2022-04-26 00:40:16 来源: 太原癫痫医院 咨询医生
he purpose of this report was to update the 2006 International League Against Epilepsy (ILAE) report and identify the level of evidence for long-term efficacy or effectiveness for antiepileptic drugs (AEDs) as initial monotherapy for patients with newly diagnosed or untreated epilepsy. All applicable articles from July 2005 until March 2012 were identified, evaluated, and combined with the previous ysis (Glauser et al., 2006) to provide a comprehensive update.
The prior ysis methodology was utilized with three modifications: (1) the detectable noninferiority boundary approach was dropped and both failed superiority studies and prespecified noninferiority studies were yzed using a noninferiority approach, (2) the definition of an adequate comparator was clarified and now includes an absolute minimum point estimate for efficacy/effectiveness, and (3) the relationship table between clinical trial ratings, level of evidence, and conclusions no longer includes a recommendation column to reinforce that this review of efficacy/evidence for specific seizure types does not imply treatment recommendations.
This evidence review contains one clarification: The commission has determined that class I superiority studies can be designed to detect up to a 20% absolute (rather than relative) difference in the point estimate of efficacy/effectiveness between study treatment and comparator using an intent-to-treat ysis. Since July, 2005, three class I randomized controlled trials (RCT) and 11 class III RCTs he been published. The combined ysis (1940-2012) now includes a total of 64 RCTs (7 with class I evidence, 2 with class II evidence) and 11 meta-yses.
New efficacy/effectiveness findings include the following: levetiracetam and zonisamide he level A evidence in s with partial onset seizures and both ethosuximide and valproic acid he level A evidence in children with childhood absence epilepsy.
There are no major changes in the level of evidence for any other subgroup. Levetiracetam and zonisamide join carbamazepine and phenytoin with level A efficacy/effectiveness evidence as initial monotherapy for s with partial onset seizures. Although ethosuximide and valproic acid now he level A efficacy/effectiveness evidence as initial monotherapy for children with absence seizures, there continues to be an alarming lack of well designed, properly conducted epilepsy RCTs for patients with generalized seizures/epilepsies and in children in general.
These findings reinforce the need for multicenter, multinational efforts to design, conduct, and yze future clinically relevant adequately designed RCTs. When selecting a patient's AED, all relevant variables and not just efficacy and effectiveness should be considered.
- J Allergy Clin Immunol：IgE对鼻息肉有影响吗？
- BMC Complement Med Ther：丁香可用于治疗念珠菌性炎症
- 白癜风光疗有很多方法 因地制宜教你选择
- 2015 神经系统疾病诊疗进展
- 月经期间要注意 有些药物和食物不能食用
- Sci Rep：口服药物，或破坏阿尔茨海默病治疗僵局
- 男人吃什么补 男人吃什么补肾固精
- 38癫痫患者年病史上的感谢信 道出了浓浓的医患情况
- 背痛是什么病 背痛的原因(2)
- Circ Ep：左室肥厚高血压患者新发房颤增加SCD风险
- 癫痫病是否可以受孕 癫痫病的治疗
- 中医如何放射治疗癫痫病 癫痫病的预防
- 哪种药物治疗癫痫病比较好 西药能够设法控制症状
- 世界癫痫日 | 生物学防治 规范诊疗 告别癫痫