he purpose of this report was to update the 2006 International League Against Epilepsy (ILAE) report and identify the level of evidence for long-term efficacy or effectiveness for antiepileptic drugs (AEDs) as initial monotherapy for patients with newly diagnosed or untreated epilepsy. All applicable articles from July 2005 until March 2012 were identified, evaluated, and combined with the previous ysis (Glauser et al., 2006) to provide a comprehensive update.
The prior ysis methodology was utilized with three modifications: (1) the detectable noninferiority boundary approach was dropped and both failed superiority studies and prespecified noninferiority studies were yzed using a noninferiority approach, (2) the definition of an adequate comparator was clarified and now includes an absolute minimum point estimate for efficacy/effectiveness, and (3) the relationship table between clinical trial ratings, level of evidence, and conclusions no longer includes a recommendation column to reinforce that this review of efficacy/evidence for specific seizure types does not imply treatment recommendations.
This evidence review contains one clarification: The commission has determined that class I superiority studies can be designed to detect up to a 20% absolute (rather than relative) difference in the point estimate of efficacy/effectiveness between study treatment and comparator using an intent-to-treat ysis. Since July, 2005, three class I randomized controlled trials (RCT) and 11 class III RCTs he been published. The combined ysis (1940-2012) now includes a total of 64 RCTs (7 with class I evidence, 2 with class II evidence) and 11 meta-yses.
New efficacy/effectiveness findings include the following: levetiracetam and zonisamide he level A evidence in s with partial onset seizures and both ethosuximide and valproic acid he level A evidence in children with childhood absence epilepsy.
There are no major changes in the level of evidence for any other subgroup. Levetiracetam and zonisamide join carbamazepine and phenytoin with level A efficacy/effectiveness evidence as initial monotherapy for s with partial onset seizures. Although ethosuximide and valproic acid now he level A efficacy/effectiveness evidence as initial monotherapy for children with absence seizures, there continues to be an alarming lack of well designed, properly conducted epilepsy RCTs for patients with generalized seizures/epilepsies and in children in general.
These findings reinforce the need for multicenter, multinational efforts to design, conduct, and yze future clinically relevant adequately designed RCTs. When selecting a patient's AED, all relevant variables and not just efficacy and effectiveness should be considered.
拍照信源地址
编辑: jiang上一页:癫痫猝死:凶嫌是谁?
下一页:临床如何临床是否患有轻度癫痫
- 2022-05-05JAMA Neurol:复温期间癫痫复发增加与2年随访时神经发育异常结局的关系
- 2022-04-13急性缺血性卒中支架联合溶栓治疗优于单纯溶栓治疗
- 2022-04-12进军主流免疫治疗
- 2022-04-11Sci Adv:掉头发,不要害怕!调整基因表达的小分子microRNA 能促进毛发再生!
- 2022-04-11癫痫患者手术评估新型工具
- 2022-04-07药学版元宵灯谜 看你能猜对几个问题
- 进军主流免疫治疗
- Sci Adv:掉头发,不要害怕!调整基因表达的小分子microRNA 能促进毛发再生!
- 癫痫患者手术评估新型工具
- 药学版元宵灯谜 看你能猜对几个问题
- UCB的Vimpat癫痫新适应症在美国获批
- 癫痫猝死:凶手是谁?
- FDA批准开浦兰治疗1个月至4岁癫痫儿童
- Medpage Today:不同类型的抗癫痫药物更有利
- Neurology:颅脑损伤增加了迟发性癫痫的风险,高损伤频率、重伤、老年人尤其是
- 特发性癫痫大发作药物治疗的首选
- 【用药问答】癫痫发作和局限性发作的首选治疗是什么?
- 三庚酸酯可治疗1型转运体缺陷综合征
- 儿童癫痫的病因是什么?
- 如何了解癫痫的症状和治疗?
- 罕见病例:自发性颞极性扩张伴癫痫发作
- 控制癫痫患者再次抽搐,不包括可选药物?
- 癫痫患者停药问题解决了吗?最新的预测模型已经发布!
- 常见的癫痫病因有哪些?
- 北京癫痫医院治疗费用
- 不注意这些问题,吃多少药都没用!
- 英国竞争监管机构指控辉瑞癫痫药品价格过高
- 抗癫痫药物预防新发癫痫:任重而道远
- 脑梗死的症状是什么有这些前兆要谨慎
- 世界癫痫日 | 科学防治 标准诊疗 告别癫痫
- 癫痫患者应多喝牛奶,饮食疗法公开
- 羊角病能生孩子吗?
- 癫痫饮食有哪些禁忌?
- 小孩癫痫病怎么生物科学治疗
- 怎么了解癫痫病的症状与放射治疗
- 癫痫频繁发作伤害极大,如何减少癫痫频发? 日常生活之中这样做!
- 癫痫病发病究竟是还好
- 心率多少算是正常 如何维持正常心率不变
- 癫痫病的腹泻有哪些 有这腹泻需注意
- 研究称猪肉绦虫患者的癫痫由p微粒引起
- 做癫痫病须要多少钱
- 治疗成年人癫痫病的多钱
- 生病能治癫痫病吗
- 癫痫能治好吗?这些知识你可能不究竟
- 怎样放射治疗癫痫病最有效
- 世界癫痫日|碰见癫痫发作,如何紧急应对?