Pregabalin as adjunctive therapy for partial epilepsy: An audit study in 96 patients from the South East of England

Valentin, Antonio; Moran, Nicholas; Hadden, Robert D.M.; Oakes, Amy; Elwes, Robert; Delamont, Robert S.; Mullatti, Nandini; Nashef, Lina

doi:10.1016/j.seizure.2009.01.001

Cited by 14 publications

(16 citation statements)

References 17 publications

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“…These rates were not dissimilar to those from other clinical audits where the drug was discontinued by 40-60% of patients over 1-2.5 years (9,(11)(12)(13). These rates were not dissimilar to those from other clinical audits where the drug was discontinued by 40-60% of patients over 1-2.5 years (9,(11)(12)(13).…”

Section: Discussionmentioning

confidence: 41%

Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit

Stephen

Parker

Kelly

et al. 2011

Acta Neurologica Scandinavica

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Section: Discussionmentioning

confidence: 41%

Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit

Stephen

Parker

Kelly

et al. 2011

Acta Neurologica Scandinavica

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“…However, in comparison with TPM, the retention rate appears to be higher with LEV (46 vs. 38% at 2 years), because LEV had a more favorable side‐effect profile than TPM with comparable efficacy (Bootsma et al., 2008b). The results from the available observational studies of PGB and ZNS in patients with refractory epilepsy are also unsatisfactory, with retention rates of 40–60% at 1–2 years for PGB (Carreño et al., 2007; Brandt et al., 2009; Valentin et al., 2009), and 45% and 29% at 2 and 3 years (respectively) for ZNS (Wroe et al., 2008). For both AEDs, treatment discontinuation was mostly because of inefficacy.…”

Section: Discussionmentioning

confidence: 99%

Clinical comparability of the new antiepileptic drugs in refractory partial epilepsy: A systematic review and meta-analysis

et al. 2011

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SUMMARYPurpose: Evaluate the clinical comparability of new antiepileptic drugs (AEDs) in partial refractory epilepsy. Methods: Systematic review of randomized trials (RCTs) comparing a new AED (add-on treatment) with placebo or another AED. Primary outcomes: responder ( ‡50% seizure reduction) and withdrawal (tolerability) rates. Pooled estimates of odds ratios (ORs) and number needed treat/harm (NNT/NNH) taking into account baseline risk were derived by random-effects meta-analysis. Adjusted frequentist indirect comparisons between AEDs were estimated. Key Findings: Sixty-two placebo-controlled (12,902 patients) and eight head-to-head RCTs (1,370 patients) were included. Pooled ORs for responder and withdrawal rates (vs. placebo) were 3.00 [95% confidence interval (CI) 2.63-3.41] and 1.48 (1.30-1.68), respectively. Indirect comparisons of responder rate based on relative measurements of treatment effect (ORs) favored topiramate (1.52; 1.06-2.20) in comparison to all other AEDs, whereas gabapentin (0.67; 0.46-0.97) and lacosamide (0.66; 0.48-0.92) were less efficacious, without significant heterogeneity. When analyses were based on absolute estimates (NNTs), topiramate and levetiracetam were more efficacious, whereas gabapentin and tiagabine were less efficacious. Withdrawal rate was higher with oxcarbazepine (OR 1.60; 1.12-2.29) and topiramate (OR 1.68; 1.07-2.63), and lower with gabapentin (OR 0.65; 0.42-1.00) and levetiracetam (OR 0.62; 0.43-0.89). Significance: The differences found are of relatively small magnitude to allow a definitive conclusion about which new AED(s) has superior effectiveness. This uncertainty probably reflects the limitations of conclusions based on indirect evidence. The process of pharmacologic clinical decision making in partial refractory epilepsy probably depends more on other aspects, such as individual patient characteristics and pharmacoeconomics, than on available controlled randomized evidence.

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“…In one study, only 4% of patients taking pregabalin reported cognitive problems [Valentin et al 2009]. When present, possible CAEs include deterioration in verbal and visual episodic memory [Ciesielski et al 2006].…”

Section: Pregabalinmentioning

confidence: 99%

The cognitive impact of antiepileptic drugs

Eddy¹,

Rickards²,

Cavanna³

2011

Ther Adv Neurol Disord

319

189

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Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.

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Pregabalin as adjunctive therapy for partial epilepsy: An audit study in 96 patients from the South East of England

Abstract: Pregabalin seems to be an effective and well-tolerated anti-epileptic drug when used as add-on treatment in patients with refractory partial epilepsy.

Cited by 14 publications

References 17 publications

Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit

Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit

Clinical comparability of the new antiepileptic drugs in refractory partial epilepsy: A systematic review and meta-analysis

The cognitive impact of antiepileptic drugs

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