Faught E, Holmes G L, Rosenfeld W E, Novak G, Neto W, Greenspan A, Schmitt J, Yuen E, Reines S, Haas M
University of Alabama at Birmingham Epilepsy Center, Civitan International Research Center 312, 1719 6th Ave. South, Birmingham, AL 35294-0021, USA.
Neurology. 2008 Nov 11;71(20):1586-93. doi: 10.1212/01.wnl.0000334751.89859.7f.
To evaluate the efficacy, safety, and tolerability of carisbamate (CRS), an investigational drug, as adjunctive treatment for partial-onset seizures in adults.
A randomized, double-blind, placebo-controlled, multicenter, dose-ranging study was conducted in 12 countries. Patients counted seizures during an 8-week baseline period, and then, if eligible, entered a double-blind phase consisting of a 4-week dose-titration period (target CRS doses: 100, 300, 800, or 1,600 mg/d or placebo in two divided doses) and a 12-week maintenance period. The primary efficacy variable was percent reduction in partial-onset seizure frequency during the double-blind phase compared with pretreatment baseline. Safety data and responder rates were also assessed.
Five hundred thirty-seven patients were randomized, and 82% completed the study. In the intent-to-treat population (n = 533), CRS at doses of > or =300 mg/d (p < or = 0.006) reduced the frequency of partial-onset seizures vs placebo: 6% (placebo) vs 24% (300 mg/d), 21% (800 mg/d), and 29% (1,600 mg/d) for CRS. Adverse events consisted primarily of CNS effects, and led to discontinuation of drug in 8% of the placebo group vs 5% (100 mg/d), 6% (300 mg/d), 12% (800 mg/d), and 19% (1,600 mg/d) of the CRS groups.
Carisbamate at doses of 300, 800, and 1,600 mg/d was effective as adjunctive therapy for reducing the frequency of partial-onset seizures.
评估一种研究性药物卡立普多(CRS)作为成人部分性发作癫痫辅助治疗的疗效、安全性和耐受性。
在12个国家进行了一项随机、双盲、安慰剂对照、多中心、剂量范围研究。患者在8周的基线期记录发作次数,然后,如果符合条件,进入双盲阶段,包括4周的剂量滴定期(目标CRS剂量:100、300、800或1600mg/d,或安慰剂,分两次服用)和12周的维持期。主要疗效变量是双盲阶段与治疗前基线相比部分性发作频率的降低百分比。还评估了安全性数据和缓解率。
537例患者被随机分组,82%完成了研究。在意向性治疗人群(n = 533)中,剂量≥300mg/d的CRS(p≤0.006)与安慰剂相比降低了部分性发作频率:安慰剂组为6%,CRS组300mg/d为24%,800mg/d为21%,1600mg/d为29%。不良事件主要包括中枢神经系统效应,导致安慰剂组8%的患者停药,CRS组100mg/d为5%,300mg/d为6%,800mg/d为12%,1600mg/d为19%。
剂量为300、800和1600mg/d的卡立普多作为辅助治疗可有效降低部分性发作的频率。