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.
查看也就是说地址
- 2022-04-262013年国际抗癫痫该协会抗癫痫药使用指南
- 2022-04-1117 年度经验:随访胡须斑秃预后
- 2021-11-16癫痫病饮食治疗法包含哪些素材
- 如何辨别男人是否真阳痿?
- Circ Ep:左室肥厚高血压患者新发房颤增加SCD风险
- Rheumatology:甘氨酸通过SAM介导的GPX4类风湿性关节炎启动子甲基化铁浓度变化研究
- 17 年度经验:随访胡须斑秃预后
- 女性身体的这六个特征可能是卵巢癌的信号。不要粗心
- Skin Pharmacol Physiol:壳聚糖凝胶能有效减少皮肤出油
- 继发性痛经和原发性痛经有什么区别?
- 癫痫治疗障碍仍难以克服
- 白癜风光疗有很多方法 因地制宜教你选择
- BMC ENDOCR DISORD:T2DM患者要想保护肾功能,就必须控制体重!
- 治疗白癜风的阿普斯特临床数据
- JAMA:阳性结果的文章一定更受关注吗?
- 白癜风老年人日常护理注意事项
- 生发偏方 4种生发偏方使头发更浓密
- Neurology CP:1例巨细胞动脉炎
- 男性健康饮食 有利于男性健康的12种食物
- 癫痫患者应多喝牛奶,饮食疗法公开
- 白癜风会传染吗?
- 【用药情报站】临床应用应听取各种药种药物禁忌证?
- 儿童白癜风的原因是什么 儿童白癜风怎么办?
- 治疗类风湿性关节炎/膝骨关节炎的专家共识
- Diabetes Obes Metab:恩格列净对肝脂肪变性和纤维化标志物的影响及其与心肾结局的关系
- 癫痫患者手术评估新型工具
- 可怕的黑线征
- KIDNEY INT REP:除了年龄,肾功能下降还与哪些决定性因素有关?
- 你在中国当医生的五少痛点?
- 脉诊公式,中医必备 !
- 治疗前庭大腺囊肿需要注意什么?
- 治疗癫痫病小头痛药物
- 了解婴儿癫痫的病因 实际有哪些
- 神经胶质瘤无罪释放的谷氨酸盐可诱发癫痫
- AAN/AES最新指南:首次非诱发官能癫痫的治疗
- 化疗癫痫病最佳
- 小儿癫痫病治疗则否的事项
- 无论如何怎么样控制癫痫病
- 刚出生癫痫的病因有哪些啊
- 【用药问答】用药癫痫大发作和局限性发作的药物?
- 癫痫持续状态:院内和院外发生有何不同?
- 难治性癫痫病怎么进行疗程
- 癫痫病的腹泻及治疗