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:后天一时期癫痫病症状能治疗吗
下一页:哪些抗菌药物可诱发发作?
- 2022-04-252013年国际抗癫痫联合会抗癫痫药性使用指南
- 灼烧综合征的原因不容忽视治疗
- 抗癫痫药物预防新发癫痫:任重而道远
- FDA批准Aptiom用于治疗患者癫痫发作
- FDA批准开浦兰治疗1个月至4岁癫痫儿童
- AP&T: 影响维多珠单抗和乌斯他单抗治疗炎性肠病患者安全的因素只有并发症,而不是年龄
- 病例报告:水浴 PUVA 治疗皮下环状肉芽肿
- 烧口综合征注意事项!
- 手术学习:颅内脊索瘤内镜下三脑室入路治疗
- 福州一医院用嫩模照片宣传妇科被判赔偿3.2 万
- Cell Death Dis:SPATS2调节细胞周期,促进肝癌的发生和发展
- 癫痫治疗障碍仍难以克服
- 男士保健茶 这个夏天让你喝健康(2)
- 荣获精鼎医药Scrip最佳合同研究组织称号
- 煮螃蟹的方法 这样吃螃蟹味道也不错
- 寄生虫感染可能会增加儿童气道高反应的风险
- 黑芝麻的营养价值 吃黑芝麻的好处
- 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
- 凌腾医学宣布,卡妥索双抗对介苗治疗失败的非肌层浸润性膀胱癌的第一次临床试验已经完成
- 2018 KSOG立场声明:双侧输卵管切除术降低女性卵巢癌/输卵管癌/腹膜癌的平均风险
- 20160809家政女皇栏目:陈允斌讲的功效
- BMJ:血浆置换对ANCA相关性血管炎患者的影响
- FDA警告怀孕期间使用丙戊酸钠药物
- 白癜风早期症状
- 常见妇科炎症的相关问答
- 甲硝唑 VS 替硝唑,只是一字之差吗?
- Clin cancer res:子宫内膜样卵巢癌或子宫内膜癌的治疗策略
- 第一次同房失败,怎么治疗?
- 38年病史的癫痫病患者一封感谢信 道出浓浓医患情
- 癫痫的症状及治疗法则 四种治疗法则远离癫痫
- Neurology:颅脑损伤增加迟发性抑郁症发生风险,高损伤频率、重伤、老年人尤甚
- 不用开颅也能“手术”治疗癫痫?天坛医院启动临床研究
- 高血压会遗传?不能同高血压患者结婚?专家有话说
- 北京治疗癫痫病谁最出色
- 癫痫病需要开刀吗
- 癫痫患者防止发作,饮食注意事项“划重点”,看看万不可吃“它”
- 癫痫的高血压有很多
- 怎样服用抗癫痫药物可以减小副反应
- 癫痫病是怎么引起的发病 癫痫病的病症是什么
- 不应漏服、误服、乱服药,治疗癫痫一刻都不能松懈!
- 惹来癫痫病的病因有哪些