Newer antiepileptic drugs in the treatment of status epilepticus: impact on prognosis

Details

Ressource 1Download: BIB_2A5B6F8B80C1.P001.pdf (123.87 [Ko])
State: Public
Version: After imprimatur
Serval ID
serval:BIB_2A5B6F8B80C1
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Newer antiepileptic drugs in the treatment of status epilepticus: impact on prognosis
Author(s)
Jaques L.
Director(s)
Rossetti A.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2011
Language
english
Number of pages
12
Abstract
Background: Newer antiepileptic drugs (AED) are increasingly prescribed, and seem to have a comparable efficacy as the classical AED, but are better tolerated. Very scarce data exist regarding their prognostic impact in patients with status epilepticus (SE). We therefore analyzed the evolution of prescription of newer AED between 2006-2010 in our prospective SE database, and assessed their impact on SE prognosis.¦Methods: We found 327 SE episodes occurring in 271 adults. The use of older versus newer AED (levetiracetam, pregabalin, topiramate, lacosamide) and its relationship to outcome (return to clinical baseline conditions, new handicap, or death) were analyzed. Logistic regression models were applied to adjust for known SE outcome predictors.¦Results: We observed an increasing prescription of newer AED over time (30% of patients received them at the study beginning, vs. 42% towards the end). In univariate analyses, patients treated with newer AED had worse outcome than those treated with classical AED only (19% vs 9% for mortality; 33% vs 64% for return to baseline, p<0.001). After adjustment for etiology and SE severity, use of newer AED was independently related to a reduced likelihood of return to baseline (p<0.001), but not to increased mortality.¦Conclusion: This retrospective study shows an increase of the use of newer AED for SE treatment, but does not suggest an improved prognosis following their prescription. Also in view of their higher price, well-designed, prospective assessments analyzing their impact on efficacy and tolerability should be conducted before a widespread use in SE.
Keywords
levetiracetam, topiramate, pregabaline, lacosamide, outcome, mortality
Create date
21/05/2012 10:21
Last modification date
20/08/2019 13:10
Usage data