Peltola J, Peltola M, Auvinen A, Raitanen J, Fallah M, Keränen T
Division of Neurology and Rehabilitation, Tampere University Hospital, Finland.
Acta Neurol Scand. 2009 Jan;119(1):55-60. doi: 10.1111/j.1600-0404.2008.01062.x. Epub 2008 Jun 24.
We evaluated long-term retention rates of newer antiepileptic drugs (AED) in adults with localization-related epilepsy retrospectively.
We estimated retention rates by Kaplan-Meier method in all 222 patients (age > or = 16) with localization-related epilepsy exposed to new AED at the Tampere University Hospital.
There were 141 patients exposed to lamotrigine, 78 to levetiracetam, 97 to topiramate, 68 to gabapentin, and 69 to tiagabine. Three-year retention rate for lamotrigine was 73.5%, levetiracetam 65.4%, topiramate 64.2%, gabapentin 41.7%, and tiagabine 38.2%. The most common cause for withdrawal of these AED was lack of efficacy.
Our study suggests that there are clinically significant differences among gabapentin, lamotrigine, levetiracetam, tiagabine, and topiramate as treatment for focal epilepsy in everyday practice. Gabapentin and tiagabine seem to be less useful than the other three AED. Furthermore, our study supports the value of retention rate studies in assessing outcome of the drugs in clinical practice.
我们回顾性评估了新型抗癫痫药物（AED）在成人局灶性癫痫患者中的长期留存率。
我们采用Kaplan-Meier法估算了坦佩雷大学医院所有222例年龄≥16岁、局灶性癫痫且接触新型AED的患者的留存率。
141例患者使用拉莫三嗪，78例使用左乙拉西坦，97例使用托吡酯，68例使用加巴喷丁，69例使用噻加宾。拉莫三嗪的三年留存率为73.5%，左乙拉西坦为65.4%，托吡酯为64.2%，加巴喷丁为41.7%，噻加宾为38.2%。停用这些AED最常见的原因是疗效不佳。
我们的研究表明，在日常临床实践中，加巴喷丁、拉莫三嗪、左乙拉西坦、噻加宾和托吡酯作为局灶性癫痫的治疗药物存在临床上的显著差异。加巴喷丁和噻加宾似乎比其他三种AED的疗效差。此外，我们的研究支持留存率研究在评估临床实践中药物疗效方面的价值。
