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在成人癫痫部分发作患者中作为辅助治疗的依佐加滨醋酸盐的长期安全性和疗效:一项为期 1 年的开放性扩展研究结果。

Long-term safety and efficacy of eslicarbazepine acetate as adjunctive therapy in the treatment of partial-onset seizures in adults with epilepsy: results of a 1-year open-label extension study.

机构信息

Department of Neurology, University of Essen, Essen, Germany.

出版信息

Epilepsy Res. 2013 Feb;103(2-3):262-9. doi: 10.1016/j.eplepsyres.2012.07.014. Epub 2012 Aug 4.

DOI:10.1016/j.eplepsyres.2012.07.014
PMID:22871333
Abstract

OBJECTIVE

To evaluate the long-term safety, tolerability and efficacy of once-daily eslicarbazepine acetate (ESL) as adjunctive therapy in adults with partial-onset seizures.

METHODS

One-year open-label extension (OLE) study with ESL in patients who completed a randomised, double-blind placebo-controlled trial (study BIA-2093-302; Epilepsy Res. 89 (2010) 278-285). Starting dose was 800 mg once-daily, for 4 weeks; thereafter, dose could be individualised within the 400-1,200 mg range. Doses of concomitant antiepileptic drugs were to be kept stable.

RESULTS

Overall, 325 patients were enrolled (intent-to-treat population); 223 (68.6%) patients completed 1-year of treatment. ESL median dose was 800 mg once-daily. Compared to the baseline period of the double-blind study completed prior to this OLE study, median seizure frequency decreased by 32% in weeks 1-4, and between 37% and 39% thereafter. The responder rate (seizure reduction ≥ 50%) was 37% during weeks 1-4 and thereafter ranged between 38% and 42% per 12-week interval. Proportion of seizure-free patients per 12-week interval ranged between 5% and 11%. Improvements from baseline in several Quality of Life in Epilepsy Inventory-31 (QOLIE-31) and Montgomery Asberg Depression Rating Scale (MADRS) scores were observed. Adverse events (AEs) were reported by 83% of patients. AEs occurring in ≥ 10% of patients were dizziness, headache and somnolence. AEs were usually of mild to moderate intensity.

CONCLUSION

In this study, ESL demonstrated a sustained therapeutic effect and was well tolerated during 1-year add-on treatment of adults with partial-onset seizures. Additionally, significant improvements in quality of life domains and depressive symptoms were observed under long-term treatment with once-daily ESL.

摘要

目的

评估每日一次依佐加滨醋酸乙酯(ESL)作为成人部分发作性癫痫辅助治疗的长期安全性、耐受性和疗效。

方法

这是一项为期 1 年的依佐加滨醋酸乙酯开放标签扩展(OLE)研究,纳入了完成随机、双盲安慰剂对照试验(研究 BIA-2093-302;Epilepsy Res. 89 (2010) 278-285)的患者。起始剂量为 800mg 每日 1 次,持续 4 周;此后,剂量可在 400-1200mg 范围内个体化调整。同时使用的抗癫痫药物剂量应保持稳定。

结果

共有 325 例患者入组(意向治疗人群);223 例(68.6%)患者完成了 1 年的治疗。ESL 的中位剂量为 800mg 每日 1 次。与这项 OLE 研究之前完成的双盲研究的基线期相比,第 1-4 周时中位癫痫发作频率降低了 32%,此后则降低了 37%-39%。在第 1-4 周时,缓解率(癫痫发作减少≥50%)为 37%,此后每 12 周间隔缓解率在 38%-42%之间。每 12 周间隔无癫痫发作的患者比例在 5%-11%之间。多项癫痫患者生活质量量表 31 项(QOLIE-31)和蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评分与基线相比均有改善。83%的患者报告了不良事件(AE)。发生率≥10%的 AE 为头晕、头痛和嗜睡。AE 通常为轻至中度。

结论

在这项研究中,ESL 在成人部分发作性癫痫的辅助治疗中,经过 1 年的添加治疗,显示出持续的治疗效果,并且具有良好的耐受性。此外,在长期每日 1 次使用 ESL 治疗时,观察到生活质量领域和抑郁症状的显著改善。

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