A Life-Course Assessment Of Medication Use And Medical Costs Of Lennox-Gastaut Syndrome (Lgs)

Montouris, Georgia; Piña-Garza, JE; Vekeman, Francis; Cheng, WY; Tuttle, EG; Giguere-Duval, Philippe; Duh,; Isojärvi, Jouko

doi:10.1016/j.jval.2016.03.212

Cited by 1 publication

(5 citation statements)

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“…Most individuals with LGS receive ASMs to manage their symptoms 23,26,28,30,34,36,42,53,55,60,69,78,80,82,83,88,91,95–100 . Across 23 studies with information on LGS treatment, 19 reported that all individuals with LGS received ASMs, and the other four studies generally found that more than 80% of individuals used ASMs.…”

Section: Resultsmentioning

confidence: 99%

“…Another USA‐based study showed that costs for LGS were approximately three times higher than for other epilepsies 69,90 . Pharmacy costs ($1592–$24 018) were mainly driven by the high costs of ASMs, with some evidence of rising costs over time 69,90–92 …”

Section: Resultsmentioning

confidence: 99%

“…69,90 Pharmacy costs ($1592-$24 018) were mainly driven by the high costs of ASMs, with some evidence of rising costs over time. 69,[90][91][92] Across five studies, inpatient admissions ranged from .6 to 3.6 per patient-year, 67,69,72,89,93 with a mean length of each hospital stay of 2-5 days. 72,93 Four studies showed that outpatient visits ranged from 6.3 to 11.8 per patient-year.…”

Section: Economic Burdenmentioning

confidence: 99%

“…Most individuals with LGS receive ASMs to manage their symptoms. 23,26,28,30,34,36,42,53,55,60,69,78,80,82,83,88,91,[95][96][97][98][99][100] Across 23 studies with information on LGS treatment, 19 reported that all individuals with LGS received ASMs, and the other four studies generally found that more than 80% of individuals used ASMs. However, pharmacoresistance associated with switching of ASMs 21,23,34,36,39,41,45,49,50,72,73,77,85,92,93,95,96,[101][102][103][104] and polytherapy 51,105 was common.…”

Section: Treatment Burdenmentioning

confidence: 99%

“…Non-ASM treatments for LGS included ketogenic diet, corpus callosotomy, VNS, focal resection, deep brain stimulation, antipsychotics, and selective serotonin reuptake inhibitors. 18,36,38,39,50,58,77,82,85,91,95,104,105,[108][109][110] Additional treatment modalities are commonly used concurrently with ASMs, with one study from South Korea (n = 68) reporting that 61.8% of individuals were receiving non-ASM treatments concurrently with ASMs. 82 Adverse events (AEs) were associated with treatment with ASMs, corpus callosotomy, dietary changes, and VNS.…”

Section: Treatment Burdenmentioning

confidence: 99%

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A comprehensive systematic literature review of the burden of illness of Lennox–Gastaut syndrome on patients, caregivers, and society

Cross,

Benítez,

Roth

et al. 2024

Epilepsia

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Fully elucidating the burden that Lennox–Gastaut syndrome (LGS) places on individuals with the disease and their caregivers is critical to improving outcomes and quality of life (QoL). This systematic literature review evaluated the global burden of illness of LGS, including clinical symptom burden, care requirements, QoL, comorbidities, caregiver burden, economic burden, and treatment burden (PROSPERO ID: CRD42022317413). MEDLINE, Embase, and the Cochrane Library were searched for articles that met predetermined criteria. After screening 1442 deduplicated articles and supplementary manual searches, 113 articles were included for review. A high clinical symptom burden of LGS was identified, with high seizure frequency and nonseizure symptoms (including developmental delay and intellectual disability) leading to low QoL and substantial care requirements for individuals with LGS, with the latter including daily function assistance for mobility, eating, and toileting. Multiple comorbidities were identified, with intellectual disorders having the highest prevalence. Although based on few studies, a high caregiver burden was also identified, which was associated with physical problems (including fatigue and sleep disturbances), social isolation, poor mental health, and financial difficulties. Most economic analyses focused on the high direct costs of LGS, which arose predominantly from medically treated seizure events, inpatient costs, and medication requirements. Pharmacoresistance was common, and many individuals required polytherapy and treatment changes over time. Few studies focused on the humanistic burden. Quality concerns were noted for sample representativeness, disease and outcome measures, and reporting clarity. In summary, a high burden of LGS on individuals, caregivers, and health care systems was identified, which may be alleviated by reducing the clinical symptom burden. These findings highlight the need for a greater understanding of and better definitions for the broad spectrum of LGS symptoms and development of treatments to alleviate nonseizure symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%