Anti-seizure medications and quality of life in person with epilepsy

Dwivedi, Rekha; Tiwari, Prabhakar; Tripathi, Manjari

doi:10.1016/j.heliyon.2022.e11073

Cited by 18 publications

(8 citation statements)

References 40 publications

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“…In multivariate analysis, only at initial evaluation did the number of AEM taken remain significantly associated with QOLIE-31-P TS. Our findings are partially in line with earlier research that has described the influence of polytherapy on QOL [23,24]. Other studies have found no correlations between the numbers of ASM and QOL [25,26].…”

Section: Discussionsupporting

confidence: 93%

Influence of Clinical Factors on the Quality of Life in Romanian People with Epilepsy—A Follow-Up Study in Real-Life Clinical Practice

Cioriceanu

Constantin

Bobescu

et al. 2023

JPM

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Background: This study aimed to assess the influence of various clinical factors on the quality of life perception of patients with epilepsy over a follow-up period in current clinical practice. Methods: Thirty-five PWE evaluated via video-electro-encephalography in the Clinical Hospital of Psychiatry and Neurology in Brasov, Romania, were included, and the quality of life was assessed using the Romanian version of the QOLIE-31-P questionnaire. Results: At baseline, the mean age was 40.03 (±14.63) years; the mean duration of epilepsy was 11.46 (±12.90) years; the mean age at the first seizure was 28.57 (±18.72); and the mean duration between evaluations was 23.46 (±7.54) months. The mean (SD) QOLIE-31-P total score at the initial visit (68.54 ±15.89) was lower than the mean (SD) QOLIE-31-P total score at the follow-up (74.15 ± 17.09). Patients with epileptiform activity recorded via video-electro-encephalography, using polytherapy, those with uncontrolled seizures, and those with one or more seizures per month had statistically significantly lower QOLIE-31-P total scores at baseline and follow-up. Multiple linear regression analyses revealed seizure frequency as a significant inverse predictor of quality of life in both evaluations. Conclusions: The QOLIE-31-P total score was improved during the follow-up period, and medical professionals should use instruments to evaluate quality of life and identify patterns while trying to improve the outcomes of patients with epilepsy.

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Section: Discussionsupporting

confidence: 93%

Influence of Clinical Factors on the Quality of Life in Romanian People with Epilepsy—A Follow-Up Study in Real-Life Clinical Practice

Cioriceanu

Constantin

Bobescu

et al. 2023

JPM

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“…[1][2][3] Nonetheless, many patients with drug-resistant epilepsy have polytherapy with ASMs, often in high doses, which increases toxicity and negatively affects quality of life. [20][21][22] From this perspective, application of cenobamate, which allows tapering of a patient's comedication, can be potentially beneficial. Although there is no marketing authorization for monotherapy with cenobamate, it will be interesting to see in clinical practice whether cenobamate alone also leads to good seizure control in individual patients.…”

Section: Discussionmentioning

confidence: 99%

“…The probability of improved seizure control is known to decrease with each subsequently added ASM 1–3 . Nonetheless, many patients with drug‐resistant epilepsy have polytherapy with ASMs, often in high doses, which increases toxicity and negatively affects quality of life 20–22 . From this perspective, application of cenobamate, which allows tapering of a patient's comedication, can be potentially beneficial.…”

Section: Discussionmentioning

confidence: 99%

Add‐on treatment with cenobamate is already effective at low doses in refractory focal epilepsy: A prospective observational study

