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Efficacy and safety of sodium valproate plus lamotrigine in children with refractory epilepsy
Dongli Zhang1, Li Qiu1, Yuan Zhang1
1Department of Neurology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221000, P.R. China.
Insights
Sodium valproate combined with lamotrigine significantly improves treatment efficacy and safety for refractory epilepsy in children. Serum markers neuron-specific enolase and S100β protein effectively predict treatment outcomes.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Biomarker Research
Background:
- Refractory epilepsy (RE) in children presents significant treatment challenges.
- Current therapeutic options for pediatric RE often have limited efficacy or considerable side effects.
- Novel therapeutic strategies and reliable efficacy predictors are needed for pediatric RE management.
Purpose of the Study:
- To evaluate the efficacy and safety of combined sodium valproate (SV) and lamotrigine (LTG) therapy versus SV monotherapy in pediatric RE.
- To investigate the predictive value of serum neuron-specific enolase (NSE) and S100β protein levels for treatment efficacy in pediatric RE.
Main Methods:
- A comparative study involving 110 children with RE, divided into an SV monotherapy group (n=51) and an SV + LTG combination therapy group (n=59).
- Serum levels of NSE and S100β were measured using ELISA.
- Efficacy, seizure frequency, adverse reactions, and levels of BDNF and NGF were assessed and compared between groups.
Main Results:
- The combination therapy group demonstrated a significantly higher total effective rate and lower seizure frequency compared to the SV monotherapy group.
- The SV + LTG group exhibited significantly lower incidence of adverse reactions.
- Effectively treated children showed significantly lower serum NSE and S100β levels, with AUCs of 0.828 for NSE and 0.814 for S100β, indicating predictive value.
Conclusions:
- Combination therapy with sodium valproate and lamotrigine is superior to sodium valproate monotherapy for treating refractory epilepsy in children.
- Serum neuron-specific enolase and S100β protein are valuable biomarkers for predicting the efficacy of epilepsy treatment in pediatric patients.
Abstract:
Efficacy and safety of sodium valproate (SV) and lamotrigine (LTG) in treating refractory epilepsy (RE) in children and the predictive value of serum neuron-specific enolase (NSE) and central nervous system specific S100β protein (S100β) on efficacy assessment were explored. A total of 110 RE children admitted to Xuzhou Children's Hospital, Xuzhou Medical University were enrolled. Patients treated with SV alone served as the control group (n=51), and those treated with SV plus LTG as the study group (n=59). Serum NSE and S100β expression levels were measured by enzyme-linked immunosorbent assay (ELISA). The efficacy, seizure frequency, adverse reactions, concentration of serum brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF), and expression of serum NSE and S100β were observed and compared. The total effective rate in the study group was significantly higher than that in the control group, and the seizure frequency and incidence of adverse reactions were significantly lower than that in the control group. The study group showed remarkably higher BDNF and NGF than the control group after treatment. The expression of serum NSE and S100β in effectively treated children were significantly lower than that in ineffectively treated children. The area under the curve (AUC) of serum NSE and S100β were 0.828 and 0.814 respectively. SV combined with LTG is better and safer than SV alone in the treatment of RE in children. Serum NSE and S100β are of high value in predicting the efficacy.
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