The Retention Rate of Treatment and Long-term Tolerability of the New Type of Antiepileptic Drugs_West China Medical Journal

Authors：

 LinXu ¹ , LuXiuying ¹ , WuXueying ¹ , HeJinyu ¹ , ZhouDong ²

1. Department of Neurology, AVIC 363 Hospital, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

New types of antiepileptic drug; Retention rate; Adverse effects; Tolerability

DOI：

10.7507/1002-0179.20160062

Video：

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Objective To evaluate the treatment retention rate of five new types of antiepileptic drugs:lamotrigine (LTG), topiramate (TPM), oxcarbazepine (OXC), levetiracetam (LEV) and gabapentin (GBP) and their tolerability. Methods A total of 216 patients diagnosed as epilepsy by receiving the long-term video electroencephalography monitoring between October 2012 and October 2014 were randomized into five drug treatment groups (LTG, n=57; TPM, n=42; OXC, n=49; LEV, n=47; GBP, n=21) and received corresponding dose of drug therapy. The seizure frequency, adverse events and number of patients giving up therapy were collected and recorded via phone or interview every 4 weeks. Every follow-up retention rate of every drug group equals current patient number continuing therapy/initial patient number of this drug group×100%. When the trial ended, Kaplan-Meier curve and Cox proportional risk model were applied for statistical analysis. Results The trial lasted for 106 weeks. The final retention rate of LTG was the highest (85.9%), and GBP was the lowest (14.3%). Most patients could continue the therapy until the end of the trial after 24 weeks. The leading causes of discontinuing therapy included:no efficacy, rash, sedation and aggressive behavior. Conclusion The retention rate of new types of antiepileptic drugs is associated with these elements:drug efficacy, adverse events, individual tolerability of drug, drug accessibility and the patients' individual preference of drug administration.

Citation： LinXu, LuXiuying, WuXueying, HeJinyu, ZhouDong. The Retention Rate of Treatment and Long-term Tolerability of the New Type of Antiepileptic Drugs. West China Medical Journal, 2016, 31(2): 225-229. doi: 10.7507/1002-0179.20160062 Copy

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1. Panayiotopoulos CP. The new ILAE report on terminology and concepts for the organization of epilepsies:critical review and contribution[J]. Epilepsia, 2012, 53(3):399-404.
2. Chung S, Wang N, Hank N. Comparative retention rates and long-term tolerabilityof new antiepileptic drugs[J]. Seizure, 2007, 16(4):296-304.
3. Eddy CM, Rickards HE, Cavanna AE. Behavioral adverse effects of antiepileptic drugs in epilepsy[J]. J Clin Psychopharmacol, 2012, 32(3):362-375.
4. Verrotti A, Prezioso G, Di Sabatino F, et al. The adverse event profile of levetiracetam:a meta-analysis on children and adults[J]. Seizure, 2015, 31(31):49-55.
5. Matsuo M, Fuji A, Matsuzaka T, et al. Effectiveness and safety of long-term levetiracetam treatment in patients with refractory epilepsy[J]. No To Hattatsu, 2015, 47(4):272-278.
6. Cramer JA, Mintzer S, Wheless J, et al. Adverse effects of antiepileptic drugs:a brief overview of important issues[J]. Expert Rev Neurother, 2010, 10(6):885-891.
7. Peltola J, Peltola M, Auvinen A, et al. Retention rates of new antiepileptic drugs in localization-related epilepsy:a single-center study[J]. Acta Neurol Scand, 2009, 119(1):55-60.
8. Bootsma HP, Ricker L, Hekster YA, et al. The impact of side effects on long-term retention in three new antiepileptic drugs[J]. Seizure, 2009, 18(5):327-331.
9. Molokwu OA, Ezeala-Adikaibe BA, Onwuekwe IO. Levetiracetam-induced rage and suicidality:two case reports and review of literature[J]. Epilepsy Behav Case Rep, 2015(4):79-81.
10. Chen B, Detyniecki K, Hirsch LJ, et al. Cross-sensitivity of patient-perceived adverse cognitive effects with antiepileptic drug use[J]. Epilepsy Behav, 2015, 46(46):151-157.
11. Simister RJ, Sander JW, Koepp MJ. Long-term retention rates of new antiepileptic drugs in adults with chronic epilepsy and learning disability[J]. Epilepsy Behav, 2007, 10(2):336-339.
12. Mills JK, Ruslan NE, Lewis TG, et al. Retention rate of Gabapentin in children with intractable epilepsies at 1 year[J]. Seizure, 2012, 21(1):28-31.
13. Werhahn KJ, Trinka E, Dobesberger J, et al. A randomized, double-blind comparison of antiepileptic drug treatment in the elderly with new-onset focal epilepsy[J]. Epilepsia, 2015, 56(3):450-459.
14. Arif H, Buchsbaum R, Pierro J, et al. Comparative effectiveness of 10 antiepileptic drugs in older adults with epilepsy[J]. Arch Neurol, 2010, 67(4):408-415.
15. Zhu F, Lang SY, Wang XQ, et al. Long-term effectiveness of antiepileptic drug monotherapy in partial epileptic patients:a 7-year study in an epilepsy center in China[J]. Chin Med J (Engl), 2015, 128(22):3015-3022.
16. Feng XF, Chen YX, Liu L, et al. Retention rates of levetiraceram in Chinese children and adolescents with epilepsy[J]. Eur J Paediatr Neurol, 2015, 19(2):143-148.

West China Medical Journal

The Retention Rate of Treatment and Long-term Tolerability of the New Type of Antiepileptic Drugs

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