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Published on: August 17, 2021
Short-term efficacy and safety of valproate sustained-release formulation in newly diagnosed partial epilepsy
Dirk Deleu1, Hassan Al-Hail, Boulenouar Mesraoua
1Department of Neurology (Medicine) Hamad Medical Corporation, PO Box 3050, Doha, State of Qatar. ddeleu@hmc.org.qa
Insights
Valproate sustained-release monotherapy effectively controlled seizures in newly diagnosed epilepsy patients of all ages. This epilepsy treatment was well-tolerated, with most patients achieving seizure freedom within six months.
Area of Science:
- Neurology
- Clinical Pharmacology
Background:
- Epilepsy affects millions globally, necessitating effective and well-tolerated treatments.
- Partial seizures (PS) are common, requiring targeted therapeutic strategies.
- Valproate (VPA) is a widely used antiepileptic drug.
Purpose of the Study:
- To assess the efficacy and safety of valproate (VPA) sustained-release in monotherapy for newly diagnosed epilepsy patients.
- To evaluate VPA's effectiveness across all age groups presenting with partial seizures (PS), with or without secondary generalization.
Main Methods:
- A multicenter, prospective, observational, open-label study conducted in Gulf Cooperation Council (GCC) countries.
- Enrolled adults and children (≥6 years) with newly diagnosed partial epilepsy.
- Primary endpoint: 6-month seizure remission rate; secondary endpoints: retention rate, global impression, dose, and safety.
Main Results:
- Eighty-seven percent of patients achieved seizure freedom at 6 months with VPA sustained-release monotherapy (average dose 22 mg/kg/day).
- The treatment retention rate was 80.5%, with 66 out of 77 patients completing the study.
- Adverse drug reactions, primarily hair loss and tremor, were reported in less than 20% of patients, predominantly in adults.
Conclusions:
- Short-term valproate (VPA) sustained-release monotherapy demonstrates significant efficacy in seizure control for newly diagnosed epilepsy patients.
- The treatment is well-tolerated in this patient population, supporting its use in clinical practice.
Objective:
To evaluate the efficacy and safety of valproate (VPA) sustained-released in monotherapy across all ages in newly-diagnosed epileptic patients with partial seizures (PS) with or without secondary generalization.
Methods:
This was a multicenter, prospective, observational, open-label, non-comparative study involving the Gulf Cooperation Council (GCC) countries except the Kingdom of Saudi Arabia, and was performed between November 2004 and May 2006. Adults and children (6 years or older with newly diagnosed partial epilepsy [PE]) with or without secondary generalization were enrolled. The primary efficacy parameter was 6 month-remission rate (proportion of seizure-free patients in relation to total number of retained patients). Secondary efficacy parameters included: 6 month-retention rate, investigator's clinical global impression rating, maximal effective dose and safety profile.
Results:
Seventy-seven patients were enrolled; 56% adults and 44% children, with average duration of epilepsy of 5 months in the pediatric and 17 months in the adult group. Seizures type distribution: PS with secondary generalization (62%), complex PS (53%) and simple PS (14%). The majority had idiopathic seizures (48%). Sixty-six patients completed the study (treatment retention rate 80.5%). At 6 months, 87% of patients became seizure free with VPA sustained-release monotherapy (average dose 22 mg/kg/day). Adverse drug reactions (hair loss and tremor) were recorded in <20% of patients, mostly affecting adults.
Conclusion:
In this population, short-term treatment with VPA sustained-release in monotherapy provides good seizure control and is well tolerated.
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