19-05-2015 | Effect of AEDs on status epilepticus ‘needs more research’

20 May 2015
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UK epilepsy research news report on a new study that has shed light on the potential need for more research and understanding to better evaluate the effectiveness of antiepileptic drugs (AEDs) in the treatment of status epilepticus.

Conducted by the Universitetsmedizin Rostock and published in the medical journal Epilepsy & Behavior, the study indicated that efficacy rates of AEDs for this purpose currently vary greatly depending on the assessment criteria used. Currently, there is no global means of determining when an AED is successful in ceasing a cases of status epilepticus.

The researchers have presented a data subset from a large retrospective study which, when completed, will cover all treated cases of status epilepticus at the university's neurological department from January 2010 to June 2013.

Four different criteria were used to assess for AED effectiveness. The first criterion was the last AED administered before status epilepticus termination; the second was the last drug introduced to the regime within 72 hours before termination without changes in the comedication; the third was the last drug introduced or increased in dose within 24 hours before termination without comedication changes; and the fourth was the last drug introduced within 72 hours before termination, even allowing for comedication changes.

A total of 37 treatment episodes in 32 patients were analysed, with phenytoin, valproate, levetiracetam and lacosamide being the therapies used. In 31 episodes, at least one AED was given intravenously.

It was shown that efficacy rates in the whole case series, according to all four criteria, were not significantly different between the four AEDs. However, there was a considerable difference in efficacy rates for each AED when evaluating them with the different criteria.

The researchers concluded: "Our data show that statistically significant results concerning the efficacy of different AEDs in different subtypes of status epilepticus may depend on the outcome criteria. Therefore, efficacy criteria for the effectiveness of AEDs in the treatment of SE should be standardised."

Posted by Anne Brown - http://www.epilepsyresearch.org.uk

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