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URL
上一页:癫痫治疗障碍仍难以克服
下一页:男性癫痫,这些问题你有关注吗?
- 2022-05-10芬氟拉明治疗Lennox-Gastaut遗传性的III期临床试验取得积极结果
- 2022-05-04深入了解新生儿低钙遗传性鉴别诊断方法
- 2022-04-26全面性癫痫的先兆研究课题
- 2022-04-202013年国际抗癫痫协会抗癫痫药使用指南
- 癫痫治疗障碍仍难以克服
- FDA批准塞尔基因Otezla治疗银屑病性关节炎
- 原发性小肠淋巴管扩张症一例
- 临床试验显示XenoPort 银屑病药物胃肠道副作用较严重
- 注射激素会导致外周色素减少和萎缩
- 广西百色破获药案:涉及74家药店,3000多盒
- 疾病新知:毛囊性白癜风
- 银屑病常用药物进入医疗保险,有效减轻患者的医疗负担
- 病例报告:水浴 PUVA 治疗皮下环状肉芽肿
- FDA 批准银屑病新药 ixekizumab
- 诺华Cosentyx欧盟批准治疗中重度斑块状银屑病
- 为什么女教师成为男性的首选目标(3)
- 智能手机真能成为诊断工具吗?未必!
- Alz Res Therapy:健康饮食可以降低痴呆的风险
- 泡温泉时不能忽视的事情
- 治疗白癜风的阿普斯特临床数据
- 白癜风应该做哪些检查?
- 专家回答,如何诊断儿童白癜风?
- 为什么光疗能有效治疗白癜风?
- 2015第31届国际癫痫大会(IEC)
- 白癜风老年人日常护理注意事项
- Sci Rep:成人睾丸中内源性素系统成分的特征和定位
- 银屑病的诊断方法
- 治疗皮肤病的女性远离各种皮肤病
- 白癜风病愈后如何巩固防复发?
- 生发偏方 4种生发偏方使头发更浓密
- 癫痫症状 如何护理癫痫患者?
- 心理百科:春节期间小心疾病
- 癫痫病的症状及疗程
- 可诱发高血压的药物汇总
- 癫痫病需要怎样来进行治疗
- 抑郁症的治疗方法 中医拔罐治抑郁症小方法(2)
- 癫痫病的早期征状 有这些征状小心癫痫病
- 记得神内副高笔试
- 怎么治疗癫痫病真实感比较好
- 出院能治癫痫病吗
- 依然服用抗癫痫药会得骨质疏松吗?
- 痫疾的治疗方法是什么 痫疾有这些偏方
- 20130508养生堂:栾国明讲癫痫病的早期疼痛
- 癫痫病会遗传吗 癫痫的疗程方法