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Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit.
MedLine Citation:
PMID:  21434875     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Stephen LJ, Parker P, Kelly K, Wilson EA, Leach V, Brodie MJ. Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01507.x. © 2011 John Wiley & Sons A/S. Aims -  Pregabalin (PGB) was licensed in Europe as an add-on antiepileptic drug (AED) for the treatment of partial-onset seizures in 2004. This audit assessed the response to adjunctive PGB in patients with uncontrolled seizures. Methods -  PGB was titrated in 135 patients [73 men; 62 women, aged 18-76 (median 44 years) until one of the following occurred: ≥6 months' seizure freedom, ≥50% or <50% seizure reduction over 6 months; PGB withdrawal because of adverse effects, lack of efficacy or both. Results -  Of the 135 patients, 14 (10.4%) became seizure-free for ≥6 months (median PGB dose 300 mg/day; range 75-600 mg). A ≥ 50% seizure reduction occurred in 33 (24.4%) patients; 20 (14.8%) had <50% reduction. PGB was withdrawn in 68 (50.4%) (40 adverse effects, seven lack of efficacy and 21 both). Commonest problems resulting in withdrawal were sedation (n = 18), weight gain (n = 14) and ataxia (n = 9). There was a positive correlation between increasing dose and weight gain (r = 0.42, P = 0.045). Conclusions -  Add-on PGB benefited 50% of patients, but only 10% achieved 6 months' seizure freedom. Adverse effects, most commonly sedation, dose-related weight gain and ataxia, led to drug discontinuation by 45%. Prospective audits of novel AEDs are a useful adjunct to randomized, controlled trials in managing epilepsy.
Authors:
L J Stephen; P Parker; K Kelly; E A Wilson; V Leach; M J Brodie
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-21
Journal Detail:
Title:  Acta neurologica Scandinavica     Volume:  -     ISSN:  1600-0404     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370336     Medline TA:  Acta Neurol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 John Wiley & Sons A/S.
Affiliation:
Epilepsy Unit, Division of Cardiovascular & Medical Sciences, Western Infirmary, Glasgow, UK.
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