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首页> 外文OA文献 >The dynamics of drug treatment in epilepsy: an observational study in an unselected population based cohort with newly diagnosed epilepsy followed up prospectively over 11-14 years
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The dynamics of drug treatment in epilepsy: an observational study in an unselected population based cohort with newly diagnosed epilepsy followed up prospectively over 11-14 years

机译：癫痫药物治疗的动力学：观察性 在未选择的人群中进行新诊断的队列研究 癫痫病的随访时间为11-14年

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OBJECTIVES—To studyprospectively long term dynamics and patterns of treatment in apopulation based cohort of patients with newly diagnosed epilepsy.
METHODS—564 patientswith definite epilepsy entered the UK National General Practice Studyof Epilepsy (NGPSE), between 1984 and 1987,and were prospectivelyfollowed up for between 11-14 years.
RESULTS—Treatment wasstarted in 433 (77%) patients. Only 15% of single seizure patientshad medication prescribed initially, although due to high seizurerecurrence, more than 70% ultimately received antiepilepticmedication. 209/564 patients (37%) were on drug therapy for epilepsyat the time of last follow up. 168/564 patients (30%) have stayedcontinuously on medication and another 41/564 patients (7%) restarteddrug therapy because of seizure recurrence, having withdrawnmedication. 98/209 (47%) of those on treatment are known to be in 5 year terminal remission. Phenytoin (29%) and carbamazepine (27%) werethe most commonly preferred first line drugs followed by valproate(15%). Less than half of treated patients with partial seizuresreceived carbamazepine as a first line drug and less than a third withgeneralised seizures were prescribed valproate as first choice drug.Nine out of 31 (29%) patients with one or more seizures a week at lastfollow up had never tried a second drug and only seven (23%) had triedfour or more drugs. 11% of all treatment changes involved a newantiepileptic drug. Treatment changes were associated with low terminalremission rates.
CONCLUSIONS—Out of30 000 patients with newly diagnosed epilepsy every year in the UnitedKingdom, about 6000 have inadequate seizure control in the long term.About a third of the patients in this group have one or more seizuresevery month. Only two thirds of these patients with frequent seizuresare likely to switch medication to try and achieve better seizurecontrol. There is probably still considerable room for improvement inprescribing practice in the United Kingdom.


机译：目的—前瞻性研究新诊断的癫痫患者的人群基础上的长期动态和治疗方式。方法－ 1984年至1987年间，有564例确诊为癫痫的患者进入了英国国家癫痫全科医学研究（NGPSE），前瞻性随访了11至14年。结果— 433（77％）例患者开始治疗。最初只有15％的癫痫发作患者曾开过处方药，尽管由于癫痫复发率高，最终超过70％的患者接受了抗癫痫药物治疗。在最后一次随访时，有209/564名患者（37％）接受了癫痫药物治疗。 168/564例患者（30％）连续服药，另有41/564例患者（7％）因癫痫发作复发而停药，因此重新开始药物治疗。已知接受治疗的患者中有98/209人（占47％）处于5年终末缓解期。苯妥英（29％）和卡马西平（27％）是最常用的一线药物，其次是丙戊酸盐（15％）。接受治疗的部分性癫痫患者中，不到一半接受卡马西平作为一线药物，少于三分之一的全身性癫痫患者被给予丙戊酸盐作为首选药物.31名患者中有9名（29％）每周随访一次或多次癫痫发作从未尝试过第二种药物，只有七种（23％）尝试过四种或更多药物。所有治疗改变中有11％涉及新抗癫痫药。治疗的改变与终末缓解率低有关。结论：在英国，每年有3万名新诊断的癫痫病患者，长期来看，约有6000名癫痫控制不足。该组中约有三分之一的患者每个月有一个或多个癫痫发作。在这些癫痫发作频繁的患者中，只有三分之二可能会改用药物以达到更好的癫痫发作控制。在英国，处方药的实践可能仍有很大的改进空间。

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