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Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy
Idiopathic Generalized Epilepsy (IGE) patients may not achieve optimal seizure control with monotherapy. Our goal was to evaluate the efficacy of combination therapy in a retrospective series of IGE patients receiving different antiseizure medication (ASM) regimens. We retrospectively identified all...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296520/ https://www.ncbi.nlm.nih.gov/pubmed/35854146 http://dx.doi.org/10.1038/s41598-022-16718-x |
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author | Pipek, Leonardo Zumerkorn Pipek, Henrique Zumerkorn Castro, Luiz Henrique Martins |
author_facet | Pipek, Leonardo Zumerkorn Pipek, Henrique Zumerkorn Castro, Luiz Henrique Martins |
author_sort | Pipek, Leonardo Zumerkorn |
collection | PubMed |
description | Idiopathic Generalized Epilepsy (IGE) patients may not achieve optimal seizure control with monotherapy. Our goal was to evaluate the efficacy of combination therapy in a retrospective series of IGE patients receiving different antiseizure medication (ASM) regimens. We retrospectively identified all patients with adolescence onset IGE with typical clinical and EEG features from a single epilepsy specialist clinic from 2009 to 2020. We evaluated long-term seizure control, for VPA, LEV, LTG mono and combination therapy. We studied 59 patients. VPA was more commonly used in men (84%) than in women (44%) (p < 0.05). VPA was the initial drug of choice in 39% of patients, followed by LEV (22%) and LTG (14.9%). Thirty-nine patients (66.1%) achieved complete seizure control for at least one year. Fifty patients (84.7)% had partial control, without GTC occurrence, for at least one year. VPA was superior to LTG for complete seizure control (p = 0.03), but not for minor seizure control or pseudoresistance (p > 0.05). Combination therapy was superior to LEV and LTG monotherapy for complete control (p = 0.03), without differences for minor seizures and pseudoresistance outcomes (p > 0.05). Combination therapy not including VPA was also non-inferior to VPA monotherapy in all settings. Combination therapy was superior to LTG and LEV monotherapy in IGE, and may be equally effective including or not VPA. Combination therapy including LTG, LEV, and/or VPA is an effective treatment option after monotherapy failure with one of these ASM in IGE. Dual therapy with LEV–LTG should be considered in monotheraphy failure, to avoid fetal effects of in utero VPA exposure. |
format | Online Article Text |
id | pubmed-9296520 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-92965202022-07-21 Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy Pipek, Leonardo Zumerkorn Pipek, Henrique Zumerkorn Castro, Luiz Henrique Martins Sci Rep Article Idiopathic Generalized Epilepsy (IGE) patients may not achieve optimal seizure control with monotherapy. Our goal was to evaluate the efficacy of combination therapy in a retrospective series of IGE patients receiving different antiseizure medication (ASM) regimens. We retrospectively identified all patients with adolescence onset IGE with typical clinical and EEG features from a single epilepsy specialist clinic from 2009 to 2020. We evaluated long-term seizure control, for VPA, LEV, LTG mono and combination therapy. We studied 59 patients. VPA was more commonly used in men (84%) than in women (44%) (p < 0.05). VPA was the initial drug of choice in 39% of patients, followed by LEV (22%) and LTG (14.9%). Thirty-nine patients (66.1%) achieved complete seizure control for at least one year. Fifty patients (84.7)% had partial control, without GTC occurrence, for at least one year. VPA was superior to LTG for complete seizure control (p = 0.03), but not for minor seizure control or pseudoresistance (p > 0.05). Combination therapy was superior to LEV and LTG monotherapy for complete control (p = 0.03), without differences for minor seizures and pseudoresistance outcomes (p > 0.05). Combination therapy not including VPA was also non-inferior to VPA monotherapy in all settings. Combination therapy was superior to LTG and LEV monotherapy in IGE, and may be equally effective including or not VPA. Combination therapy including LTG, LEV, and/or VPA is an effective treatment option after monotherapy failure with one of these ASM in IGE. Dual therapy with LEV–LTG should be considered in monotheraphy failure, to avoid fetal effects of in utero VPA exposure. Nature Publishing Group UK 2022-07-19 /pmc/articles/PMC9296520/ /pubmed/35854146 http://dx.doi.org/10.1038/s41598-022-16718-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Pipek, Leonardo Zumerkorn Pipek, Henrique Zumerkorn Castro, Luiz Henrique Martins Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy |
title | Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy |
title_full | Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy |
title_fullStr | Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy |
title_full_unstemmed | Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy |
title_short | Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy |
title_sort | seizure control in mono- and combination therapy in a cohort of patients with idiopathic generalized epilepsy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296520/ https://www.ncbi.nlm.nih.gov/pubmed/35854146 http://dx.doi.org/10.1038/s41598-022-16718-x |
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