第三代抗发作药物的现实世界比较:来自COMPARE研究的结果
Roberta Roberti1, Gianfranco Di Gennaro1, Francesca Anzellotti2
1Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy.
Epilepsia
|December 5, 2023
概括
第三代抗发作药物 (ASM),如布里瓦拉塞坦和佩拉曼奈尔,在患者中,与拉克萨米德相比,显示出更高的断药风险. 治疗的有效性和不良事件因患者的特征而异,包括先前使用 levetiracetam 和性别.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 的研究研究.
背景情况:
- 对于第三代抗发作药物 (ASM) 存在有限的比较数据.
- 了解比较有效性和耐受性对于优化治疗至关重要.
- 这项研究解决了对较新的ASM的现实世界证据的需求.
研究的目的:
- 在患者 (PWE) 中,比较布里瓦拉 (BRV),埃斯利卡巴泽平乙酸 (ESL),拉克萨米德 (LCM) 和佩拉曼奈尔 (PER) 的有效性和耐受性.
- 评估保留率作为有效性的主要衡量标准.
- 作为次要目标,评估有效性和安全性概况.
主要方法:
- 涉及22个意大利中心的多中心,回顾性研究.
- 包括成人PWE开始使用BRV,ESL,LCM或PER的附加治疗 (2018年1月至2021年10月).
- 通过保留率 (卡普兰-梅尔曲线) 衡量有效性;通过响应者状态衡量有效性;通过不良事件 (AE) 衡量安全性. 用于分析的多层次物流模型.
主要成果:
- 分析了960名患者,主要是焦点.
- 与LCM相比,在BRV (特别是LIVE-naïve) 和PER中观察到更高的退学风险.
- 妇女在ESL中显示出更高的断药风险;在未知病因的病例中,PER的断药率更高. 根据LEV病史和性别,BRV疗效有所不同. 在PER和BRV (LEV-naïve) 中,AEs的发生率高于LCM.
结论:
- 关于第三代ASM的现实世界比较数据可以指导个性化治疗策略.
- 患者的人口统计学和临床因素显著影响治疗结果和耐受性.
- 根据个体患者资料量身定制ASM选择对于改善管理至关重要.
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