A comparative study of effect of sodium valproate sustained-release tablets versus topiramate in newly diagnosed adult symptomatic epilepsy_Journal of Epilepsy

Authors：

XI Zhijie ¹ , CHENG Tao ² , SI Lili ³ , XIAO Xiaoqiang ³ , WU Dongmei ³ ,  SUN Hongbin ³

1. Department of Neurology, Chengdu No.8 People’s Hospital, Chengdu 610000, China;
2. Department of Neurology, Chengdu Sport University Affiliated Sports Hospital, Chengdu 610041, China;
3. Department of Neurology, Sichuan Province People’s Hospital, Chengdu 610041, China;

Corresponding author：

SUN Hongbin, Email: shb1369@aliyun.com

Keywords：

Newly diagnosed adult symptomatic epilepsy; Sodium valproate sustained release tablets; Topiramate; Curative effect; Quality of life

DOI：

10.7507/2096-0247.20180053

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Objective The study was performed to compare the efficacy and effect on quality of life of sodium valproate (VPA) sustained-release tablets versus topiramate (TPM) in newly diagnosed adult symptomatic epilepsy. Methods This is aprospective, randomized controlled trial on 200 patients newly diagnosed as adult symptomatic epilepsy in Sichuan Province People’s Hospital druing September 2014 to December 2016. The patients were randomly divided into VPA group (n=110) and TPM group (n=90). Then we evaluated the efficacy, retention rate, adverse reactions, and quality of life of the two groups after one year of treatment. Results The total effective rate of VPA group was 69.1%, and the rate of no seizures was 38.2%; the total effective rate of TPM was 62.2%, and the rate of no seizures was 42.2%. No statistically significant difference in the effective rate and no seizure rate was found between the two groups. There was no statistical difference in the retention rate between the two groups(69.1% vs. 65.6%, P>0.05) . The incidence of adverse reactions of VPA was significantly lower than that of TPM (9.1%vs. 20%, P<0.05). The quality of life of the two groups was significantly improved from baseline before treatment. VPA group showed significantly better performance than TPM group on mood and cognitive improvement (P<0.05). Conclusion ① There was no significant difference in efficacy and retention rate between VPA sustained-release tablet and TPM on adult patients with symptomatic epilepsy after one year's treatment; ② The incidence of adverse reactions of TPM group was significantly higher than that of VPA group; ③ VPA sustained-release tablets and TPM can significantly improve the overall quality of life of patients, and VPA sustained-release tablets is significantly better than topiramate on the improvement of emotional and cognitive function.

Citation： XI Zhijie, CHENG Tao, SI Lili, XIAO Xiaoqiang, WU Dongmei, SUN Hongbin. A comparative study of effect of sodium valproate sustained-release tablets versus topiramate in newly diagnosed adult symptomatic epilepsy. Journal of Epilepsy, 2018, 4(4): 324-329. doi: 10.7507/2096-0247.20180053 Copy

