Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy
ObjectiveWe evaluate the effect of distinct clinical features on anti-seizure medication (ASM) doses in seizure-free and not seizure-free patients aged ≥16 years with new-onset epilepsy.Materials and methodsThis study included 459 patients with a validated diagnosis of epilepsy. The most prescribed...
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| Format: | Article |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1159339/full |
| _version_ | 1797752240035856384 |
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| author | Hire Hersi Hire Hersi Jukka Peltola Jukka Peltola Jani Raitanen Jukka T. Saarinen |
| author_facet | Hire Hersi Hire Hersi Jukka Peltola Jukka Peltola Jani Raitanen Jukka T. Saarinen |
| author_sort | Hire Hersi |
| collection | DOAJ |
| description | ObjectiveWe evaluate the effect of distinct clinical features on anti-seizure medication (ASM) doses in seizure-free and not seizure-free patients aged ≥16 years with new-onset epilepsy.Materials and methodsThis study included 459 patients with a validated diagnosis of epilepsy. The most prescribed ASMs were oxcarbazepine (OXC; n = 307), followed by valproic acid (VPA; n = 115), carbamazepine (CBZ; n = 81), and lamotrigine (LTG; n = 67). The seizure freedom rate with their first or subsequent ASM was 88.0%. A retrospective analysis of patient records was performed to determine any association between doses of ASMs and patient characteristics.ResultsThe median OXC dose in seizure-free patients aged >60 years was 600 mg compared to 900 mg in younger patients. When controlling for age but not in an unadjusted model, the median dose of OXC was lower (300 mg, p = 0.018) for seizure-free patients compared to non-seizure-free patients, and the median dose of OXC was also 300 mg lower among older patients aged >60 years (p < 0.001). The median OXC doses for men aged ≤60 years were 300 mg higher than for women aged >60 years (900 mg vs. 600 mg, p = 0.021). The median dose of VPA was 400 mg higher in men than in women (p < 0.001) and 400 mg higher in not seizure-free patients compared to seizure-free patients only when adjusting for sex (p < 0.001). Higher median doses for CBZ were registered with FAS compared with FBTCS (difference in median doses of 200 mg; p = 0.017).ConclusionSignificant OXC dose differences were detected between age groups, whereas VPA dosing was different in men and women. Moreover, CBZ doses were dependent on some seizure types. These data allow for the individualization of the initial target dosing based on key clinical characteristics. |
| first_indexed | 2024-03-12T17:01:25Z |
| format | Article |
| id | doaj.art-faa4c5605e1247d08b6bd8e252e93788 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T17:01:25Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-faa4c5605e1247d08b6bd8e252e937882023-08-07T14:45:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-08-011410.3389/fneur.2023.11593391159339Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsyHire Hersi0Hire Hersi1Jukka Peltola2Jukka Peltola3Jani Raitanen4Jukka T. Saarinen5Department of Neurology, Vaasa Central Hospital, Vaasa, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, FinlandDepartment of Neurology, Tampere University Hospital, Tampere, FinlandSpecial Services Unit, Faculty of Social Sciences (Health Sciences), UKK Institute for Health Promotion Research, Tampere University, Tampere, FinlandDepartment of Neurology, Vaasa Central Hospital, Vaasa, FinlandObjectiveWe evaluate the effect of distinct clinical features on anti-seizure medication (ASM) doses in seizure-free and not seizure-free patients aged ≥16 years with new-onset epilepsy.Materials and methodsThis study included 459 patients with a validated diagnosis of epilepsy. The most prescribed ASMs were oxcarbazepine (OXC; n = 307), followed by valproic acid (VPA; n = 115), carbamazepine (CBZ; n = 81), and lamotrigine (LTG; n = 67). The seizure freedom rate with their first or subsequent ASM was 88.0%. A retrospective analysis of patient records was performed to determine any association between doses of ASMs and patient characteristics.ResultsThe median OXC dose in seizure-free patients aged >60 years was 600 mg compared to 900 mg in younger patients. When controlling for age but not in an unadjusted model, the median dose of OXC was lower (300 mg, p = 0.018) for seizure-free patients compared to non-seizure-free patients, and the median dose of OXC was also 300 mg lower among older patients aged >60 years (p < 0.001). The median OXC doses for men aged ≤60 years were 300 mg higher than for women aged >60 years (900 mg vs. 600 mg, p = 0.021). The median dose of VPA was 400 mg higher in men than in women (p < 0.001) and 400 mg higher in not seizure-free patients compared to seizure-free patients only when adjusting for sex (p < 0.001). Higher median doses for CBZ were registered with FAS compared with FBTCS (difference in median doses of 200 mg; p = 0.017).ConclusionSignificant OXC dose differences were detected between age groups, whereas VPA dosing was different in men and women. Moreover, CBZ doses were dependent on some seizure types. These data allow for the individualization of the initial target dosing based on key clinical characteristics.https://www.frontiersin.org/articles/10.3389/fneur.2023.1159339/fullantiseizure medicationnewly diagnosed epilepsyseizure freedomtreatment outcomesoxcarbazepinevalproic acid |
| spellingShingle | Hire Hersi Hire Hersi Jukka Peltola Jukka Peltola Jani Raitanen Jukka T. Saarinen Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy Frontiers in Neurology antiseizure medication newly diagnosed epilepsy seizure freedom treatment outcomes oxcarbazepine valproic acid |
| title | Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy |
| title_full | Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy |
| title_fullStr | Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy |
| title_full_unstemmed | Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy |
| title_short | Effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy |
| title_sort | effect of clinical features on antiseizure medication doses in patients with newly diagnosed epilepsy |
| topic | antiseizure medication newly diagnosed epilepsy seizure freedom treatment outcomes oxcarbazepine valproic acid |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1159339/full |
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