Double-blind substitution of vigabatrin and valproate in carbamazepine-resistant partial epilepsy. 012 Study group.
In: Epilepsy research, Jg. 34 (1999-04-01), Heft 2-3, S. 199-205
Online
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Zugriff:
Patients from 12 countries reporting two or more partial seizures per month despite treatment with optimal doses of CBZ were randomised to additional vigabatrin (VGB, 2-4 g daily) or sodium valproate (VPA, 1-2 g daily) using a double-blind, double-dummy design. The study included a 6 month retrospective baseline on unchanged CBZ dosage, a month's prospective baseline, a short titration phase, and an assessment period lasting 3 months on duotherapy. CBZ was withdrawn over a further 2 months in responders ( > or = 50% monthly seizure reduction compared with baseline), who continued on alternative monotherapy for 3 or more months. If seizure control deteriorated, CBZ was reinstated and these patients were also followed up for 3 months. A total of 215 patients (108 VGB, 107 VPA) reporting a mean of seven partial seizures per month fulfilled the criteria for the intention-to-treat analysis. 53 and 51% of patients in the VGB and VPA group respectively achieved a monthly reduction in seizure numbers > or = 50%, respectively. 27 and 31% maintained alternative monotherapy. Overall, 17% (7% monotherapy, 10% duotherapy) of the VGB treated patients and 19% (8% monotherapy, 11% duotherapy) of the VPA group remained seizure-free during the final 3 month treatment period. VGB and VPA, which increase neuronal inhibition mediated by gamma aminobutyric acid, can be added to or substituted for CBZ when this Na+ channel blocker fails to control partial seizures. This lends credence to the hypothesis in support of a mechanistic approach to the management of epilepsy.
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Double-blind substitution of vigabatrin and valproate in carbamazepine-resistant partial epilepsy. 012 Study group.
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Autor/in / Beteiligte Person: | Brodie, MJ ; Mumford, JP |
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Zeitschrift: | Epilepsy research, Jg. 34 (1999-04-01), Heft 2-3, S. 199-205 |
Veröffentlichung: | Amsterdam : Elsevier Science Publishers, c1987-, 1999 |
Medientyp: | academicJournal |
ISSN: | 0920-1211 (print) |
DOI: | 10.1016/s0920-1211(98)00110-7 |
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