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欧洲视角下智力障碍患者使用吡仑帕奈的反应。

European perspective of perampanel response in people with Intellectual Disability.

机构信息

Cornwall Partnership NHS Foundation Trust, Redruth, UK.

University of Exeter, Truro, UK.

出版信息

Acta Neurol Scand. 2020 Sep;142(3):255-259. doi: 10.1111/ane.13261. Epub 2020 May 26.

Abstract

BACKGROUND

Epilepsy prevalence is over 20% for those with ID. It is difficult to diagnose and treat and more likely to be treatment resistant. The evidence informing prescribing is sparse, particularly for new drugs such as perampanel (PMP).

AIMS OF THE STUDY

This study seeks to strengthen the research evidence regarding PMP for people with ID by pooling information from two isolated and separately conducted studies: the UK-based Epilepsy Database Register (Ep-ID) and the data from the Kempenhaeghe clinic in the Netherlands.

METHODS

A single data set of comparable data was created and analysed under agreement and supervision of a UK statistician.

RESULTS

Seizure reduction within twelve months was evident in 62% of Dutch and 47% of UK patients. Retention rates were higher for those in the UK (P = .01) and for patients with moderate to profound ID, whilst side effects were more prominent in the Dutch cohort.

CONCLUSIONS

Comparable rates of seizure reduction are in line with estimates for non-ID patients, adding to the evidence suggesting that PMP has a similar impact on those with ID. Taking a European perspective and sharing data across centres can help strengthen the evidence for prescribing antiepileptic drugs in the ID population.

摘要

背景

智障患者的癫痫患病率超过 20%。癫痫的诊断和治疗难度大,且更可能出现耐药。指导处方的证据稀缺,对于新药物如吡仑帕奈(PMP)更是如此。

研究目的

本研究旨在通过汇集来自英国癫痫数据库注册(Ep-ID)和荷兰 Kempenhaeghe 诊所的两项独立研究的数据,为智障患者使用 PMP 的研究证据提供补充。

研究方法

在英国统计学家的协议和监督下,创建并分析了具有可比性的单一数据集。

结果

荷兰患者中有 62%、英国患者中有 47%在 12 个月内癫痫发作减少。英国患者的保留率更高(P=0.01),中度至重度智障患者的保留率更高,而荷兰队列中副作用更为明显。

结论

与非智障患者的估计值相当的癫痫发作减少率,为 PMP 对智障患者产生相似影响的证据提供了补充。从欧洲角度出发并在中心之间共享数据,可以帮助加强智障人群中抗癫痫药物处方的证据。

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