JAMA Neurol:抗癫痫药物治疗耐受性研究

2020-02-25MedSciMedSci原创

二代抗癫痫药物的普及并没有改善总体治疗耐受性

耐受性是决定 癫痫治疗效果的关键因素,近日研究人员考察了抗癫痫药物(ASMS)耐受性不佳的有关因素,并考察耐受性随时间的变化。

研究在苏格兰开展,1982年7月至2012年10月期间新 诊断并治疗的1795名癫痫患者参与研究,进行单变量和多变量生存分析,考察潜在危险因素与不可耐受不良反应(AEs)之间的关系,并比较了3个时期(1982年7月至1992年6月、1992年7月至2002年6月和2002年7月至2016年4月)初始单药治疗不可耐受AE发生率。

患者中,男性969人(54.0%),平均年龄33岁。总计接受了3241份ASMs治疗,其中504份(15.6%)在6个月内因不可耐受的AEs停药。未满18岁 儿童的不可耐受AE率低于成年人(18-64岁:经调整的危险比[aHR],1.58;vs ≥65岁:aHR:1.90),而女性(aHR:1.60;)和5次以上癫痫预处理(aHR,1.24)人群的AE风险增加。对于单一ASM治疗,由于AEs(aHR:1.18)和先前其他ASMs(aHR:1.31)引起停药次数增加,导致不可耐受AEs风险增加。二代ASMs作为初始治疗的比例从22.3%上升到68.7%。在3个研究时期内,初始治疗的不能耐受AE率差异不显著。(10.1% vs 13.8% vs 14.0%)。

研究认为,二代抗癫痫药物的普及并没有改善总体治疗耐受性。

原始出处:

Bshra Ali A. Alsfouk et al. Tolerability of Antiseizure Medications in Individuals With Newly Diagnosed Epilepsy.JAMA Neurol. February 24, 2020.

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