hepurposeofthisreportwastoupdatethe2006InternationalLeagueAgainstEpilepsy(ILAE)reportandidentifythelevelofevidenceforlong-termefficacyoreffectivenessforantiepilepticdrugs(AEDs)asinitialmonotherapyforpatientswithnewlydiagnosedoruntreatedepilepsy.AllapplicablearticlesfromJuly2005untilMarch2012wereidentified,evaluated,andcombinedwiththepreviousysis(Glauseretal.,2006)toprovideacomprehensiveupdate.
Thepriorysismethodologywasutilizedwiththreemodifications:(1)thedetectablenoninferiorityboundaryapproachwasdroppedandbothfailedsuperioritystudiesandprespecifiednoninferioritystudieswereyzedusinganoninferiorityapproach,(2)thedefinitionofanadequatecomparatorwasclarifiedandnowincludesanabsoluteminimumpointestimateforefficacy/effectiveness,and(3)therelationshiptablebetweenclinicaltrialratings,levelofevidence,andconclusionsnolongerincludesarecommendationcolumntoreinforcethatthisreviewofefficacy/evidenceforspecificseizuretypesdoesnotimplytreatmentrecommendations.
Thisevidencereviewcontainsoneclarification:ThecommissionhasdeterminedthatclassIsuperioritystudiescanbedesignedtodetectuptoa20?solute(ratherthanrelative)differenceinthepointestimateofefficacy/effectivenessbetweenstudytreatmentandcomparatorusinganintent-to-treatysis.SinceJuly,2005,threeclassIrandomizedcontrolledtrials(RCT)and11classIIIRCTshebeenpublished.Thecombinedysis(1940-2012)nowincludesatotalof64RCTs(7withclassIevidence,2withclassIIevidence)and11meta-yses.
Newefficacy/effectivenessfindingsincludethefollowing:levetiracetamandzonisamidehelevelAevidenceinswithpartialonsetseizuresandbothethosuximideandvalproicacidhelevelAevidenceinchildrenwithchildhoodabsenceepilepsy.
Therearenomajorchangesinthelevelofevidenceforanyothersubgroup.LevetiracetamandzonisamidejoincarbamazepineandphenytoinwithlevelAefficacy/effectivenessevidenceasinitialmonotherapyforswithpartialonsetseizures.AlthoughethosuximideandvalproicacidnowhelevelAefficacy/effectivenessevidenceasinitialmonotherapyforchildrenwithabsenceseizures,therecontinuestobeanalarminglackofwelldesigned,properlyconductedepilepsyRCTsforpatientswithgeneralizedseizures/epilepsiesandinchildreningeneral.
Thesefindingsreinforcetheneedformulticenter,multinationaleffortstodesign,conduct,andyzefutureclinicallyrelevantadequatelydesignedRCTs.Whenselectingapatient'sAED,allrelevantvariablesandnotjustefficacyandeffectivenessshouldbeconsidered.
查看信源地址
编辑:jiang下一页:白癜风的病因是什么?
- 2022-04-13诺华银屑病药物 Secukinumab 比依那西普好
- 2022-04-12玫瑰精油的美白效果 怎么办?
- 2022-04-11预测癫痫患者再入院风险
- 2022-04-11月经性癫痫患者妊娠期癫痫控制更好
- 2022-04-07试验性依那西普生物类似物 CHS-0214 3 期研究的主要终点
- 2022-04-04银屑病药物 Brodalumab 自杀倾向副作用AZ 遭受重创
- 诺华银屑病药物 Secukinumab 比依那西普好
- 玫瑰精油的美白效果 怎么办?
- 预测癫痫患者再入院风险
- 月经性癫痫患者妊娠期癫痫控制更好
- 试验性依那西普生物类似物 CHS-0214 3 期研究的主要终点
- 白癜风光疗有很多方法 因地制宜教你选择
- 银屑病药物 Brodalumab 自杀倾向副作用AZ 遭受重创
- JAAD:介绍滤泡性湿疹
- 90为什么一人还有这种能力?
- 注射激素会导致外周色素减少和萎缩
- 白癜风症状 有些白斑可以预防白癜风
- 李敖病逝!面对医疗展示勇士的姿态
- 癫痫诊断的依据是什么?
- Rheumatology:甘氨酸通过SAM介导的GPX4类风湿性关节炎启动子甲基化铁浓度变化研究
- 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
- JPD:左旋多巴-治疗帕金森病的卡比多巴肠凝胶与生活质量和症状有什么关系?
- 羊角病能生孩子吗?
- 【关注】扬子江、联环药业同日获得畅销泌尿系统药,50亿市场掀起波澜
- 白癜风患者吃生葵花子有助于治疗吗?
- 抗癫痫药物预防新发癫痫:任重而道远
- 每四个女人就有一个子宫肌瘤。这个肿瘤有多可怕?
- 中医如何治疗癫痫 癫痫预防?
- 20首款慢性肾脏病治疗药物Forxiga获得NICE推荐
- 小便疼痛
- 白癜风的病因是什么?
- 2013国际抗癫痫联合会抗癫痫药用指南
- 戴只手表就能测癫痫?智能穿戴仪器太牛了
- 癫痫病的成因具体分为哪些
- 怎么才能规约对癫痫病的治疗
- 外科手术癫痫病的最佳方法如何能治好
- 治疗癫痫病择一北京哪家医院好
- 治好癫痫病同样的方法是什么
- EMA建议:限制育龄期女性可用丙戊酸盐
- 治疗儿童癫痫病是什么方法很好呢
- 2015 神经系统疾病诊疗十分困难大盘点
- 40年内只报道25例 癫痫致双侧股骨颈右腿该咋整?
- 癫痫病的发病有哪些病因
- 癫痫病的最佳治疗法期
- 癫痫病年中发作的病因
- 哪里有病人癫痫病医院