hepurposeofthisreportwastoupdatethe2006InternationalLeagueAgainstEpilepsy(ILAE)reportandidentifythelevelofevidenceforlong-termefficacyoreffectivenessforantiepilepticdrugs(AEDs)asinitialmonotherapyforpatientswithnewlydiagnosedoruntreatedepilepsy.AllapplicablearticlesfromJuly2005untilMarch2012wereidentified,evaluated,andcombinedwiththepreviousysis(Glauseretal.,2006)toprovideacomprehensiveupdate.
Thepriorysismethodologywasutilizedwiththreemodifications:(1)thedetectablenoninferiorityboundaryapproachwasdroppedandbothfailedsuperioritystudiesandprespecifiednoninferioritystudieswereyzedusinganoninferiorityapproach,(2)thedefinitionofanadequatecomparatorwasclarifiedandnowincludesanabsoluteminimumpointestimateforefficacy/effectiveness,and(3)therelationshiptablebetweenclinicaltrialratings,levelofevidence,andconclusionsnolongerincludesarecommendationcolumntoreinforcethatthisreviewofefficacy/evidenceforspecificseizuretypesdoesnotimplytreatmentrecommendations.
Thisevidencereviewcontainsoneclarification:ThecommissionhasdeterminedthatclassIsuperioritystudiescanbedesignedtodetectuptoa20?solute(ratherthanrelative)differenceinthepointestimateofefficacy/effectivenessbetweenstudytreatmentandcomparatorusinganintent-to-treatysis.SinceJuly,2005,threeclassIrandomizedcontrolledtrials(RCT)and11classIIIRCTshebeenpublished.Thecombinedysis(1940-2012)nowincludesatotalof64RCTs(7withclassIevidence,2withclassIIevidence)and11meta-yses.
Newefficacy/effectivenessfindingsincludethefollowing:levetiracetamandzonisamidehelevelAevidenceinswithpartialonsetseizuresandbothethosuximideandvalproicacidhelevelAevidenceinchildrenwithchildhoodabsenceepilepsy.
Therearenomajorchangesinthelevelofevidenceforanyothersubgroup.LevetiracetamandzonisamidejoincarbamazepineandphenytoinwithlevelAefficacy/effectivenessevidenceasinitialmonotherapyforswithpartialonsetseizures.AlthoughethosuximideandvalproicacidnowhelevelAefficacy/effectivenessevidenceasinitialmonotherapyforchildrenwithabsenceseizures,therecontinuestobeanalarminglackofwelldesigned,properlyconductedepilepsyRCTsforpatientswithgeneralizedseizures/epilepsiesandinchildreningeneral.
Thesefindingsreinforcetheneedformulticenter,multinationaleffortstodesign,conduct,andyzefutureclinicallyrelevantadequatelydesignedRCTs.Whenselectingapatient'sAED,allrelevantvariablesandnotjustefficacyandeffectivenessshouldbeconsidered.
查看信源地址
编辑:jiang- 2022-04-20吡仑帕奈借助于用药可改善部分发作型癫痫患者的症状
- 2022-04-13病例学习:伴皮层下囊肿的巨脑性脑白质病
- 2022-04-12FDA批准开浦兰治疗1个月至4岁癫痫儿童
- 2022-04-11癫痫猝死:凶手是谁?
- 2022-04-11抗癫痫药物预防新发癫痫:任重而道远
- 2022-04-07癫痫治疗障碍仍难以克服
- FDA批准开浦兰治疗1个月至4岁癫痫儿童
- 癫痫猝死:凶手是谁?
- 抗癫痫药物预防新发癫痫:任重而道远
- 癫痫治疗障碍仍难以克服
- GW制药Epidiolex治疗Dret综合征获得欧盟孤儿药资格
- 2013国际抗癫痫联合会抗癫痫药用指南
- FDA批准Aptiom用于治疗患者癫痫发作
- 综述:癫痫持续状态诊治最新进展
- 癫痫的治疗方法 中医拔罐治疗癫痫的小方法(2)
- 心理百科:春节期间小心疾病
- 癫痫患者手术评估新型工具
- 癫痫发作对中风患者静脉溶栓的长期转移有效
- 癫痫的检查诊断方法有哪些 癫痫的检查费用高?
- 2015 神经系统疾病诊疗进展
- NeuroImage:纤维球成像可用于癫痫的进展
- 继发性癫痫能治愈吗 治疗癫痫有几个步骤
- 不注意这些问题,吃多少药都没用!
- 特发性癫痫大发作药物治疗的首选
- 三庚酸酯可治疗1型转运体缺陷综合征
- 第四届全国临床脑电图实践基础理论与实践操作培训班
- 英国竞争监管机构指控辉瑞癫痫药品价格过高
- 月经性癫痫患者妊娠期癫痫控制更好
- Circ Ep:左室肥厚高血压患者新发房颤增加SCD风险
- 羊角病能生孩子吗?
- Medpage Today:不同类型的抗癫痫药物更有利
- 上海率先探索异地就医门诊费直接结算
- 上海率先探索异地求医门诊费用直接结算
- 佩带只手表就能测癫痫发作?智能穿佩带设备太牛了
- 治疗癫痫病比较好的小儿
- 孩子癫痫有规律发作,可能是家长在治疗的过程之中做错了这几点
- 癫痫病发病根本是怎么回事
- 心率多少而今正常 如何维持正常心率不变
- 癫痫病持续发作的病症
- 人脑或存在两种短时记忆系统
- 2016AAN:中枢神经系统专家发表具有前景的专业见解
- 治疗法腹型癫痫病需要多少钱
- 中风癫痫病怎么治疗比较快
- 癫痫病爱吃什么可以控制
- 后天以前癫痫病症状能治疗吗
- 癫痫病长时间发作都有哪些病因