在人类项目中使用抗药物的模式
Jonah Fox1, Sarah Barnard2, Shruti H Agashe3
1Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Epilepsia
|October 17, 2023
概括
超过三分之一的焦点患者继续接受初始抗发作药物 (ASM) 单疗法. 许多人过渡到其他ASM或多疗法,而lamotrigine的持续时间比 levetiracetam更长.
科学领域:
- 神经学 神经学
- 临床药理学 临床药理学
背景情况:
- 焦点的诊断需要有效的抗发作药物 (ASM) 管理.
- 最初的治疗通常涉及ASM单一治疗,但长期的坚持和有效性各不相同.
- 了解ASM使用的自然史对于优化患者的治疗结果至关重要.
研究的目的:
- 研究ASM单一治疗在新诊断的焦点患者的长期结果.
- 分析ASM使用模式,包括过渡到顺序单疗法或多疗法.
- 为了比较通常处方的ASM的初始单一治疗的持续时间.
主要方法:
- 来自人类项目数据的分析,包括443名新诊断的焦点患者.
- 将患者分为单疗法,顺序单疗法和多疗法组.
- 使用考克斯的比例危险模型来评估初始ASM单疗时间的差异.
主要成果:
- 36.3%的患者继续接受最初的ASM单疗法,平均持续时间为1.9年.
- 列维基拉塞坦是最常见的初始ASM (57.3%),其次是拉莫特里金 (17.4%).
- 与 levetiracetam (中位数1.5年) 相比,接受lamotrigine的患者的治疗时间明显更长 (中位数3.1年).
结论:
- 略超过三分之一的焦点患者保持初始ASM单疗法.
- 几乎60%的患者没有停留在最初的单一疗法转换为连续单一疗法,而40%转移到多疗法.
- 与 levetiracetam 相比,lamotrigine 作为初始单一治疗的使用时间更长.
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