Newer Antiepileptic Drugs in Status Epilepticus: Prescription Trends and Outcomes in Comparison with Traditional Agents.

Détails

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Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_36D08836A6EF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Newer Antiepileptic Drugs in Status Epilepticus: Prescription Trends and Outcomes in Comparison with Traditional Agents.
Périodique
CNS drugs
Auteur(s)
Beuchat I., Novy J., Rossetti A.O.
ISSN
1179-1934 (Electronic)
ISSN-L
1172-7047
Statut éditorial
Publié
Date de publication
04/2017
Peer-reviewed
Oui
Volume
31
Numéro
4
Pages
327-334
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
Newer antiepileptic drugs (AEDs) are increasingly prescribed; however, relatively limited data are available regarding their use in status epilepticus (SE) and the impact on outcome.
The aim of this study was to explore the evolution in prescription patterns of newer and traditional AEDs in this clinical setting, and their association with prognosis.
We analyzed our prospective adult SE registry over a 10-year period (2007-2016) and assessed the yearly use of newer and traditional AEDs and their association with mortality, return to baseline conditions at discharge, and SE refractoriness, defined as treatment resistance to two AEDs, including benzodiazepines.
In 884 SE episodes, corresponding to 719 patients, the prescription of at least one newer AED increased from 0.38 per SE episode in 2007 to 1.24 per SE episode in 2016 (mostly due to the introduction of levetiracetam and lacosamide). Traditional AEDs (excluding benzodiazepines) decreased over time from 0.74 in 2007 to 0.41 in 2016, correlating with the decreasing use of phenytoin. The prescription of newer AEDs was independently associated with a lower chance of return to baseline conditions at discharge (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.40-0.84) and a higher rate of SE refractoriness (OR 19.84, 95% CI 12.76-30.84), but not with changes in mortality (OR 1.08, 95% CI 0.58-2.00).
We observed a growing trend in the prescription of newer AEDs in SE over the last decade; however, our findings might suggest an associated increased risk of SE refractoriness and new disability at hospital discharge. Pending prospective, comparative studies, this may justify some caution in the routine use of newer AEDs in SE.

Mots-clé
Adult, Aged, Aged, 80 and over, Anticonvulsants/therapeutic use, Cohort Studies, Female, Humans, Male, Middle Aged, Practice Patterns, Physicians'/trends, Prognosis, Registries, Retrospective Studies, Status Epilepticus/drug therapy, Status Epilepticus/physiopathology, Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
04/04/2017 19:19
Dernière modification de la notice
20/08/2019 14:24
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