1.	Schmidt D, Sillanpaa M. Prevention of epilepsy: Issues and innovations. Curr Neurol Neurosci Rep, 2016, 16(11): 95.
2.	郭毅. 中国西部地区老年癫痫患者临床特征及治疗现状.西南医科大学, 硕士学位论文, 2016.
3.	贝政平. 内科疾病诊断标准. 北京: 科技出版社. 2001: 839-840, 842.
4.	Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 1981, 22(4): 489-501.
5.	Cramer JA, Perrine K, Devinsky O, et al. Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory. Epilepsia, 1998, 39(1): 81-88.
6.	任晓琳. 对成年癫痫患者生活质量量表的评价和修订. 中国人民解放军第一军医大学, 硕士学位论文, 2003.
7.	Wang FL, Gu XM, Hao BY, et al. Influence of marital status on the quality of life of Chinese adult patients with epilepsy. Chin Med J(Engl), 2017, 130(1): 83-87.
8.	McLean MJ, Macdonald RL. Sodium valproate, but not ethosuximide, produces use- and oltage-dependent limitation of high frequency repetitive firing of action potentials of mouse central neurons in cell culture. J Pharmacol Exp Ther, 1986, 237(3): 1001-1011.
9.	French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of the new antileptic drugs II: Treatment of refractory epilepsy. Neurology, 2004, 62(8), 1261-1273.
10.	Privitera MD, Brodie MJ, Mattson RH, et al. Topiramate, carbamazepine and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy. Acta Neurol Scand, 2003, 107(3): 165-175.
11.	Lai EC, Hsieh CY, Su CC, et al. Comparative persistence of antiepileptic drugs in patients with epilepsy: A STROBE-compliant retrospective cohort study. Medicine, 2016, 95(35): e4481.
12.	林旭, 卢秀英, 伍雪英, 等. 新型抗癫痫药物治疗保留率及长期耐受性的研究. 华西医学, 2016, 31(02): 225-229.
13.	Jalava M, Sillanpaa M. Concurrent illness in adult with childhoodonset epilepsy: a population-based 35-year follow-up study. Epilepsia, 1996, 37(12): 1155-1163.
14.	Jones JE, Hermann BP, Barry JJ, et al. Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy Behav, 2003, 4(Suppl 3): 31-38.
15.	Gur-Ozmen S, Leibetseder A, Cock HR, et al. Screening of anxiety and quality of life in people with epilepsy. Seizure, 2016, 45(11): 107-113.
16.	Lin CY. Using Hospital Anxiety and Depression Scale (HADS) on patients with epilepsy: Confirmatory factor analysis and Rasch models. Seizure, 2016, 45(11): 42-46.
17.	Loiselle KA, Ramsey RR, Rausch JR, et al. Trajectories of health-related quality of life among children with newly diagnosed epilepsy. J Pediatr Psychol, 2016, 41(9): 1011-1021.
18.	Pigott K, Galizia I, Vasudev K, et al. Topiramate for acute affective episodes in bipolar disorder in adults. Cochrane Database Syst Rev, 2016, 9(9): CD003384.
19.	Rajna P. Effects of antiepileptic drugs on mood of people with epilepsy. Ideggyogy Sz, 2007, 60(9-10): 381-391.
20.	Mula M. Negative effects of antiepileptic drugs on mood in patients with epilepsy. Drug Saf, 2007, 30(7): 555-567.
21.	Coppola G, Caliendo G, Veggiotti P, et al. Topiramate as add-on drug in children, adolescents and young adults with Lennox-Gastaut syndrome: An Italian multicentric study. Epilepsy Res, 2002, 51(1): 147-153.
22.	Guay DR. Newer antiepileptic drugs in the management of agitation/aggression in patients with dementia or developmental disability.Consult Pharm, 2007, 22(12): 1004-1034.
23.	Kuo SH. Topiramate in treatment of tourette syndrome. Clin Neuropharmacol, 2010, 33(1): 32-34.
24.	Martin P, Schreiner A, Rettig K, et al. Topiramate in patients with epilepsy and intellectual disability. Epilepsy Behav, 2009, 14(3): 496-502.
25.	Molina-Hernández M, Téllez-Alcántara NP, Olivera-López JI. Estrous cycle variation in anxiolytic-like effects of topiramate in Wistar rats in two animal models of anxiety-like behavior. Pharmacol Biochem Behav, 2013, 103(3): 631-636.
26.	Navarrete F, Pérez-Ortiz JM.Pregabalin- and topiramate-mediated regulation of cognitive and motor impulsivity in DBA/2 mice. Br J Pharmacol, 2012, 167(1): 183-195.
27.	Aldenkamp AP, Baker G, Mulder OG. A multicenter, randomized clinical study to evaluate the effect on cognitive function of topiramate compared with valproate as add-on therapy to carbamazepine in patients with partial-onset seizures. Epilepsia, 2000, 41(9), 1167-1178.
28.	Sarangi SC, Kakkar AK, Kumar R, et al. Effect of lamotrigine, levetiracetam & topiramate on neurobehavioural parameters & oxidative stress in comparison with valproate in rats. Indian J Med Res, 2016, 144(1): 104-111.
29.	Baeta E, Santana I, Castro G, et al. Cognitive effects of therapy with topiramate in patients with refractory partial epilepsy. Rev Neurol, 2002, 34(8), 737-741.
30.	Pietrzak B, Konopka A, Wojcieszak J. Effect of topiramate on hippocampus-dependent spatial memory in rats. Pharmacol Rep, 2013, 65(5): 1152-1162.
31.	Tang Y, Xia W, Yu X, et al. Altered cerebral activity associated with topiramate and its withdrawal in patients with epilepsy with language impairment: An fMRI study using the verb generation task. Epilepsy Behav, 2016, 59: 98-104.
32.	Szaflarski JP. Topiramate and its effect on fMRI of language in patients with right or left temporal lobe epilepsy. Epilepsy Behav, 2012, 24(1): 74-80.

