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
上一页:巨细胞病毒性葡萄膜胆
- 2022-05-03这些最新颁发的国家科技年度关乎你我的健康
- 2022-05-02不知发生什么事情的我,诚惶诚恐地站在院长的办公室。
- 2022-05-022013年国际抗癫痫理事会抗癫痫药使用指南
- 2022-04-26吡仑帕奈辅助用药可改善部分头痛型癫痫患者的症状
- 2022-04-20儿童癫痫病的较从新治疗方法是什么?
- 2022-04-13银屑病常用药物进入医疗保险,有效减轻患者的医疗负担
- 药学版元宵灯谜 看你能猜对几个问题
- 诺华Cosentyx欧盟批准治疗中重度斑块状银屑病
- 疾病新知:毛囊性白癜风
- 焦虑和疾病认知影响银屑病关节炎患者的健康生活量表
- 癫痫治疗障碍仍难以克服
- 病例报告:水浴 PUVA 治疗皮下环状肉芽肿
- 美国FDA关于坏死因子阻滞剂、硫唑嘌呤和/或硫唑嘌呤的安全性更新
- 诺华银屑病药物 Secukinumab 比依那西普好
- 自身免疫病也可以免疫治疗
- PLoS ONE:新的合成蛋白能快速激活免疫系统抵抗流感
- 儿童癫痫的早期症状 癫痫的原因
- 罕见病例:自发性颞极性扩张伴癫痫发作
- 白癜风症状 有些白斑可以预防白癜风
- 如何预防男性结石?结石保健方法
- 预测癫痫患者再入院风险
- 的颜色为什么更深(3)
- 癫痫猝死:凶手是谁?
- 奇怪的精神分裂症行为令人困惑 手术可以帮助患者恢复正常
- 白癜风防治指南:记住这六点,对你的病情有帮助!
- Circ Ep:左室肥厚高血压患者新发房颤增加SCD风险
- 精囊恶性预防 五大保健措施
- 为什么光疗能有效治疗白癜风?
- 黑芝麻的营养价值 吃黑芝麻的好处
- Lancet Psy:Asperger 综合征患者自杀率高
- 血清钙水平可预测甲氨蝶呤治疗银屑病的效果
- 太极拳教程 简单小运动美容抗衰老
- 虽然医学越来越发达,但这四种疾病尚未治愈!别再上当了
- 小儿癫痫病有什么征状
- 于明治好癫痫病的方法哪个好
- 怎样服用癫痫药物可以增高副反应
- 癫痫病爱吃什么可以控制
- 【用药问答】癫痫大发作和局限发作的首选治疗为?
- Sage自愿性明星药物获FDA快速审批承诺
- Diabetes Obes Metab:恩格列净对胃脂肪变性和纤维化标志物的影响及其与心肾结局的关系
- 怎么明了癫痫病的症状与治疗
- 女性癫痫病怎么放射治疗最快
- 避免二次开颅手术创伤 精准微创毁损斩断“传导随身携带”破解难治性
- 怎样治疗癫痫病最必需
- 向对侧转移:部分性癫痫过后状态
- FDA批准开浦兰治疗一个月至4岁癫痫儿童病征