Retention rates of rufinamide in pediatric epilepsy patients with and without Lennox–Gastaut Syndrome

Abstract

Summary Objective To evaluate the effectiveness of rufinamide (RFM) in patients with Lennox–Gastaut Syndrome (LGS) compared to those with other epilepsy syndromes using time to treatment failure (retention rate) as the outcome measure. Methods In this retrospective cohort study, characteristics and outcomes of all patients receiving RFM in 2009 and 2010 were recorded. The primary outcome measure was RFM failure, defined as discontinuation of RFM or initiation of an additional antiepileptic therapy. The secondary outcome measure was discontinuation of RFM. Kaplan–Meier method survival curves were generated for time to RFM failure, for all patients and by the presence or absence of Lennox Gastaut Syndrome (LGS). The impact of age, seizure type, fast or slow drug titration, and concomitant therapy with valproate on retention rate were evaluated using Cox regression models. Results One hundred thirty-three patients were included, 39 (30%) of whom had LGS. For all patients, the probability of remaining on RFM without additional therapy was 45% at 12 months and 30% at 24 months. LGS diagnosis was an independent predictor of time to RFM failure (HR 0.51, 95% CI 0.31–0.83), with a median time to failure of 18 months in LGS compared to 6 months in all others (p = 0.006). Conclusions In a broad population of children with refractory epilepsy, around half will continue taking the medication for at least a year without additional therapy. Patients with LGS are two times more likely to continue RFM without additional therapy compared to those without LGS.

Rufinamide (Inovelon) in the Treatment of Lennox–gastaut Syndrome (A Review of Literature and Clinical Case)

“…Диагноз СЛГ явился независи-мым предиктором увеличения времени до «неудачи лечения» руфинамидом (отношение шансов (ОШ) 0,51; 95 % доверительный интервал (ДИ) 0,31-0,83), медиана времени до отмены руфинамида составила 18 мес при СЛГ и 6 мес при других формах эпилеп-сии (p = 0,006). Таким образом, в данном исследо-вании вероятность высокого эффекта руфинамида без назначения дополнительного препарата была в 2 раза выше у больных с СЛГ по сравнению с па-циентами без этого диагноза [21].…”

Rufinamide in the Treatment of Lennox–gastaut Syndrome: Review of Foreign Literature

“…K. Kessler et al (2015) оценивали эффектив-ность руфинамида у пациентов с СЛГ по сравнению с пациентами с другими эпилептическими синдро-мами. Основным критерием оценки эффективности был показатель удержания на терапии (или время до прекращения лечения).…”

“…Диагноз СЛГ явился независимым предиктором увеличения време-ни до «неудачи лечения» руфинамидом (отношение шансов (ОШ) 0,51; 95 % доверительный интервал (ДИ) 0,31-0,83), медиана времени до отмены руфина-мида составила 18 мес при СЛГ и 6 мес при других формах эпилепсии (p = 0,006). Таким образом, веро-ятность высокого эффекта руфинамида в данном ис-следовании без назначения дополнительного препа-рата была в 2 раза выше у пациентов с СЛГ по сравнению с пациентами без СЛГ [14].…”

Rufinamide in patients with Lennox-Gastaut syndrome

“…48 For patients not having LGS in this analysis (n=94), the probability of remaining on rufinamide treatment with or without additional therapy was 49% and 40%, respectively, at 12 months compared to 78% and 64% in patients with LGS (n=39). The median time to discontinuation of rufinamide or additional therapy was 18 months for patients with LGS versus 6 months for those with other epilepsy types.…”

“…The median time to discontinuation of rufinamide or additional therapy was 18 months for patients with LGS versus 6 months for those with other epilepsy types. 48 Overall, in double-blind, open-label, and observational studies, rufinamide has proven to be efficacious in reducing seizure frequency and/or severity in children and young adults, allowing a large proportion of patients to live with 50% fewer seizures, including the drop attacks that so frequently reduce QoL. Although rufinamide overall dosing tends to be lower with slower titration schedules in realworld settings compared with those used in clinical studies, real-world clinical experience still reinforces the efficacy of rufinamide seen in the double-blind clinical studies.…”