Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Seizure. 2011 Jan;20(1):23-6. doi: 10.1016/j.seizure.2010.09.014. Epub 2010 Oct 14.
The goals of this study were to evaluate the efficacy, safety, and quality of life profiles of ER formulation of valproate in patients with epilepsy. This was a prospective, multicentre, open-lable study. Patients with a definite diagnosis of epilepsy were included and prescribed the ER formulation of valproate as initial or add-on therapy for 6 months. Efficacy and safety re-evaluation procedures were performed at 1 (V1), 3 (V2), and 6 months (V3) after enrollment. A QOLIE-31 inventory was used to assess the quality of life before and after the 6-month treatment. Nine hundred and fifty-eight patients with diagnosis of epilepsy were included in the analysis. The mean of seizure frequency at baseline was 8.56 per month. The median maintenance dose of the ER valproate was 750 mg per day. The number of seizure attacks per month was significantly decreased at the last visit compared to baseline by 88.3%. Patients improved quality of life in the fields of 'seizure worry' (P=0.000), 'overall quality of life' (P=0.000), 'social function' (P<0.01), and 'Question 31' (P=0.000), but showed decreased 'energy' (P=0.000). In the early phase of treatment, the main adverse effects included drowsiness, dizziness, and anorexia. By 6 months of treatment, weight gain, alopecia, and tremor were most frequently reported. The results of the present study demonstrated that patients receiving ER valproate as add-on or mono-therapy for 6 months exhibited significantly greater median percent reductions from baseline in seizure frequency for all seizure types, and significantly higher responder rates and higher seizure freedom rates, with good tolerance and improved quality of life.
本研究的目的在于评估癫痫患者应用 ER 型丙戊酸钠的疗效、安全性和生活质量。这是一项前瞻性、多中心、开放标签的研究。纳入明确诊断为癫痫的患者,并将 ER 型丙戊酸钠作为初始或添加治疗方案,疗程为 6 个月。入组后第 1(V1)、3(V2)和 6 个月(V3)进行疗效和安全性评估。使用 QOLIE-31 量表评估 6 个月治疗前后的生活质量。958 例癫痫患者纳入分析。基线时癫痫发作频率的平均值为 8.56 次/月。ER 型丙戊酸钠的维持剂量中位数为 750mg/天。与基线相比,末次随访时每月癫痫发作次数显著减少 88.3%。患者在“发作担忧”(P=0.000)、“总体生活质量”(P=0.000)、“社会功能”(P<0.01)和“问题 31”(P=0.000)领域的生活质量得到改善,但“精力”(P=0.000)降低。在治疗早期,主要不良反应包括嗜睡、头晕和食欲不振。治疗 6 个月时,体重增加、脱发和震颤最常被报告。本研究结果表明,接受 ER 型丙戊酸钠添加或单药治疗 6 个月的患者,所有类型癫痫发作的频率均有显著的中位数百分比降低,应答率和无发作率更高,具有良好的耐受性和改善的生活质量。