Outcomes of sustained-release formulation of valproate and topiramate monotherapy in patients with epilepsy: a multi-centre, cohort study

New-generation antiepileptic drugs (AEDs) tend to replace traditional AEDs as the first-line choice for epilepsy. However, whether this change results in better outcome, especially in China, remains unknown. Two broad spectrum AEDs, the traditional drug of sustained-release formulation of valproate...

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Bibliographic Details
Published in:PloS one 2012-12, Vol.7 (12), p.e47982
Main Authors: Hu, Yida, Huang, Xishun, Shen, Dinglie, Ding, Meiping, Sun, Hongbin, Peng, Bin, Hu, Xiangshu, Li, Hua, Zeng, Kebin, Xi, Zhiqin, Zhang, Ying, Cao, Qingqing, Liu, Jing, Zhou, Yan, Wu, Mengjiao, Lu, Yaodong, Chen, Guojun, Wang, Xuefeng
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anticonvulsants - administration & dosage
Anticonvulsants - adverse effects
Antiepileptic agents
Brain research
Care and treatment
Child
Child, Preschool
China
Classification
Clinical medicine
Cohort analysis
Cohort Studies
Comparative analysis
Confidence intervals
Controlled release
Drugs
Epilepsy
Epilepsy - drug therapy
Epilepsy - physiopathology
Female
Fructose - administration & dosage
Fructose - adverse effects
Fructose - analogs & derivatives
Generations
Hospitals
Humans
Male
Medical research
Medicine
Middle Aged
Neurology
Patient outcomes
Patients
Product introduction
Proportional Hazards Models
Public health
Remission
Risk assessment
Seizures
Social and Behavioral Sciences
Studies
Topiramate
Treatment Outcome
Valproic acid
Valproic Acid - administration & dosage
Valproic Acid - adverse effects
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Summary:New-generation antiepileptic drugs (AEDs) tend to replace traditional AEDs as the first-line choice for epilepsy. However, whether this change results in better outcome, especially in China, remains unknown. Two broad spectrum AEDs, the traditional drug of sustained-release formulation of valproate (SRVPA) and the new-generation drug of topiramate, were compared in patients with epilepsy as monotherapy in this multi-centre, observational cohort study from 2000 to 2011. The primary outcome was time to treatment failure. The secondary outcomes included time to first seizure, time to 12-month remission, and time to 24-month remission. Drug tolerability was assessed. Cox proportional hazard models (95% confidence interval [CI]) were used to analyse the relative risks expressed as hazard ratios (HR). Of the 1008 recruited patients, 519 received SRVPA and 489 received topiramate. SRVPA was better than topiramate (28.3% vs. 41.5%; HR = 0.62, [95% CI 0.49-0.77]; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0047982