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.
查看信源定址
上一页:一文掌控癫痫用药宝典
下一页:隐源性癫痫死亡率多于
- 2022-05-10中期癫痫的表现是什么
- 2022-04-28中年癫痫病早期症状是什么
- 2022-04-25隐源性癫痫死亡率多于
- 2022-04-212013年国际上抗癫痫联合会抗癫痫药使用指南
- 2022-03-22张海澄,北京大学人民医院:心脏病发作后的该如何保障?
- 2021-12-06千万别忽略婴儿癫痫病症状
- (ED)器质性的原因是什么?
- 预测癫痫患者再入院风险
- 你在中国当医生的五少痛点?
- 孕妇能吃木瓜吗?
- 罕见病例:自发性颞极性扩张伴癫痫发作
- 暖宝宝能治痛经吗 如何缓解痛经(2)
- 睾丸一大一小,一高一低…不要惊慌这三种睾丸问题!了解清楚是关键
- 好吧,怎么会突然鞘膜积液?
- 抗癫痫药物预防新发癫痫:任重而道远
- 妇幼医院综合外科开始分专业注册诊疗!
- 儿童马蹄肾应注意泌尿或其他系统畸形
- 男性异常勃起需警惕
- Radiology:利用MR颞叶癫痫病灶内侧指纹识别评价的价值
- 附件炎症状
- 原发性心脏副神经节瘤
- 【预约直播】铿锵的论道 不炎,越来越多--「郁金香论坛」学术沙龙即将举行
- 张海澄,北京大学人民医院:心脏病发作后的该如何保障?
- 羊角病能生孩子吗?
- 叉烧包的馅怎么做 很好吃
- 手术学习:颅内脊索瘤内镜下三脑室入路治疗
- 原发性甲状腺功能亢进症常被误诊
- 简单而不简单的疾病:经典输尿管结石 1 病例
- Eur Urol Focus:预测术后中度肾功能丧失的列线图
- 治疗鼻窦真菌感染
- 控制癫痫患者再次抽搐,不包括可选药物?
- PLoS One:在低睾丸素水平男性中,睾丸素治疗和恶性癌症风险研究
- 提高滴虫性炎的治愈率,注意以下饮食禁忌!
- 山东省援助湖北医疗队被授予齐鲁时代楷模
- 抗击癫痫在中国:20年征程,从临床过渡到公卫战略
- 癫痫的治疗方法 癫痫病按摩五步临床(2)
- 癫痫病哪家医院治疗法好
- 疗法癫痫病最权威医院
- 癫痫外科手术常见4个误区!
- 每天半斤茶叶,连喝20年?
- 普瑞巴林单药治疗部分病态癫痫发作安全有效
- 俯卧位是否成为癫痫猝死的又一可怕因素
- 癫痫病是怎样引致的 了解癫痫病的病因
- 北京天坛医院成功实施国内首例“磁共振引导下脑转移疣激光消融术(LITT)”
- 癫痫病不停发作都有哪些病因
- 癫痫是多种脑转到的症状表现?