Therapeutic drug monitoring of newer generation antiseizure medications at the point of treatment failure.

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License: CC BY 4.0
Serval ID
serval:BIB_3FCED610441B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Therapeutic drug monitoring of newer generation antiseizure medications at the point of treatment failure.
Journal
Seizure
Author(s)
Fluckiger P., Aícua-Rapún I., André P., Rossetti A.O., Decosterd L.A., Buclin T., Novy J.
ISSN
1532-2688 (Electronic)
ISSN-L
1059-1311
Publication state
Published
Issued date
01/2022
Peer-reviewed
Oui
Volume
94
Pages
66-69
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The benefit of therapeutic drug monitoring (TDM) of newer generation antiseizure medications (ASM) has been little studied. A recent randomized study suggested that TDM at each medical visit did not bring a significant benefit, but the study did not investigate TDM in cases of treatment failure. Accordingly, we realized a post hoc analysis of this trial.
We analyzed 282 TDMs in 136 patients. We compared TDM performed at visits after treatment failure versus without treatment failure, reporting the proportion of drug levels out of range and the prescriber's adherence to dosage recommendations according to measured drug levels.
There was no statistical difference in terms of proportion of out of range plasma drug levels (47% vs 50%, p = 0.7) or adherence of prescribers to the clinical pharmacologists' dosage recommendations (21% vs 30%, p = 0.6) between visits after treatment failure and visits without treatment failure, respectively. Knowledge of prior drug levels did not modify the results.
Systematic TDM at appointments following treatment failure showed similar results to TDM at visits without treatment failure. The prescribers' adherence with dosage recommendations was low in both cases. It is not clear whether better prescriber adherence would improve patient outcome. Furthermore, the ability to detect poor patient compliance is limited in a planned outpatient appointment. The study setting does not reflect on the general usefulness of TDM.
Keywords
Drug Monitoring, Humans, Treatment Failure, Antiepileptic drugs, Antiseizure drugs
Pubmed
Web of science
Open Access
Yes
Create date
10/12/2021 17:36
Last modification date
15/01/2022 7:31
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