早期のと単発発作に対する即時対延期抗薬治療:ランダム化対照試験
Lancet (London, England)
|June 14, 2005
まとめ
抗薬の治療を開始すると,発作が少ない患者では,短期的に発作の再発を迅速に軽減します. しかし,即時の治療は,遅延した治療と比較して,長期的な発作寛解率を改善しません.
科学分野:
- 神経学 神経学とは
- 臨床薬理学 臨床薬理学とは
背景:
- 発作が少ないまたは頻度が低い患者の抗薬 (AED) 治療を開始する最適なタイミングは不明である.
- 遅延されたAED治療と即時のAED治療のリスクと利益の比較は,明確にする必要があります.
研究 の 目的:
- 単発発発作および早期発作の患者における即時対延期AED治療方針を比較する.
- これらの政策が短期的な発作再発と長期的な結果に与える影響を評価する.
主な方法:
- 1847人の単発発作または早期発作の患者を対象とした,マスクを外した多センターランダム化研究です.
- 評価されたアウトカムには,第1回,第2回,第5回発作までの時間,2年間の寛解までの時間,ランダム化後の1~3~5年間の発作自由度,および生活の質が含まれています.
- 治療意図分析が採用されました.
主要な成果:
- AEDの即時の治療は,最初の発作 (HR 1.4),第2発作 (HR 1.3),第1発作 (HR 1.5),第2発作 (HR 1.3),第1発作 (HR 1.5) までの時間を大幅に増加させました.
- また,即時の治療により,2年間の発作寛解 (p=0.023) も得られた.
- 長期的な発作無症 (3~5年) や即時治療と延期治療のグループ間の生活の質の有意な違いは認められなかった.
結論:
- AEDの即時の治療は,最初の発作または早期のの診断から最初の1〜2年以内に発作の発生を効果的に減少させます.
- 即効治療と延期治療の選択は,この患者集団における長期発作寛解率に影響を与えないようです.
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