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一项多中心试验,评估奥卡西平口服混悬液单药治疗新诊断为部分性发作的儿童的疗效:临床和认知评估。

A multicenter trial of oxcarbazepine oral suspension monotherapy in children newly diagnosed with partial seizures: a clinical and cognitive evaluation.

机构信息

Department of Pediatrics, Korea University College of Medicine, Seoul, Republic of Korea.

出版信息

Seizure. 2012 Nov;21(9):679-84. doi: 10.1016/j.seizure.2012.07.007. Epub 2012 Aug 14.

Abstract

PURPOSE

We conducted a prospective, multicenter, open label trial to evaluate the effectiveness of oxcarbazepine (OXC) oral suspension as monotherapy for children newly diagnosed with partial seizures.

METHODS

This trial included a two- to eight-week titration and stabilization period to achieve effective target doses and a 24-week maintenance phase. The primary outcome measure was the seizure-free rate over six months, while a secondary measure was the change in cognition and behavior from screening to the end of the maintenance phase. The effectiveness of OXC was compared in intellectually normal versus intellectually impaired children (intelligence quotient <70).

RESULTS

We enrolled 171 patients and analyzed 168 as the per-protocol (PP) group (3 patients had protocol violations). The mean age of the PP group was 8.4±2.7 years. The maintenance dose of OXC was 24.9±8.0mg/kg/day. Of the 168 patients included in the efficacy analysis, 122 (72.6%) completed the study and 94 (56.0%) became seizure-free after the OXC treatment. Comparing the efficacy of OXC for intellectually normal and intellectually impaired patients, 79 (56.8%) of the 139 intellectually normal patients and 15 (51.7%) of the 29 intellectually impaired patients became seizure-free (P=0.61). After treatment, intelligence scale scores improved in intellectually normal patients compared to the intellectually impaired children (P<0.05). Social problems quantified by behavior scales improved in intellectually impaired patients compared to intellectually normal children (P<0.05).

CONCLUSIONS

OXC is effective and well-tolerated as monotherapy in children with partial seizures. There was no difference in the effectiveness of OXC between intellectually normal and intellectually impaired children.

摘要

目的

我们进行了一项前瞻性、多中心、开放性标签试验,以评估奥卡西平(OXC)口服液作为新诊断为部分性癫痫儿童的单药治疗的有效性。

方法

该试验包括 2 至 8 周的滴定和稳定期,以达到有效目标剂量和 24 周的维持期。主要结局测量是六个月的无发作率,次要结局测量是从筛查到维持期结束时认知和行为的变化。OXC 在智力正常和智力受损(智商<70)儿童中的有效性进行了比较。

结果

我们招募了 171 名患者,分析了 168 名符合方案(PP)组(3 名患者违反了方案)。PP 组的平均年龄为 8.4±2.7 岁。OXC 的维持剂量为 24.9±8.0mg/kg/天。在纳入疗效分析的 168 名患者中,122 名(72.6%)完成了研究,94 名(56.0%)在 OXC 治疗后无发作。比较 OXC 对智力正常和智力受损患者的疗效,139 名智力正常患者中有 79 名(56.8%)和 29 名智力受损患者中有 15 名(51.7%)无发作(P=0.61)。治疗后,智力正常患者的智力评分较智力受损儿童有所改善(P<0.05)。与智力正常儿童相比,智力受损患者的行为量表量化的社会问题有所改善(P<0.05)。

结论

OXC 作为部分性癫痫儿童的单药治疗是有效且耐受良好的。OXC 在智力正常和智力受损儿童中的疗效无差异。

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