Treatment of paediatric epilepsy in Germany: antiepileptic drug utilisation in children and adolescents with a focus on new antiepileptic drugs.

BACKGROUND

Treatment of paediatric epilepsy has advanced with the development of new antiepileptic drugs (AEDs). There are few data for Germany to which extent new AEDs are used in the treatment of childhood epilepsy.

AIMS

To characterise utilisation of antiepileptics in children and adolescents with a specific emphasis on new AEDs.

METHODS

Data were obtained from the German Pharmacoepidemiological Research Database for the period 2004-2006. Descriptive analyses were performed to assess prevalence and incidence of AED use stratified by age and sex. Mono- and combination therapy were considered as well as diagnoses and physician speciality.

RESULTS

We identified 13,197 children with AED use who received a total of 226,856 AED prescriptions. The majority of children treated with an AED were diagnosed with epilepsy (11,872; 89.96%). Of all AED prescriptions, 140,992 (62.15%) were for conventional and 85,864 (37.85%) were for new AEDs. One-year prescribing prevalence ranged between 4.10 and 4.11 per 1000 children. Incidence of AED use was 0.91 (95% CI: 0.87-0.95) per 1000 person-years in 2005 and 0.84 (95% CI: 0.81-0.89) per 1000 person-years in 2006. Monotherapy (9821; 74.42%) was more prevalent than combination therapy. Most AEDs were prescribed by paediatricians (147,150; 64.86%).

CONCLUSIONS

The introduction of the new AEDs had less impact on prescribing of AEDs in children than has been reported for adults. AED prescribing overall was in line with published guidelines.