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
下一页:【盘点】最新助听器损伤研究
- 2022-05-02【盘点】最新助听器损伤研究
- 2022-04-282013年国际上抗癫痫联合会抗癫痫药使用指南
- 2022-04-132016AAN:神经专家发表了有前途的专业见解
- 2022-04-12抗癫痫药物预防新发癫痫:任重而道远
- 2022-04-11PLoS ONE:新的合成蛋白能快速激活免疫系统抵抗流感
- 2022-04-11第四届全国临床脑电图实践基础理论与实践操作培训班
- 抗癫痫药物预防新发癫痫:任重而道远
- PLoS ONE:新的合成蛋白能快速激活免疫系统抵抗流感
- 第四届全国临床脑电图实践基础理论与实践操作培训班
- 预测癫痫患者再入院风险
- 癫痫治疗障碍仍难以克服
- FDA批准开浦兰治疗1个月至4岁癫痫儿童
- Diabetes Obes Metab:恩格列净对肝脂肪变性和纤维化标志物的影响及其与心肾结局的关系
- 癫痫猝死:凶手是谁?
- 特发性癫痫大发作药物治疗的首选
- 老年人癫痫的症状是什么?
- 【用药情报站】临床应用应听取各种药种药物禁忌证?
- 罕见病例:自发性颞极性扩张伴癫痫发作
- 综述:癫痫持续状态诊治最新进展
- DCR: 慢性肾病对局部晚期直肠癌患者接受新辅助放化疗的预后影响
- UCB的Vimpat癫痫新适应症在美国获批
- NeuroImage:纤维球成像可用于癫痫的进展
- 癫痫患者停药问题解决了吗?最新的预测模型已经发布!
- 癫痫会遗传吗 癫痫的治疗方法
- 被WHO推荐,IVD国产替代品在结核病诊断领域取得了新的成果
- 继发性癫痫能治愈吗 治疗癫痫有几个步骤
- 手术学习:颅内脊索瘤内镜下三脑室入路治疗
- 儿童癫痫的早期症状 癫痫的原因
- FDA批准Aptiom用于治疗患者癫痫发作
- 黑芝麻的营养价值 吃黑芝麻的好处
- 上海率先探索异地就医门诊费直接结算
- 癫痫发作对中风患者静脉溶栓的长期转移有效
- 控制癫痫患者再次抽搐,不包括可选药物?
- 治疗未婚癫痫病的多钱
- 癫痫病化痰方法 传统医学特色
- 中科西部干细胞研究部:干细胞治疗脑出血后遗症国内有新药了!
- 癫痫病中风究竟是怎么回事
- 【用药问答】治疗癫痫大猝死和局限性猝死的药物?
- 癫痫病有哪些成因-
- 类亨廷顿病综合征鉴别病人的7种临床特点
- 经典病例验证:手把手教你治疗强攻击性患者
- 男性癫痫病怎么治疗才能有效
- 癫痫病吃什食物优点多
- 什么是局灶性帕金森氏症?局灶性帕金森氏症的治疗
- 癫痫病吃什么可以管控
- 月经性癫痫患者妊娠期癫痫控制情况很好