Neurology Medical News about refractory partial epilepsy;topiramate;add-on therapy

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Long-term efficacy and tolerability of topiramate as add-on therapy in refractory partial epilepsy: An observational study
Epilepsia, 07/01/09

Cho YJ et al. – Low-dose and slow-dose escalation of topiramate (TPM) in add-on therapy for pts with refractory partial epilepsy is effective and well tolerated in long-term, individualized clinical practice.

Methods

Retrospective, single-center, long-term observational study of long-term efficacy and tolerability of TPM as add-on therapy in pts with refractory partial epilepsy
Subjects: Pts fulfilling Berg medical intractability criteria with newly prescribed TPM as add-on therapy between January 2000-June 2002
Usual starting dosage of TPM: 50 mg/day
Optimal-dose adjustments based on individual clinical responses
Analysis of efficacy and tolerability every year during 5-yr follow-up in intention-to-treat (ITT) population

Results

Of 125 study pts, 107 (85.6%) followed for 5 yrs
Retention rate: 87.2% at 1 yr; 64% at 5 yrs
At end of 5 yrs, 69.0% median seizure frequency reduction rate; 43.2% responder rate in ITT population
Cumulative seizure-free rate (SFR): 30.4%
Terminal 1-yr SFR: 12.8% in ITT population (20.0% in completers) at 5-yr follow-up
Adverse events (AEs) in 39.2% of pts, including significant AEs leading to antiepileptic drug (AED) withdrawal in 14.4%
Most common AEs: anorexia (16.0%), weight loss (10.4%), gastrointestinal symptoms (8.8%)
Concomitant AEDs reduced in 25.0% of completers

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