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氟苯丙胺治疗德拉维综合征:德国、西班牙、意大利和英国的患者、照顾者和家庭生活质量的照顾者和临床医生报告的益处。

Fenfluramine treatment for Dravet syndrome: Caregiver- and clinician-reported benefits on the quality of life of patients, caregivers, and families living in Germany, Spain, Italy, and the United Kingdom.

机构信息

Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA.

Zogenix Limited, now a part of UCB, Medical Affairs, 5858 Horton Street, Suite 455, Emeryville, CA 94608, USA.

出版信息

Epilepsy Res. 2023 Feb;190:107091. doi: 10.1016/j.eplepsyres.2023.107091. Epub 2023 Jan 15.

Abstract

OBJECTIVE

Clinical trial data and prior preliminary research indicate that fenfluramine (FFA) provides meaningful improvements in seizure-related and quality of life (QOL) outcomes for individuals with Dravet syndrome (DS), their caregivers, and their families. This study sought to replicate and extend these preliminary findings in a new sample of individuals with DS and their families who live in European countries.

METHODS

Study participants were European clinicians and parents caring for individuals with DS who had participated in an EU FFA Early Access Program. Participants completed one-on-one semi-structured interviews and were asked the extent to which they noticed changes in a number of the child's seizure- and non-seizure-related QOL domains after starting FFA treatment. Participants were also asked about the benefits of FFA treatment to the caregivers' lives and for the family unit.

RESULTS

25 parent caregivers and 16 clinicians participated. The caregivers and clinicians reported improvements in both seizure-related (i.e., reductions in seizure activity, improvements in the frequency or type of seizure triggers and post-ictal recovery times, and improved post-seizure function) and non-seizure-related (e.g., cognition, focus, alertness, speech, academic performance, behavior, sleep, motor function) QOL domains after FFA treatment in individuals with DS. Caregivers also reported improved mood and more time for things they enjoyed, felt less overwhelmed, reported better sleep quality, and had less personal and family stress; clinicians corroborated most of these reports. All clinicians (100%) and most (96%) caregivers said they would "very likely" or "quite likely" recommend FFA to others with DS.

CONCLUSIONS

Real-world experience in Europe with FFA treatment is associated with meaningful improvements in many QOL domains for individuals with DS and their families; replicating findings from a previous study of DS patients and their families from the USA. Caregivers and clinicians provided specific examples of the benefits of FFA for people with DS, caregivers, and their families and are very likely to recommend FFA to others with DS.

摘要

目的

临床试验数据和先前的初步研究表明,芬氟拉明(FFA)可显著改善德拉维特综合征(DS)患者及其照护者和家庭的与癫痫发作相关的生活质量(QOL)和整体生活质量(QOL)结果。本研究旨在通过来自欧洲国家的 DS 患者及其家庭的新样本复制和扩展这些初步发现。

方法

研究参与者为参与欧盟 FFA 早期准入计划的欧洲临床医生和照顾 DS 患者的父母。参与者完成了一对一的半结构化访谈,并被问及在开始 FFA 治疗后,他们注意到孩子的一些与癫痫发作无关的 QOL 领域的变化程度。参与者还被问及 FFA 治疗对照护者生活和家庭单位的好处。

结果

共有 25 名家长和 16 名临床医生参与了这项研究。照护者和临床医生报告称,DS 患者在 FFA 治疗后,癫痫发作相关(即癫痫发作活动减少、癫痫发作诱因的频率或类型以及癫痫发作后恢复时间改善,以及癫痫发作后功能改善)和非癫痫发作相关(如认知、注意力、警觉性、言语、学业成绩、行为、睡眠、运动功能)的 QOL 领域均有所改善。照护者还报告称,他们的情绪改善了,有更多时间做自己喜欢的事情,感到不那么不知所措,睡眠质量提高了,个人和家庭压力减轻了;临床医生证实了这些报告中的大部分。所有临床医生(100%)和大多数(96%)照护者表示,他们“很可能”或“很可能”向其他 DS 患者推荐 FFA。

结论

在欧洲使用 FFA 治疗的实际经验与 DS 患者及其家庭的许多 QOL 领域的显著改善相关;这与美国以前对 DS 患者及其家庭的研究结果一致。照护者和临床医生提供了 FFA 对 DS 患者、照护者及其家庭的具体益处的例子,他们非常可能向其他 DS 患者推荐 FFA。

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