抗发作药物停用导致发作风险增加的变化,在症控制良好的患者中:综合分析
Samuel W Terman1, Geertruida Slinger2, Adriana Koek1,3
1Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.
Epilepsia open
|December 10, 2023
概括
在没有的患者中停止服用抗发作药物 (ASM) 会使发作风险增加7-37%,没有单一的因素预测这种变化. 个人风险评估对于治疗决策至关重要.
科学领域:
- 神经学 神经学
- 临床药理学 临床药理学
- 的研究研究.
背景情况:
- 目前的指导方针建议在没有的患者中考虑停止抗药物治疗 (ASM).
- 关于停药对发作风险的影响在个体之间如何不同,研究有限.
研究的目的:
- 为了确定改变ASM停药对发作风险影响的患者因素.
- 为了确定在低风险和高风险患者群体中停止ASM治疗后发作风险增加的范围.
主要方法:
- 来自三个数据集的数据汇总,其中包括没有发作的患者,他们要么停止或继续使用ASM.
- 进行了时间到第一次发作分析,以评估影响ASM停药相对影响的个体患者因素.
- 使用调整后勤回归,评估了两年发作风险增加的分布.
主要成果:
- 该研究包括1626名患者;678名 (42%) 计划停止ASM治疗.
- 平均预测的2年发作风险为停止治疗的43%和继续治疗的21%,平均绝对增加21%.
- 风险增加的中位数在7%至37%之间,在调整后,没有单一的患者因素显著改变了这一效应.
结论:
- 没有个体患者因素显著改变了与ASM停药相关的发作风险增加.
- 停用ASM可以导致各种发作风险增加 (7%-37%),需要个性化风险评估.
- 关于停止ASM治疗的知情决定需要仔细考虑患者的偏好和个性化风险计算.
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