Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, and the National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Epilepsy Res. 2011 Sep;96(1-2):39-44. doi: 10.1016/j.eplepsyres.2011.04.012. Epub 2011 May 20.
Zonisamide (ZNS) is an antiepileptic drug (AED) with multiple putative mechanisms of action. It is chemically unrelated to other AEDs. It has been available in Japan since 1989 but was only licensed in Europe in 2005. Its efficacy and tolerability have been shown in several randomised controlled trials, but large studies on long-term performance in Western clinical practice are scarce. We assessed a large cohort of consecutive people who started ZNS at a tertiary epilepsy referral centre, from June 2005 to July 2009. Forty-six percent of the 417 people included were still taking ZNS at last follow-up, with an estimated retention rate at three years of 30%. Almost one third of the population reported a period of improvement in terms of seizure reduction of at least six months duration whilst on ZNS. Sixteen people became seizure free for at least six months and seven of these were seizure free for one year or more. Adverse events occurred in 58%, frequently CNS-related. People on three or more AEDs and people starting zonisamide at 25mg daily rather than 50mg or more, were more likely to discontinue ZNS. Retention rates for ZNS were similar to those previously reported, and comparable to lamotrigine, topiramate, pregabalin, higher than gabapentin, and lower than levetiracetam.
唑尼沙胺（ZNS）是一种具有多种潜在作用机制的抗癫痫药物（AED）。它与其他 AED 无化学相关性。自 1989 年以来，它在日本已经上市，但直到 2005 年才在欧洲获得许可。它的疗效和耐受性已在几项随机对照试验中得到证实，但在西方临床实践中关于长期表现的大型研究很少。我们评估了 2005 年 6 月至 2009 年 7 月在一家三级癫痫转诊中心开始使用 ZNS 的连续大量患者。在纳入的 417 人中，有 46%的人在最后一次随访时仍在服用 ZNS，估计三年内的保留率为 30%。近三分之一的患者报告在服用 ZNS 期间有至少六个月的癫痫发作减少期有所改善。16 人至少六个月无癫痫发作，其中 7 人一年或更长时间无癫痫发作。58%的人出现了不良事件，经常与中枢神经系统相关。服用三种或更多种 AED 的人和每天起始剂量为 25mg 的 ZNS 患者比起始剂量为 50mg 或更高剂量的患者更有可能停用 ZNS。ZNS 的保留率与之前报道的相似，与拉莫三嗪、托吡酯、普瑞巴林相似，高于加巴喷丁，低于左乙拉西坦。
