% were drug failures, and 8.33% dropped out due to adverse events, with the corresponding numbers being 66.49%, 23.94%, and 9.57% in the LTG group and 72.44%, 12.99%, and 14.57% in the LEV group. Rash was the most common adverse event for CBZ (3.43%) and LTG (6.38%), and mood changes were the most commen adverse event for LEV (7.87%). Among the 3 groups (n = 646), AED tolerance rates and AED retention rates showed no significant difference (p = 0.08 and p = 0.23, respectively). Seizure-freedom rate difference among the 3 groups (n = 574) was significant (p = 0.003), and seizure-freedom rate for LEV was superior to CBZ (p = 0.001) and to LTG (p = 0.006). CONCLUSION: At the end of the 24-month study period, in a head-to-head comparison of single-source bioequivalent generic formulations, superior seizure-freedom rate and comparable tolerability and retention rates for LEV were observed when compared with CBZ and LTG.
Authors: Felix Rosenow; Carmen Schade-Brittinger; Nicole Burchardi; Sebastian Bauer; Karl Martin Klein; Yvonne Weber; Holger Lerche; Stefan Evers; Stjepana Kovac; Susanne Hallmeyer-Elgner; Götz Winkler; Joachim Springub; Mathias Niedhammer; Erhard Roth; Ilonka Eisensehr; Jörg Berrouschot; Stephan Arnold; Michael Schröder; Anja Beige; Wolfgang H Oertel; Adam Strzelczyk; Anja Haag; Philipp S Reif; Hajo M Hamer Journal: J Neurol Neurosurg Psychiatry Date: 2012-05-17 Impact factor: 10.154
Authors: Hiba Arif; Richard Buchsbaum; Joanna Pierro; Michael Whalen; Jessica Sims; Stanley R Resor; Carl W Bazil; Lawrence J Hirsch Journal: Arch Neurol Date: 2010-04
Authors: J A French; A M Kanner; J Bautista; B Abou-Khalil; T Browne; C L Harden; W H Theodore; C Bazil; J Stern; S C Schachter; D Bergen; D Hirtz; G D Montouris; M Nespeca; B Gidal; W J Marks; W R Turk; J H Fischer; B Bourgeois; A Wilner; R E Faught; R C Sachdeo; A Beydoun; T A Glauser Journal: Neurology Date: 2004-04-27 Impact factor: 9.910
Authors: Aaron S Kesselheim; Margaret R Stedman; Ellen J Bubrick; Joshua J Gagne; Alexander S Misono; Joy L Lee; M Alan Brookhart; Jerry Avorn; William H Shrank Journal: Drugs Date: 2010-03-26 Impact factor: 9.546
Authors: David M Labiner; Alan B Ettinger; Toufic A Fakhoury; Steve S Chung; Bassel Shneker; William O Tatum Iv; J Mitchell Miller; Alain Vuong; Anne E Hammer; John A Messenheimer Journal: Epilepsia Date: 2008-11-04 Impact factor: 5.864