ABSTRACT
OBJECTIVE: To analyze the effectiveness and tolerability of perampanel across different seizure types in routine clinical care of patients with idiopathic generalized epilepsy (IGE). METHODS: This multicenter, retrospective, 1-year observational study collected data from patient records at 21 specialist epilepsy units in Spain. All patients who were aged ≥12 years, prescribed perampanel before December 2016, and had a confirmed diagnosis of IGE were included. RESULTS: The population comprised 149 patients with IGE (60 with juvenile myoclonic epilepsy, 51 generalized tonic-clonic seizures [GTCS] only, 21 juvenile absence epilepsy, 10 childhood absence epilepsy, 6 adulthood absence epilepsy, and one Jeavons syndrome). Mean age was 36 years. The retention rate at 12 months was 83% (124/149), and 4 mg was the most common dose. At 12 months, the seizure-free rate was 59% for all seizures (88/149); 63% for GTCS (72/115), 65% for myoclonic seizures (31/48), and 51% for absence seizures (24/47). Seizure frequency was reduced significantly at 12 months relative to baseline for GTCS (78%), myoclonic (65%), and absence seizures (48%). Increase from baseline seizure frequency was seen in 5.2% of patients with GTCS seizures, 6.3% with myoclonic, and 4.3% with absence seizures. Perampanel was effective regardless of epilepsy syndrome, concomitant antiepileptic drugs (AEDs), and prior AEDs, but retention and seizure freedom were significantly higher when used as early add-on (after ≤2 prior AEDs) than late (≥3 prior AEDs). Adverse events were reported in 50% of patients over 12 months, mostly mild or moderate, and irritability (23%), somnolence (15%), and dizziness (14%) were most frequent. SIGNIFICANCE: In routine clinical care of patients with IGE, perampanel improved seizure outcomes for GTCS, myoclonic seizures, and absence seizures, with few discontinuations due to adverse events. This is the first real-world evidence with perampanel across different seizure types in IGE.
Subject(s)
Anticonvulsants/therapeutic use , Epilepsy, Generalized/drug therapy , Pyridones/therapeutic use , Treatment Outcome , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Nitriles , Retrospective Studies , Spain , Statistics, Nonparametric , Time Factors , Young AdultABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Hemodiafiltration/methods , Multiple Myeloma/complications , Multiple Myeloma/diagnosis , Multiple Myeloma/therapy , Bone Marrow Transplantation/methods , Hemodiafiltration/trends , Hemodiafiltration , Vincristine/therapeutic use , Doxorubicin/therapeutic use , Dexamethasone/therapeutic useABSTRACT
El impacto medioambiental de los residuos es motivo de preocupación en nuestra comunidad. Hemos estudiado a 26 pacientes en tratamiento con Diálisis Peritoneal con el fi n de conocer el comportamiento de éstos con respecto a los residuos generados en la realización de su tratamiento y su interés en colaboraren proyectos de mejora en este campo en el futuro, así como posibles estrategias para conseguirlo. Se elaboró un cuestionario para obtener la información necesaria y se cumplimentó mediante entrevista personal, voluntaria y confidencial. El comportamiento de los pacientes con respecto a los residuos ha sido calificado de correcto a tenor de los resultados obtenidos, con la excepción dela recogida de los elementos punzantes (agujas),ya que el 46% (12) de los pacientes entrevistados los depositaba encapuchados en la bolsa de basura exclusiva para la recogida de residuos del tratamiento de Diálisis Peritoneal. La mayoría de los pacientes están dispuestos a colaborar en proyectos responsables con el tratamiento de residuos (AU)
The environmental impact of waste is a cause for concern in our community. We have studied 26 patients undergoing Peritoneal Dialysis in order to find out their behaviour with regard to the waste generated in carrying out their treatment and their interest in collaborating in projects for improving this area in the future, as well as possible strategies to achieve this. A questionnaire was drawn up to obtain the necessary information and was completed through a voluntary and confidential personal interview. The patients behaviour in relation to waste was considered correct on the basis of the results obtained, except for the collection of sharp object (needles),as 46% (12) of the patients interviewed placed the needles properly covered in the exclusive bag for the collection of waste from Peritoneal Dialysis treatment. Most of the patients are willing to collaborate in waste treatment projects (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Medical Waste Disposal/methods , Peritoneal Dialysis , Forecasting , Surveys and QuestionnairesABSTRACT
Cardiac changes may occasionally occur during vagus nerve stimulation (VNS) used in epileptic patients. As they can be potentially life-threatening, it is important to detect them, and this is why an intraoperative test is performed during the implantation. Few cases of asystole during this test have been described. Only one patient with late-onset bradyarrythmia caused by VNS has been reported. This patient had been implanted 2 years and 4 months before the episode. We present another case of late asystole in a patient whose VNS had been implanted 9 years before the arrhythmia onset. In our patient, each run of stimulation produced bradyarrhythmias and very often severe asystolia due to atrium-ventricular block.
