Pharmacological management of epilepsy

Brown, Carole

doi:10.1002/pnp.422

Cited by 13 publications

(12 citation statements)

References 20 publications

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“…Nonadherent patients with epilepsy report more difficulty in attaining seizure control than adherent patients. In addition, uncontrolled seizures result in major morbidity and mortality [26]. While SCB AEDs were shown to have greater adherence rates compared with non-SCB AEDs [27], this study evaluated the association between varying SCB adherence levels and patient-reported outcomes such as HRQoL, WPAI, HRU, and costs among patients with epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Association between adherence to sodium channel blockers and patient-reported outcomes: Analysis of US survey data among patients with epilepsy

Rajagopalan

Lee

2019

Epilepsy & Behavior

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The objective of this study was to examine the relationship between adherence to treatment with sodium channel blockers (SCBs) and health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), healthcare resource utilization (HRU), and associated costs among patients with epilepsy. Methods: This retrospective cross-sectional study used data from the 2017 US National Health and Wellness Survey (NHWS; N = 75,004). Health-related quality of life (Study Short-Form 36-Item Health Survey version 2 [SF-36v2]), WPAI (Work Productivity and Activity Impairment-General Health [WPAI-GH] questionnaire), HRU, and annual costs were compared among respondents with epilepsy using SCBs categorized as low/medium adherence (n = 120) and high adherence (n = 80) using generalized linear models, controlling for patient characteristics. Results: Mental component score, Short-Form 6-Dimension (SF-6D) health utility index, bodily pain, mental health, physical functioning, role emotional, social functioning, and vitality scores were significantly lower in low/medium adherence respondents than in high adherence respondents (for all, p b 0.05). Only activity impairment was significantly higher in low/medium adherence respondents compared with the high adherence group (p b 0.001). Healthcare resource utilization did not differ significantly between the two groups; however, the number of emergency room (ER) visits and total costs were lower in the high adherence group (p = 0.038) compared with the low/medium adherence group (p = 0.040). Conclusion: High adherence to SCBs was associated with improved HRQoL, lower WPAI, and lower HRU and associated costs among patients with epilepsy. Therefore, adherence to SCBs may be an important factor in improving the abovementioned patient-reported outcomes. Findings from this study can help provide further impetus to healthcare policymakers and clinicians for addressing the low antiepileptic drug (AED) adherence levels in adult patients with epilepsy.

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Section: Discussionmentioning

confidence: 99%

Association between adherence to sodium channel blockers and patient-reported outcomes: Analysis of US survey data among patients with epilepsy

Rajagopalan

Lee

2019

Epilepsy & Behavior

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“…Epilepsy is a disease of abnormal CNS function, resembling, at times, a neurodegenerative disease. Epilepsy is typified by unprovoked and recurrent seizures (Brown, 2016). As inflammation plays a central role in epilepsy's pathogenesis as well as other essential mechanisms, including apoptosis, synaptic strength alterations, and unusual ion channels activity, ncRNAs also participate here with abnormal expression changes during epileptogenesis (Shao & Chen, 2017).…”

Section: The Interplay Between Ncrnas and Inflammation In Neurodegene...mentioning

confidence: 99%

The emerging role of noncoding RNAs in neuroinflammation: Implications in pathogenesis and therapeutic approaches

Ebrahimi

Golestani

2021

Journal Cellular Physiology

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Noncoding RNAs (ncRNAs) are important regulators of gene expression in different cell processes. Due to their ability in monitoring neural development genes, these transcripts confer neurons with the potential to exert broad control over the expression of genes for performing neurobiological functions.Although the change of ncRNA expression in different neurodegenerative diseases has been reviewed elsewhere, only recent evidence drove our attention to unravel the involvement of these molecules in neuroinflammation within these devastating disorders. Remarkably, the interactions between ncRNAs and inflammatory pathways are not fully recognized. Therefore, this review has focused on the interplay between diverse inflammatory pathways and the related ncRNAs, including microRNAs, long noncoding RNAs, and competing endogenous RNAs in Alzheimer's disease, Parkinson's diseases, amyotrophic lateral sclerosis, epilepsy, multiple sclerosis, Huntington's disease, and prion diseases. Providing novel insights in the field of combining biomarkers is a critical step for using them as diagnostic tools and therapeutic targets in clinical settings.

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“…Management of epileptic seizures requires careful therapy selection to optimise seizure control and improve a patient's quality of life (QoL) ( 9 ), balanced against significant side effects that are associated with many pharmacological treatments. The three main forms of treatment available are anti-seizure medications (ASMs), dietary modification (typically the ketogenic diet), and surgical intervention ( 4 , 5 , 7 ), with preventative ASMs remaining the mainstay of epilepsy treatment ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment Guidelines for Rare, Early-Onset, Treatment-Resistant Epileptic Conditions: A Literature Review on Dravet Syndrome, Lennox-Gastaut Syndrome and CDKL5 Deficiency Disorder

et al. 2021

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Background: Dravet syndrome (DS), Lennox-Gastaut syndrome (LGS) and CDKL5 deficiency disorder (CDD) are rare epileptic conditions, characterised by drug-resistant seizures. Seizure management in these patients requires careful therapy selection. This targeted literature review (TLR) aimed to collate and synthesise information from country-specific and international treatment guidelines for DS, LGS and CDD.Methods: A TLR was performed between 25th January and 11th March 2021. Online rare diseases and guideline databases were manually searched in addition to websites of national health technology assessment bodies for the following countries: Australia, Canada, France, Germany, Israel, Italy, Japan, Spain, Switzerland, UK and US, as defined by pre-specified eligibility criteria. Search terms, developed for each condition, were translated into local languages where appropriate. Descriptive analyses were performed to examine the geographical distribution of included guidelines; methodologies used to develop guidelines; cross-referencing of treatment recommendations made within other guidelines; patterns of treatment recommendations. An author map was created using R version 3.5.1, to visualise the extent of collaboration between authors.Results: Forty total guidelines were included, of which 29, 34 and 0 contained recommendations for DS, LGS and CDD, respectively (some provided recommendations for ≥1 condition). Most were country-specific, with guideline authors predominantly publishing in regional groups. Five guidelines were classified as “International” and displayed connections between author groups in the US, UK, France and Italy. Reported guideline development processes were lacking [43% (17 guidelines) had unclear/absent literature review methodologies] and those reported were variable, including both systematic and targeted literature reviews. Use of expert consultation was also variable. A high degree of heterogeneity was observed in the availability of treatment recommendations across disorders, with 271 and 190 recommendations for LGS and DS, respectively, and contradictory positive and negative treatment recommendations for several drugs in each indication [35% (11/31) and 22% (6/27) in LGS and DS, respectively].Conclusions: This review highlights the need for further high-quality international consensus-based treatment guidelines for LGS, DS, and particularly for CDD (for which no treatment guidelines were identified). Supra-national consensus guidance based on findings from a wider geographical range may improve resource allocation and establish an improved world-wide standard of care.

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Pharmacological management of epilepsy

Cited by 13 publications

References 20 publications

Association between adherence to sodium channel blockers and patient-reported outcomes: Analysis of US survey data among patients with epilepsy

Association between adherence to sodium channel blockers and patient-reported outcomes: Analysis of US survey data among patients with epilepsy

The emerging role of noncoding RNAs in neuroinflammation: Implications in pathogenesis and therapeutic approaches

Treatment Guidelines for Rare, Early-Onset, Treatment-Resistant Epileptic Conditions: A Literature Review on Dravet Syndrome, Lennox-Gastaut Syndrome and CDKL5 Deficiency Disorder

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