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艾司利卡西平乙酰丙酮添加治疗局灶性发作癫痫患者的疗效和安全性:来自双盲 III 期临床研究的汇总数据的综合分析。

Efficacy and safety of eslicarbazepine acetate as add-on treatment in patients with focal-onset seizures: integrated analysis of pooled data from double-blind phase III clinical studies.

机构信息

Department of Neurology, Hospital Ruber International, Madrid, Spain.

出版信息

Epilepsia. 2013 Jan;54(1):98-107. doi: 10.1111/j.1528-1167.2012.03605.x. Epub 2012 Aug 6.

Abstract

PURPOSE

To evaluate the efficacy and safety profile of eslicarbazepine acetate (ESL) added to stable antiepileptic therapy in adults with partial-onset seizures.

METHODS

Data from 1,049 patients enrolled from 125 centers, in 23 countries, in three phase III double-blind, randomized, placebo-controlled studies were pooled and analyzed. Following a 2-week titration period, ESL was administered at 400 mg, 800 mg, and 1,200 mg once-daily doses for 12 weeks.

KEY FINDINGS

Seizure frequency was significantly reduced with ESL 800 mg (p < 0.0001) and 1,200 mg (p < 0.0001) compared to placebo. Median relative reduction in seizure frequency was, respectively, 35% and 39% (placebo 15%) and responder rate was 36% and 44% (placebo 22%). ESL was more efficacious than placebo regardless of gender, geographic region, epilepsy duration, age at time of diagnosis, seizure type, and number and type of concomitant antiepileptic drugs (AEDs). Incidence of adverse events (AEs) and AEs leading to discontinuation were dose dependent. AEs occurred mainly during the first weeks of treatment, with no difference between groups after 6 weeks. Most common AEs (>10% patients) were dizziness, somnolence, and headache. The incidence of AEs in ESL groups compared to placebo was generally consistent among different subpopulations.

SIGNIFICANCE

Once-daily ESL 800 mg and 1,200 mg showed consistent results across all efficacy and safety end points. Results were independent of study population characteristics and type and number of concomitant AEDs.

摘要

目的

评估醋酸艾司利卡西平(ESL)添加到稳定的抗癫痫治疗中对部分发作性癫痫成人的疗效和安全性。

方法

汇总并分析了来自 125 个中心的 1049 例患者的三期双盲、随机、安慰剂对照研究数据。在 2 周的滴定期后,ESL 每天一次分别给予 400mg、800mg 和 1200mg 剂量,持续 12 周。

主要发现

与安慰剂相比,ESL 800mg(p<0.0001)和 1200mg(p<0.0001)可显著降低癫痫发作频率。癫痫发作频率的中位数相对减少分别为 35%和 39%(安慰剂为 15%),应答率分别为 36%和 44%(安慰剂为 22%)。ESL 无论性别、地理位置、癫痫持续时间、诊断时的年龄、癫痫发作类型以及伴随抗癫痫药物(AEDs)的数量和类型,均比安慰剂更有效。不良事件(AE)的发生率和导致停药的 AE 与剂量有关。AE 主要发生在治疗的最初几周内,治疗 6 周后各组之间没有差异。最常见的 AE(>10%患者)为头晕、嗜睡和头痛。与安慰剂相比,ESL 组的 AE 发生率在不同亚人群中通常一致。

意义

每日一次的 ESL 800mg 和 1200mg 在所有疗效和安全性终点均表现一致。结果与研究人群特征以及伴随 AEDs 的类型和数量无关。

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