1. Schmidt D, Sillanpaa M. Prevention of epilepsy: Issues and innovations. Curr Neurol Neurosci Rep, 2016, 16(11): 95.
2. 郭毅. 中国西部地区老年癫痫患者临床特征及治疗现状.西南医科大学, 硕士学位论文, 2016.
3. 贝政平. 内科疾病诊断标准. 北京: 科技出版社. 2001: 839-840, 842.
4. Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 1981, 22(4): 489-501.
5. Cramer JA, Perrine K, Devinsky O, et al. Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory. Epilepsia, 1998, 39(1): 81-88.
6. 任晓琳. 对成年癫痫患者生活质量量表的评价和修订. 中国人民解放军第一军医大学, 硕士学位论文, 2003.
7. Wang FL, Gu XM, Hao BY, et al. Influence of marital status on the quality of life of Chinese adult patients with epilepsy. Chin Med J(Engl), 2017, 130(1): 83-87.
8. McLean MJ, Macdonald RL. Sodium valproate, but not ethosuximide, produces use- and oltage-dependent limitation of high frequency repetitive firing of action potentials of mouse central neurons in cell culture. J Pharmacol Exp Ther, 1986, 237(3): 1001-1011.
9. French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of the new antileptic drugs II: Treatment of refractory epilepsy. Neurology, 2004, 62(8), 1261-1273.
10. Privitera MD, Brodie MJ, Mattson RH, et al. Topiramate, carbamazepine and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy. Acta Neurol Scand, 2003, 107(3): 165-175.
11. Lai EC, Hsieh CY, Su CC, et al. Comparative persistence of antiepileptic drugs in patients with epilepsy: A STROBE-compliant retrospective cohort study. Medicine, 2016, 95(35): e4481.
12. 林旭, 卢秀英, 伍雪英, 等. 新型抗癫痫药物治疗保留率及长期耐受性的研究. 华西医学, 2016, 31(02): 225-229.
13. Jalava M, Sillanpaa M. Concurrent illness in adult with childhoodonset epilepsy: a population-based 35-year follow-up study. Epilepsia, 1996, 37(12): 1155-1163.
14. Jones JE, Hermann BP, Barry JJ, et al. Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy Behav, 2003, 4(Suppl 3): 31-38.
15. Gur-Ozmen S, Leibetseder A, Cock HR, et al. Screening of anxiety and quality of life in people with epilepsy. Seizure, 2016, 45(11): 107-113.
16. Lin CY. Using Hospital Anxiety and Depression Scale (HADS) on patients with epilepsy: Confirmatory factor analysis and Rasch models. Seizure, 2016, 45(11): 42-46.
17. Loiselle KA, Ramsey RR, Rausch JR, et al. Trajectories of health-related quality of life among children with newly diagnosed epilepsy. J Pediatr Psychol, 2016, 41(9): 1011-1021.
18. Pigott K, Galizia I, Vasudev K, et al. Topiramate for acute affective episodes in bipolar disorder in adults. Cochrane Database Syst Rev, 2016, 9(9): CD003384.
19. Rajna P. Effects of antiepileptic drugs on mood of people with epilepsy. Ideggyogy Sz, 2007, 60(9-10): 381-391.
20. Mula M. Negative effects of antiepileptic drugs on mood in patients with epilepsy. Drug Saf, 2007, 30(7): 555-567.
21. Coppola G, Caliendo G, Veggiotti P, et al. Topiramate as add-on drug in children, adolescents and young adults with Lennox-Gastaut syndrome: An Italian multicentric study. Epilepsy Res, 2002, 51(1): 147-153.
22. Guay DR. Newer antiepileptic drugs in the management of agitation/aggression in patients with dementia or developmental disability.Consult Pharm, 2007, 22(12): 1004-1034.
23. Kuo SH. Topiramate in treatment of tourette syndrome. Clin Neuropharmacol, 2010, 33(1): 32-34.
24. Martin P, Schreiner A, Rettig K, et al. Topiramate in patients with epilepsy and intellectual disability. Epilepsy Behav, 2009, 14(3): 496-502.
25. Molina-Hernández M, Téllez-Alcántara NP, Olivera-López JI. Estrous cycle variation in anxiolytic-like effects of topiramate in Wistar rats in two animal models of anxiety-like behavior. Pharmacol Biochem Behav, 2013, 103(3): 631-636.
26. Navarrete F, Pérez-Ortiz JM.Pregabalin- and topiramate-mediated regulation of cognitive and motor impulsivity in DBA/2 mice. Br J Pharmacol, 2012, 167(1): 183-195.
27. Aldenkamp AP, Baker G, Mulder OG. A multicenter, randomized clinical study to evaluate the effect on cognitive function of topiramate compared with valproate as add-on therapy to carbamazepine in patients with partial-onset seizures. Epilepsia, 2000, 41(9), 1167-1178.
28. Sarangi SC, Kakkar AK, Kumar R, et al. Effect of lamotrigine, levetiracetam & topiramate on neurobehavioural parameters & oxidative stress in comparison with valproate in rats. Indian J Med Res, 2016, 144(1): 104-111.
29. Baeta E, Santana I, Castro G, et al. Cognitive effects of therapy with topiramate in patients with refractory partial epilepsy. Rev Neurol, 2002, 34(8), 737-741.
30. Pietrzak B, Konopka A, Wojcieszak J. Effect of topiramate on hippocampus-dependent spatial memory in rats. Pharmacol Rep, 2013, 65(5): 1152-1162.
31. Tang Y, Xia W, Yu X, et al. Altered cerebral activity associated with topiramate and its withdrawal in patients with epilepsy with language impairment: An fMRI study using the verb generation task. Epilepsy Behav, 2016, 59: 98-104.
32. Szaflarski JP. Topiramate and its effect on fMRI of language in patients with right or left temporal lobe epilepsy. Epilepsy Behav, 2012, 24(1): 74-80.

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