Novitskaya,

Schütz,

Metternich

et al. 2024

Epilepsia

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Abstract:ObjectiveCenobamate, a novel ASM with a dual mechanism of action, has been shown in pivotal trials to significantly improve seizure control in treatment‐resistant focal epilepsy. We aimed to evaluate whether these promising results could be confirmed in a real‐world setting with a follow‐up period of up to 12 months.MethodsPatients from a tertiary epilepsy centre who received cenobamate add‐on between June 2021 to October 2023 were followed up prospectively at 3, 6 and 12 months after treatment initiation for assessment of seizure outcomes and treatment‐related adverse events.ResultsThe clinical cohort included 112 adult patients with 30% non‐lesional cases and a wide spectrum of epileptogenic lesions underlying refractory focal epilepsy. We observed a significant reduction in monthly seizure frequency of all seizure types already after 3 months of treatment at a median cenobamate dose of 100 mg/day. 46% of patients were responders with a ≥ 50% seizure reduction, 26% had a ≥ 75% seizure reduction, and 9% became seizure free. Among the 74 patients with available follow‐up of 12 months, the responder rates reached 55%, 35% and 19% for ≥ 50%, ≥ 75% and 100% of seizure reduction, respectively.After 3 months of treatment, 38% of patients reported adverse effects, mainly (84%) mild to moderate in intensity. Adjustment of comedication allowed successful management of adverse effects in 32% of patients. At a group level, there was no correlation between the cenobamate daily dose and the incidence of adverse effects.SignificanceWe found a clinically relevant response to cenobamate already at a low daily dose of 100 mg also in a patient cohort with a higher degree of drug resistance than in pivotal trials. Our prospectively collected data provide real‐world evidence for high efficacy and good tolerability of the drug although no standardized treatment protocol or comparison with a control group was applied.

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“…In addition, analyses by responders and non-responders is often used in assessing medical devices and in pharmaceutical trials. Such analyses have been used in epilepsy [33], PD [34] and cognitive studies [35]. The identification of which patient characteristics can result in a positive response to treatment would help with further hypothesis generation and information regarding treatment effects.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Placebo-Controlled Study of a Transcranial Photobiomodulation Helmet in Parkinson’s Disease: Post-Hoc Analysis of Motor Outcomes

McGee

Liebert

Bicknell

et al. 2023

JCM

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Emerging evidence is increasingly supporting the use of transcranial photobiomodulation (tPBM) to improve symptoms of neurodegenerative diseases, including Parkinson’s disease (PD). The objective of this study was to analyse the safety and efficacy of tPBM for PD motor symptoms. The study was a triple blind, randomized placebo-controlled trial with 40 idiopathic PD patients receiving either active tPBM (635 nm plus 810 nm LEDs) or sham tPBM for 24 min per day (56.88J), six days per week, for 12 weeks. The primary outcome measures were treatment safety and a 37-item MDS-UPDRS-III (motor domain) assessed at baseline and 12 weeks. Individual MDS-UPDRS-III items were clustered into sub-score domains (facial, upper-limb, lower-limb, gait, and tremor). The treatment produced no safety concerns or adverse events, apart from occasional temporary and minor dizziness. There was no significant difference in total MDS-UPDRS-III scores between groups, presumably due to the placebo effect. Additional analyses demonstrated that facial and lower-limb sub-scores significantly improved with active treatment, while gait and lower-limb sub-scores significantly improved with sham treatment. Approximately 70% of participants responded to active treatment (≥5 decrease in MDS-UPDRS-III score) and improved in all sub-scores, while sham responders improved in lower-limb sub-scores only. tPBM appears to be a safe treatment and improved several PD motor symptoms in patients that responded to treatment. tPBM is proving to be increasingly attractive as a possible non-pharmaceutical adjunct therapy.

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Anti-seizure medications and quality of life in person with epilepsy

Cited by 18 publications

References 40 publications

Influence of Clinical Factors on the Quality of Life in Romanian People with Epilepsy—A Follow-Up Study in Real-Life Clinical Practice

Influence of Clinical Factors on the Quality of Life in Romanian People with Epilepsy—A Follow-Up Study in Real-Life Clinical Practice

Add‐on treatment with cenobamate is already effective at low doses in refractory focal epilepsy: A prospective observational study

A Randomized Placebo-Controlled Study of a Transcranial Photobiomodulation Helmet in Parkinson’s Disease: Post-Hoc Analysis of Motor Outcomes

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