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Comparative efficacy of zonisamide and pregabalin as an adjunctive therapy in children with refractory epilepsy
Mohammad Mahdi Taghdiri1, Mohammad Kazem Bakhshandeh Bali2, Parvaneh Karimzadeh1
1Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Pediatric Neurology Center of Excellence, Department of Pediatric Neurology, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Pregabalin and Zonisamide effectively control seizures in children with intractable epilepsy. Both drugs demonstrated similar efficacy and tolerability, offering valuable options for treatment-resistant epilepsy.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Epileptology
Background:
- Epilepsy affects a significant number of children, with approximately one-third exhibiting resistance to conventional anticonvulsant therapies.
- Intractable epilepsy in pediatric populations presents a substantial clinical challenge, necessitating the exploration of alternative treatment strategies.
Purpose of the Study:
- To evaluate the effectiveness, safety, and tolerability of pregabalin as adjunctive therapy in pediatric patients with intractable epilepsy.
- To compare the efficacy of pregabalin with Zonisamide in managing seizure frequency and severity in this patient group.
Main Methods:
- A randomized study involving 121 children with intractable epilepsy was conducted.
- Patients were assigned to receive either Zonisamide (Group A) or pregabalin (Group B) as add-on therapy to their existing medication.
- Seizure frequency and severity were assessed over a 4-week treatment interval.
Main Results:
- No significant differences in baseline characteristics (age, gender, seizure type, etc.) were observed between the Zonisamide and pregabalin groups.
- Both Zonisamide and pregabalin achieved a >50% reduction in seizure intensity in 40.2% and 45.8% of patients, respectively.
- Seizure frequency declined by 35.8-44.4% in patients treated with Zonisamide and pregabalin, with no statistically significant superiority of one drug over the other.
Conclusions:
- Both pregabalin and Zonisamide demonstrated impressive seizure control in children with intractable epilepsy.
- The studied anticonvulsants were well-tolerated, exhibiting only mild and fully reversible complications.
- Pregabalin and Zonisamide represent valuable therapeutic options for managing treatment-resistant epilepsy in pediatric patients.
Objective:
Approximately one third of epileptic children are resistant to anticonvulsant drugs. This study evaluates the effectiveness, safety, and tolerability of pregabalin as adjunctive therapy in epileptic children relative to Zonisamide.
Materials & Methods:
From April 2012 to November 2012,121 children were referred to Mofid Children's Hospital with intractable epilepsy and enrolled in the study. The patients were divided into two groups (A and B) randomly. Group A was treated with Zonisamide and group B was treated with Pregabalin in addition to prior medication. We assessed seizure frequency and severity during a 4-week interval from the beginning of the drug treatment and compared the efficacy of each in these two groups.
Results:
Group A consists of 61 patients, 26 (42.6%) girls, and35 (57.4%) boys with an age range from 1.5 months-14 years (mean, 73.9± 44.04 months). Group B consists of 60 patients, 31(51.7%) girls, 29 (48.3%) boys with an age range from 6 months-16 years (mean, 71±42.9 months). Age, gender, seizure onset, seizure frequency, seizure type, and previous antiepileptic medications showed that there was no significant difference between the groups (P>0.05). Zonisamide and pregabalin reduced more than 50% of seizure intensity in 40.2%; 45.8% of patients also had a seizure frequency decline between35.8-44.4%, respectively and there was no significant superiority between these two novel anticonvulsants (P>0.05).
Conclusion:
In this survey both pregabalin and Zonisamide were impressive for seizure control in children with intractable epilepsy and well sustained with mild complications that were completely reversible.
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