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癫痫患儿中苯巴比妥与左乙拉西坦交叉反应性的研究:一项前瞻性、观察性多中心研究。

Investigation of cross-reactivity between phenobarbital and levetiracetam in children with epilepsy: A prospective, observational multicenter study.

作者信息

Rahimi Samane, Danaei Bardia, Nasehi Mohammad Mehdi, Saket Sasan, Farahbakhsh Nazanin, Rajabnejad Maryam, Taghdiri Mohammad Mehdi

机构信息

Department of Pediatric Emergency Medicine, School of Medicine, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Epilepsy Behav Rep. 2023 Jan 11;21:100583. doi: 10.1016/j.ebr.2023.100583. eCollection 2023.

Abstract

OBJECTIVES

Pharmaceutical allergic reactions due to antiseizure medications (ASMs) are one of the major concerns in the management of patients. Finding an alternative ASM which does not cause allergic reactions and has acceptable effectiveness can be difficult. In this regard, the present study attempts to investigate the cross-reactivity between phenobarbital and levetiracetam in children under treatment for seizure control.

MATERIALS & METHODS: The present study is a prospective, observational independent assessor study. 30 children with epilepsy who were hypersensitive to phenobarbital therapy were studied. In order to evaluate the cross-reactivity of the drugs, levetiracetam replaced phenobarbital to control seizure. Within 6 months, any allergic reactions and seizure recurrences were evaluated in the patients.

RESULTS

53 % of the children in this study were female. The mean age of patients was 42.4 months. In patients' follow up no cross-reactive responses were observed in any of the patients. Seizure recurrence rate was 30 % in the first six months of follow up that with increasing dosage in the second six months of follow-up, decreased to 10 %.

CONCLUSION

Based on the results of this study, in children with epilepsy controlled by phenobarbital if allergic reactions to phenobarbital occur, levetiracetam may be used as a suitable alternative medicine.

摘要

目的

抗癫痫药物(ASMs)引起的药物过敏反应是患者管理中的主要问题之一。找到一种不会引起过敏反应且有效性可接受的替代抗癫痫药物可能很困难。在这方面,本研究试图调查苯巴比妥和左乙拉西坦在接受癫痫控制治疗的儿童中的交叉反应性。

材料与方法

本研究是一项前瞻性、观察性独立评估者研究。研究了30名对苯巴比妥治疗过敏的癫痫儿童。为了评估药物的交叉反应性,用左乙拉西坦替代苯巴比妥来控制癫痫发作。在6个月内,对患者的任何过敏反应和癫痫复发情况进行评估。

结果

本研究中53%的儿童为女性。患者的平均年龄为42.4个月。在患者随访中,未观察到任何患者有交叉反应。随访前六个月癫痫复发率为30%,在随访的后六个月随着剂量增加,复发率降至10%。

结论

基于本研究结果,在由苯巴比妥控制癫痫的儿童中,如果发生对苯巴比妥的过敏反应,左乙拉西坦可作为合适的替代药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f90a/9851852/f06fc41d80d1/gr1.jpg

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