左乙拉西坦治疗儿童癫痫的疗效和安全性。
Efficacy and Safety of Levetiracetam for Childhood Epilepsies.
机构信息
Department of Child neurology, Paediatric Clinic, Clinical Center University of Sarajevo.
出版信息
Med Arch. 2024;78(2):122-126. doi: 10.5455/medarh.2024.78.122-126.
BACKGROUND
Levetiracetam (LEV) is a broad spectrum second-generation antiepileptic drug (AED).
OBJECTIVE
The objective of the study was to investigate the efficacy and safety of levetiracetam for childhood epilepsies.
METHODS
This is single, tertiary centre observational, prospective study, that included paediatric patients who were treated with levetiracetam at Paediatric hospital University Clinical Centre Sarajevo, during the period of 15 years (2008-2022). Inclusion criteria were: paediatric patients age > 1 month, diagnosed with epilepsy according to International League Against Epilepsy. After the introduction of levetiracetam, each patient has been followed up at least 12 months. According to the outcome the patients were divided into 5 groups: seizure reduction >50%, seizure reduction <50%, complete seizure freedom, the same number of seizures and increased number of seizures. From these groups two intergroups have been formed: responders (seizure reduction >50% and complete seizure freedom) and non-responders (seizure reduction <50%, the same number of seizures and increased number of seizures).
RESULTS
The study enrolled 259 patients (141 female and 118 male), with mean age 7 years (3,0-12.0). Comorbidities were present at 129/259 (49.8%) patients. After 12 months of treatment, 25/259 (9.7%) patients had seizure reduction >50%, 30/259 (11.6%) patients had seizure reduction <50%, 154/259 (56.5%) patients had achieved seizure freedom, 31/259 (12%) patients had same number of seizures, while 19/259 (7.3%) patients had increased number of seizures. Seizure frequency between responders and non-responders, before treatment and after 12 months of treatment was statistically significant (p<0.001).
DISCUSSION
Non responders had the best outcome with ditherapy (30/79; 38%), while responders had the best outcome with monotherapy (161/180;89.4%).
CONCLUSION
Levetiracetam is efficient antiepileptic drug for different types of epilepsies in childhood, used as mono, di or polytherapy.
背景
左乙拉西坦（LEV）是一种广谱第二代抗癫痫药物（AED）。
目的
本研究旨在探讨左乙拉西坦治疗儿童癫痫的疗效和安全性。
方法
这是一项单中心、三级前瞻性观察研究，纳入了 2008 年至 2022 年期间在萨拉热窝大学临床中心儿科医院接受左乙拉西坦治疗的儿科患者。纳入标准为：年龄>1 个月的儿科患者，根据国际抗癫痫联盟诊断为癫痫。引入左乙拉西坦后，每位患者至少随访 12 个月。根据结果，患者分为 5 组：癫痫发作减少>50%、癫痫发作减少<50%、完全无癫痫发作、癫痫发作次数相同和癫痫发作次数增加。从这些组中形成了两个亚组：应答者（癫痫发作减少>50%和完全无癫痫发作）和无应答者（癫痫发作减少<50%、癫痫发作次数相同和癫痫发作次数增加）。
结果
该研究纳入了 259 名患者（141 名女性和 118 名男性），平均年龄为 7 岁（3.0-12.0）。129/259（49.8%）名患者存在合并症。治疗 12 个月后，25/259（9.7%）名患者癫痫发作减少>50%，30/259（11.6%）名患者癫痫发作减少<50%，154/259（56.5%）名患者无癫痫发作，31/259（12%）名患者癫痫发作次数相同，19/259（7.3%）名患者癫痫发作次数增加。治疗前和治疗 12 个月后，应答者和无应答者之间的癫痫发作频率有统计学意义（p<0.001）。
讨论
非应答者的最佳治疗效果是三联治疗（30/79；38%），而应答者的最佳治疗效果是单药治疗（161/180；89.4%）。
结论
左乙拉西坦是一种有效的抗癫痫药物，可用于儿童的各种类型癫痫，可作为单药、联合或多药治疗。
Zotero 插件