Lebedeva A V, Burd S G, Rubleva Yu V, Pantina N V, Yurchenko A V, Bogomazova M A, Kovaleva I I
Federal Center of Brain and Neurotechnologies, Moscow, Russia.
Pirogov Russian National Research Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(7):89-97. doi: 10.17116/jnevro202412407189.
To evaluate the experience of prescribing phenosanic acid in the practice of a neurologist/epileptologist when prescribing the second, third anticonvulsant drug (AED) as part of combination therapy for patients with manifestations of fatigue due to epilepsy.
501 patients with focal epilepsy accompanied by asthenic disorders were included in the observational program. The observation program protocol included 5 visits, including visit 1, at which screening and inclusion in the OP took place. The observation period was 10 months. At baseline and at the end of the 10-month follow-up, the patients' condition was assessed according to the following indicators: frequency and transformation of attacks with focal onset, severity of fatigue (self-assessment scale MFI-20); quality of life (questionnaire QoLiE-10-P); frequency of attacks with focal onset. The safety of phenosanic acid (Dibufelon) was also assessed.
In 10 months after the inclusion of Dibufelon as the 2nd, 3rd AED in the treatment regimen, a statistically significant (<0.01) decrease in the frequency of seizures was observed: in general - in 88% of patients; by 50% or more - in 76% of patients; transition from the group with a large number of seizures to the group with a smaller number of seizures - 74% of patients. Also when taking phenosanic acid, a positive dynamics of seizure type was noted: a reliable decrease in the proportion of patients with seizures with secondary generalization from 70% to 56%; a decrease in the number of focal seizures with impaired consciousness from 65% to 53%. In addition, there was a 38% decrease in the severity of fatigue on the MFI-20 scale (the greatest decrease on the «Mental fatigue» scale), improvement in the quality of life - a 2.7-fold increase in the mean values of the QOLIE-10 questionnaire.
The addition of phenosanic acid to antiepileptic therapy as a second or third AED allows for better control of seizures, leading to a decrease the frequency and severity of attacks and the severity of fatigue both, and an increase of the quality of life of patients with epilepsy.
评估神经科医生/癫痫专家在为癫痫所致疲劳患者进行联合治疗时,将苯磺酸作为第二种、第三种抗惊厥药物(AED)处方的经验。
501例伴有虚弱障碍的局灶性癫痫患者纳入观察项目。观察项目方案包括5次就诊,其中第1次就诊进行筛查并纳入观察项目。观察期为10个月。在基线期和10个月随访结束时,根据以下指标评估患者状况:局灶性发作的频率和转变、疲劳严重程度(MFI-20自我评估量表);生活质量(QoLiE-10-P问卷);局灶性发作的频率。还评估了苯磺酸(地布氟龙)的安全性。
在将地布氟龙作为第二种、第三种AED纳入治疗方案后的10个月内,观察到癫痫发作频率有统计学意义(<0.01)的下降:总体而言,88%的患者发作频率下降;下降50%或更多的患者占76%;从发作次数多的组转变为发作次数少的组的患者占74%。服用苯磺酸时,还注意到癫痫发作类型有积极变化:继发性全身性发作患者比例从70%可靠下降至56%;意识障碍性局灶性发作次数从65%下降至53%。此外,MFI-20量表上的疲劳严重程度下降了38%(“精神疲劳”量表下降幅度最大),生活质量得到改善——QOLIE-10问卷平均值增加了2.7倍。
在抗癫痫治疗中添加苯磺酸作为第二种或第三种AED可更好地控制癫痫发作,降低发作频率和严重程度以及疲劳严重程度,提高癫痫患者的生活质量。