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拉莫三嗪单药治疗儿童新诊断的典型失神发作:一项多中心、非对照、开放标签研究。

Lamotrigine monotherapy for newly diagnosed typical absence seizures in children: A multi-center, uncontrolled, open-label study.

作者信息

Yasumoto Sawa, Shimizu Masahiro, Sato Katsuaki, Kurata Atsuyo, Numachi Yotaro

机构信息

Department of Pediatrics, School of Medicine, Fukuoka University, Fukuoka, Japan.

GlaxoSmithKline, Tokyo, Japan.

出版信息

Brain Dev. 2016 Apr;38(4):407-13. doi: 10.1016/j.braindev.2015.10.007. Epub 2015 Oct 27.

Abstract

PURPOSE

To evaluate the efficacy and safety of lamotrigine (LTG) monotherapy for treating Japanese and South Korean pediatric patients with newly diagnosed typical absence seizures.

METHODS

Twenty patients with newly diagnosed typical absence seizures aged 4-12 years were enrolled in the study and were administered LTG at an initial dose of 0.3 mg/kg/day for 2 weeks, followed by 0.6 mg/kg/day for an additional 2 weeks. Thereafter, the dose was increased by 0.6 mg/kg/day up to a maximum of 10.2 mg/kg/day or 400 mg/day (whichever was the lower dose) until patients were confirmed to be seizure free induced by hyperventilation (HV). After confirmation, the dose was increased by one level (0.6 mg/kg/day). If the patient was found to be seizure free by HV-electroencephalography (EEG) on the following two consecutive visits, the patient entered the 12-week maintenance phase. After the maintenance phase, patients could enter the extension phase if clinically indicated.

RESULTS

The seizure-free rate confirmed by HV-EEG at the end of the maintenance phase was 35.0% (7/20 patients). Most of patients who were confirmed to be seizure free during the escalation phase had maintained seizure control during the 12-week maintenance phase and the 12-week extension phase. The most frequently noted adverse events were bronchitis, headache, and rash (20% each). No serious adverse events were reported.

CONCLUSION

Lamotrigine monotherapy in Japanese and South Korean children with typical absence seizures was well tolerated and 35.0% of patients were seizure free at the end of maintenance phase.

摘要

目的

评估拉莫三嗪(LTG)单药治疗日本和韩国新诊断的典型失神发作儿科患者的疗效和安全性。

方法

20例年龄在4至12岁新诊断的典型失神发作患者纳入本研究,初始剂量为0.3mg/kg/天服用拉莫三嗪2周,随后0.6mg/kg/天再服用2周。此后,剂量以0.6mg/kg/天递增,最高至10.2mg/kg/天或400mg/天(以较低者为准),直至通过过度换气(HV)诱发无癫痫发作得到确认。确认后,剂量增加一个级别(0.6mg/kg/天)。如果患者在接下来连续两次就诊时通过HV-脑电图(EEG)显示无癫痫发作,则进入12周维持期。维持期结束后,根据临床指征患者可进入延长期。

结果

维持期末通过HV-EEG确认的无癫痫发作率为35.0%(7/20例患者)。大多数在剂量递增期确认无癫痫发作的患者在12周维持期和12周延长期均保持癫痫发作控制。最常报告的不良事件为支气管炎、头痛和皮疹(各20%)。未报告严重不良事件。

结论

拉莫三嗪单药治疗日本和韩国典型失神发作儿童耐受性良好,维持期末35.0%的患者无癫痫发作。

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