对于耐药的焦点来说,是塞诺巴马特补充疗法
Francesco Brigo1, Simona Lattanzi2
1Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
The Cochrane database of systematic reviews
|August 1, 2024
概括
塞诺巴马特可以改善焦点的成年人的控制,但它也增加了不良事件. 需要进一步的研究来比较它与其他治疗方法,并评估其在儿童和其他类型的使用.
科学领域:
- 神经学 神经学
- 临床药理学 临床药理学
- 基于证据的医学 基于证据的医学
背景情况:
- 尽管服用抗发作药物 (ASM),但大约三分之一的患者仍然没有发作.
- 由现有的ASM无法控制的焦点是一种重大治疗挑战.
- 塞诺巴马特是一种新兴的治疗选择,用于耐火性.
研究的目的:
- 为了评估药物耐药焦点发作的添加剂口服赛诺巴酸的疗效和耐受性.
- 评估塞诺巴马特在患有的患者中有效性的评估,该患者的不受一种或多种ASM的控制.
主要方法:
- 通过全面的数据库搜索和专家咨询确定随机对照试验 (RCT) 的系统审查.
- 纳入标准侧重于对焦性的成年人中RCT比较add-on cenobamate与安慰剂或其他ASM.
- 主要结局包括至少50%的发作频率,发作自由度和不良事件的减少,分析使用治疗意图.
主要成果:
- 与安慰剂相比,添加巴酸的疗效证据显示出中等确定性,与安慰剂相比,至少50%的发作减少的可能性增加了2.17倍.
- 塞诺巴马特更频繁地实现了无性发作 (16%与5%对比),产生4.45的风险比率 (中等确定性证据).
- 对于塞诺巴酸盐 (77%对67%) 观察到不良事件的风险增加,也具有中度确定性证据.
结论:
- 添加塞诺巴酸可能有效降低发作频率,并实现发作自由的成年人耐火焦点.
- 锡诺巴的使用与可能增加不良事件有关.
- 建议进行进一步的研究,以比较赛诺巴与其他ASM,调查其在儿科群体中的使用,并探索其他类型的长期结果和疗效.
相关概念视频
Antiepileptic Drugs: Potassium Channel Activators
157
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
157
Antiepileptic Drugs: Glutamate Antagonists
305
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
305
Antiepileptic Drugs: GABAergic Pathway Potentiators
363
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
363
Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
279
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
279
Electroconvulsive Therapy
30
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
30
Antiepileptic Drugs: Calcium Channel Blockers
353
Calcium channel blockers, a class of antiepileptic drugs, regulate the flow of calcium ions within neurons.
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
353


