S Roopa B, Narayan Sujatha S, Sharma G R K, Rodrigues Rashmi J, Kulkarni Chanda
Department of Pharmacology, St John's Medical College and Hospital, Bangalore, India.
Pharmacoepidemiol Drug Saf. 2008 Aug;17(8):807-12. doi: 10.1002/pds.1540.
To investigate pattern and extent of adverse drug reactions (ADRs) associated with AEDs and to identify safer options for treatment of epilepsy.
Study was a retrospective, cross-sectional survey. Data from patients with epilepsy at the out-patient and in-patient of Neurology Department was collected in a specially designed proforma. Causality and severity of ADRs was categorized as per WHO guidelines.
Among 788 patients with epilepsy, 80 (10.27%) had ADRs. ADRs with AED monotherapy were 9.18% and with polytherapy were 11.56%. ADRs with conventional and newer AED monotherapy was 10.24% and 6.84%, respectively, and were maximum with phenytoin and clobazam (14.28% and 12.5%). ADRs were mild in 4.16%, moderate in 70.83% and severe in 25% patients. Causality was probable in 65.62%, possible in 13.54% and definite in 20.83%. Patients (15/80) were hospitalized due to ADRs. Age and gender distribution showed statistically significant difference in occurrence of ADRs (p < 0.05). Chi-square test for poly versus monotherapy and conventional versus newer AEDs did not show any significant difference.
Study showed maximum ADRs with AED polytherapy with no significant difference in frequency and severity of ADRs between conventional versus newer AEDs. This finding needs further investigation in larger number of patients to identify safer treatment options for epilepsy.
调查与抗癫痫药物(AEDs)相关的药物不良反应(ADRs)的模式和程度,并确定更安全的癫痫治疗选择。
本研究为回顾性横断面调查。通过专门设计的表格收集神经内科门诊和住院癫痫患者的数据。根据世界卫生组织指南对ADRs的因果关系和严重程度进行分类。
在788例癫痫患者中,80例(10.27%)出现ADRs。AED单药治疗的ADRs发生率为9.18%,联合治疗为11.56%。传统AED单药治疗和新型AED单药治疗的ADRs发生率分别为10.24%和6.84%,苯妥英和氯巴占的ADRs发生率最高(分别为14.28%和12.5%)。4.16%的患者ADRs为轻度,70.83%为中度,25%为重度。65.62%的因果关系为很可能,13.54%为可能,20.83%为肯定。15例(15/80)患者因ADRs住院。年龄和性别分布显示ADRs发生率存在统计学显著差异(p<0.05)。联合治疗与单药治疗以及传统AED与新型AED的卡方检验未显示任何显著差异。
研究表明,AED联合治疗的ADRs最多,传统AED与新型AED在ADRs的频率和严重程度上无显著差异。这一发现需要在更多患者中进一步研究,以确定更安全的癫痫治疗选择。