Seizure management and prescription patterns of anticonvulsants in Dravet syndrome: A multicenter cohort study from Germany and review of literature.
Epilepsy Behav
; 98(Pt A): 88-95, 2019 09.
Article
en En
| MEDLINE
| ID: mdl-31301455
ABSTRACT
OBJECTIVE:
The aim of this study was to describe the treatment pattern of patients with Dravet syndrome (DS) in Germany with routine antiepileptic drugs (AEDs) and emergency medication, and to review the literature of real-world evidence on medicine utilization of patients with DS in Europe.METHODS:
Patient use of routine AEDs and emergency medications over 3-6â¯months was analyzed from a 2018 multicenter survey of 93 caregivers of patients with DS throughout Germany. Results were contextualized in a review of real-world evidence on medicine utilization of patients with DS in Europe.RESULTS:
The variety of medications and the most frequent combinations routinely used by patients with DS (AEDs and others) are described. Patients use a large number of pharmaceutical treatments to manage seizures. The five most commonly used AEDs were sodium valproate (66% of the patients; mean daily dose 660â¯mg; 24.5â¯mg per kg bodyweight), bromide (44%; 1462â¯mg; 51.2â¯mg per kg), clobazam (41%; 10.4â¯mg; 0.32â¯mg per kg), stiripentol (35%; 797â¯mg; 27.6â¯mg per kg), and topiramate (24%; 107â¯mg; 3.5â¯mg per kg). Ninety percent had reported using emergency medications in the last 3â¯months;, with the most common medications being Buccolam (40%, an oromucosal form of midazolam) and diazepam (20%, mostly rectal application). No discernable relationships between current medication and age or seizure frequency were observed.SIGNIFICANCE:
This is the first comprehensive report of routine AEDs and emergency medication use in a large sample of patients with DS in Germany over a period of 3-6â¯months and shows that despite the most common AED combinations being in line with clinical guidelines/best practice, there is no discernable impact of best treatment on seizure frequency. We find a higher use of bromide in Germany compared with other real-world evidence in Europe.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Prescripciones de Medicamentos
/
Convulsiones
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Epilepsias Mioclónicas
/
Anticonvulsivantes
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Guideline
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Incidence_studies
/
Observational_studies
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Qualitative_research
/
Risk_factors_studies
Límite:
Female
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Humans
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Male
País como asunto:
Europa
Idioma:
En
Año:
2019
Tipo del documento:
Article