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普瑞巴林在耐药性癫痫中的保留率:1年随访,对105例连续成年患者的单中心观察

Retention rate of pregabalin in drug-resistant epilepsy: 1-year follow-up, single-centre observation in 105 consecutive, adult patients.

作者信息

Brandt Christian, May Theodor W, Pohlmann-Eden Bernd, Nieder Esther, Elsner Heike, Witte-Boelt Karin, Schuermann Inka, Ebner Alois

机构信息

Bethel Epilepsy Centre, Dept. of General Epileptology, Maraweg 21, D-33617 Bielefeld, Germany.

出版信息

Seizure. 2009 Nov;18(9):634-8. doi: 10.1016/j.seizure.2009.07.005. Epub 2009 Aug 11.

Abstract

OBJECTIVES

Pregabalin (PGB) is a newer antiepileptic drug (AED) licensed as add-on treatment for partial epilepsy in adults. Efficacy and safety have been proven in several controlled clinical studies. These trials, however, only partially reflect clinical practice. Retention rate has been established as a marker for efficacy and safety of AEDs in long-term follow-up studies.

METHODS

We evaluated the data of the first 105 patients treated with PGB at Bethel Epilepsy Centre, a tertiary referral centre for epilepsy. The patients were interviewed after 3, 6 and 12 months.

RESULTS

105 adult patients (aged 38+/-13 years) were treated with PGB, on average in combination with 2.1 AEDs (mean observation period 232 days). 76.2% had focal epilepsy, 19.0 multifocal epilepsy, and 3.8% epilepsy with both focal and generalised seizures. 40% continued PGB with the following outcome: 5.7% seizure-free for at least 1 month (4.8% for at least 3 months, 2.4% for at least 6 months; one of the seizure-free patients, however, had had epilepsy surgery during the observational period), 17.1% responders (> or =50% reduction of seizure frequency but not seizure-free), 13.3% with unchanged or increased seizure frequency. Reasons for withdrawal were lack of efficacy (47.6%) or side-effects (12.7%).

CONCLUSIONS

PGB is a new therapeutic option as add-on therapy for patients with highly refractory focal epilepsies although the therapeutic success that can be expected in this group of patients is limited.

摘要

目的

普瑞巴林(PGB)是一种新型抗癫痫药物(AED),已被批准作为成人部分性癫痫的附加治疗药物。其疗效和安全性已在多项对照临床研究中得到证实。然而,这些试验仅部分反映了临床实践情况。在长期随访研究中,留存率已被确立为AED疗效和安全性的一项指标。

方法

我们评估了在三级癫痫转诊中心伯特利癫痫中心接受PGB治疗的前105例患者的数据。在3个月、6个月和12个月后对患者进行访谈。

结果

105例成年患者(年龄38±13岁)接受了PGB治疗,平均联合使用2.1种AED(平均观察期232天)。76.2%患有局灶性癫痫,19.0%患有多灶性癫痫,3.8%患有局灶性和全身性发作的癫痫。40%的患者继续使用PGB,结果如下:5.7%至少1个月无癫痫发作(至少3个月无癫痫发作为4.8%,至少6个月无癫痫发作为2.4%;然而,其中一名无癫痫发作的患者在观察期内接受了癫痫手术),17.1%为反应者(癫痫发作频率降低≥50%但未无癫痫发作),13.3%的患者癫痫发作频率未改变或增加。停药原因是缺乏疗效(47.6%)或出现副作用(12.7%)。

结论

PGB作为附加治疗药物为高度难治性局灶性癫痫患者提供了一种新的治疗选择,尽管预期该组患者的治疗成功率有限。

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