More Than One-Third of New Cases of Epilepsy Are Treatment Refractory

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More than 1/3 of patients with epilepsy do not respond to AEDs.
More than 1/3 of patients with epilepsy do not respond to AEDs.

HealthDay News — More than one-third of patients with newly diagnosed epilepsy do not respond to treatment with antiepileptic drugs (AEDs), according to a study published online in JAMA Neurology.

Zhibin Chen, PhD, from the University of Melbourne in Australia, and colleagues conducted a longitudinal observational cohort study to assess long-term outcomes in 1795 patients with newly diagnosed and treated epilepsy. Patients were followed for a minimum of 2 years or until death.

The researchers found that 63.7% of patients had been seizure-free for the previous year or longer at the end of the study period. 

Overall, 86.8% of those achieving 1-year seizure freedom were taking monotherapy, and 89.9% had achieved seizure control with the first or second AED regimens. A total of 50.5% of the patient pool remained seizure-free for 1 year or longer with the initial AED; if this AED failed, the likelihood of seizure freedom was increased by 11.6% and 4.4% with the second and third regimens, respectively. With subsequent AEDs, only 2.12% of patients attained optimal seizure control. The odds of not responding to treatment for each subsequent medication regimen were increased 1.73 times for epilepsy that was not successfully controlled with the first AED.

"Despite the availability of many new AEDs with differing mechanisms of action, overall outcomes in newly diagnosed epilepsy have not improved," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Chen Z, Brodie MJ, Liew D, Kwan P. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study [published online December 26, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.3949



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