Relationship between the Efficacy and Safety of Topiramate and Patients’ Ages and Types of Epilepsy

• Published in: Neuroscience and behavioral physiology 2014-09, Vol.44 (7), p.765-771
• Main Authors: Kholin, A. A., Zavadenko, N. N., Il’ina, E. S., Fedonyuk, I. D., Kolpakchi, L. M., Khalilov, V. S., Kosyakova, E. S.
• Format: Article
• Language: English
• Subjects: Adults; Age; Behavioral Sciences; Biomedical and Life Sciences; Biomedicine; Compliance; Convulsions & seizures; Drug dosages; Epilepsy; Neurobiology; Neurosciences; Neurosurgery; Patients; Pediatrics
• ISSN: 0097-0549; 1573-899X
• DOI: 10.1007/s11055-014-9981-7

A total of 722 patients (374 men and 348 women, aged from three months to 57 years) were treated with topiramate during the period 2002–2012. Epilepsy was diagnosed and antiepileptic treatment was evaluated using follow-up video-EEG monitoring. Topiramate was effective in 465 patients (64.4%), the efficacy of monotherapy (72.2%) being greater than that of combined therapy (61.9%). Low efficacy was noted in 198 patients (27.4%). Aggravation was seen in 59 cases (8.2%). Compliance (remaining on treatment for more than one year) was 60.79%. High efficacy in children aged less than one year was seen in 55.2% of cases, while low efficacy was seen in 34.5% and aggravation in 10.3%; among children aged 1–3 years, high efficacy was seen in 54.8% and low efficacy was seen in 31.8%, with aggravation in 13.4%; in children aged over three years, efficacy was high in 67.3% and low in 26.2%, with aggravation in 6.5%; in the adult population aged over 18 years, the agent was effective in 82.1% of patients, with low efficacy in 16.6%, and aggravation in just one patient. Topiramate demonstrated high efficacy in the treatment of idiopathic generalized forms of epilepsy (IGE) without absences, as well as in symptomatic/cryptogenic focal forms of epilepsy. Increases in patients’ age were associated with increases in the efficacy of topiramate, while the risk of aggravation decreased significantly.