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.
查看信源地址
上一页:痉挛患儿死亡简析
下一页:小儿原发性癫痫的心脏病严重吗
- 2022-05-05JNNP:预测新发局灶性癫痫患者神经元表面自身抗体的临床特征:免疫治疗的普遍性
- 2022-04-252013年国际抗癫痫联合会抗癫痫制剂使用指南
- 2022-04-13FDA批准Aptiom用于治疗患者癫痫发作
- 第四届全国临床脑电图实践基础理论与实践操作培训班
- 北京癫痫手术费用
- 抗癫痫药物预防新发癫痫:任重而道远
- 预测癫痫患者再入院风险
- 癫痫定位新方法:无框架立体定向脑电图技术
- 癫痫发作对中风患者静脉溶栓的长期转移有效
- Diabetes Obes Metab:恩格列净对肝脂肪变性和纤维化标志物的影响及其与心肾结局的关系
- 癫痫猝死:凶手是谁?
- 北京癫痫医院治疗费用
- 罕见病例:自发性颞极性扩张伴癫痫发作
- 【用药情报站】临床应用应听取各种药种药物禁忌证?
- 2015第31届国际癫痫大会(IEC)
- 三庚酸酯可治疗1型转运体缺陷综合征
- Medpage Today:不同类型的抗癫痫药物更有利
- Circ Ep:左室肥厚高血压患者新发房颤增加SCD风险
- UCB的Vimpat癫痫新适应症在美国获批
- 癫痫治疗障碍仍难以克服
- 继发性癫痫能治愈吗 治疗癫痫有几个步骤
- 月经性癫痫患者妊娠期癫痫控制更好
- 心理百科:春节期间小心疾病
- 2016AAN:神经专家发表了有前途的专业见解
- 2015 神经系统疾病诊疗进展
- 上海率先探索异地就医门诊费直接结算
- PLoS ONE:新的合成蛋白能快速激活免疫系统抵抗流感
- FDA警告怀孕期间使用丙戊酸钠药物
- 油炸刀鱼 酥脆的美味食物
- 羊角病能生孩子吗?
- 疗程小儿癫痫病要多钱
- 后期癫痫病的症状都有什么
- 怎么治疗少男稳定型癫痫病比较好
- 孩子出现这种可能会,家长要注意了,可能是......
- 主要症状病的治疗方法是什么 主要症状病有这些偏方
- 【用药问答】癫痫大复发和局限性复发的首选治疗为?
- 早发型癫痫脑病的基因检验
- Diabetes Obes Metab:恩格列净对肝脂肪变性和纤维化标志物的影响及其与心脾结局的关系
- 真正肇因癫痫病的原因是什么呢
- 小儿癫痫病怎么判别治疗病症
- 为什么癫痫病久治不愈
- 别拖!抑郁症第一次发作就要去医院,不能拖!
- 20130712道家:杨红宣讲癫痫病人不能吃什么