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Long-term efficacy and tolerability of topiramate as add-on therapy in refractory partial epilepsy: an observational study.

Authors
 Yang-Je Cho  ;  Kyoung Heo  ;  Won-Joo Kim  ;  Sang Hyun Jang  ;  Yo Han Jung  ;  Byoung Seok Ye  ;  Dong Beom Song  ;  Byung In Lee 
Citation
 Epilepsia, Vol.50(8) : 1910-1919, 2009 
Journal Title
 Epilepsia 
ISSN
 0013-9580 
Issue Date
2009
MeSH
Adolescent ; Adult ; Aged ; Anticonvulsants/therapeutic use* ; Child ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Electroencephalography ; Epilepsies, Partial/drug therapy* ; Female ; Fructose/analogs & derivatives* ; Fructose/therapeutic use ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Maximum Tolerated Dose ; Middle Aged ; Observation/methods ; Outcome Assessment (Health Care) ; Retrospective Studies ; Secondary Prevention ; Young Adult
Keywords
Epilepsy ; Refractory ; Topiramate ; Efficacy ; Tolerability
Abstract
PURPOSE: To evaluate the long-term efficacy and tolerability of topiramate (TPM) as add-on therapy in patients with refractory partial epilepsy. METHODS: This is a retrospective, single-center, long-term observational study. Patients fulfilling the criteria of medical intractability proposed by Berg et al. were entered into the study if they were newly prescribed TPM as add-on therapy between January 2000 and June 2002. The usual starting dosage of TPM was 50 mg/day and optimal-dose adjustments were made according to individual clinical responses. Efficacy and tolerability were analyzed every year during 5-year follow-up in the "intention-to-treat (ITT) population." Retention rate was estimated by Kaplan-Meyer analysis. RESULTS: A total of 125 patients were included in the study and 107 patients (85.6%) were followed for 5 years. Retention rate was 87.2% at 1 year and 64% at 5 years. At the end of 5 years, the median seizure frequency reduction rate was 69.0% and responder rate was 43.2% in the ITT population. Cumulative seizure-free rate (SFR) was 30.4% and the terminal 1-year SFR was 12.8% in the ITT population (20.0% in completers) at 5-year follow-up. Adverse events (AEs) occurred in 39.2% of patients, including significant AEs leading to antiepileptic drug (AED) withdrawal in 14.4%. The most common AEs were anorexia (16.0%), weight loss (10.4%), and gastrointestinal symptoms (8.8%). Concomitant AEDs were reduced in 25.0% of the completers. DISCUSSION: Low-dose and slow-dose escalation of TPM in add-on therapy for patients with refractory partial epilepsy is effective and well tolerated in long-term, individualized clinical practice
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2009.02177.x/abstract
DOI
10.1111/j.1528-1167.2009.02177.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Joo(김원주) ORCID logo https://orcid.org/0000-0002-5850-010X
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Lee, Byung In(이병인)
Jang, Sang Hyun(장상현)
Jung, Yo Han(정요한)
Cho, Yang Je(조양제)
Heo, Kyoung(허경)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104731
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