Comparative persistence of antiepileptic drugs in patients with epilepsy

Lai, Edward Chia Cheng; Hsieh, Cheng Yang; Su, Chien-Chou; Yang, Yea Huei Kao; Huang, Chin Wei; Lin, Shio Jean; Setoguchi, Soko

doi:10.1097/md.0000000000004481

Cited by 12 publications

(10 citation statements)

References 37 publications

(44 reference statements)

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“…Furthermore, the mean duration of adherence with the initial regimen was around 165 days which is much lesser than the reported values of Divino et al and Lai et al i.e. 186 and 218 days in the USA and Taiwan respectively [16,36]. In our study, the 31.3 % discontinuity with AEDs was observed, which is much greater in comparison with previously reported data that claims 29.18 % of patients showed complete discontinuation of AEDs.…”

Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 66%

“…Previously, pharmacoeconomics, adherence and persistence with AEDs have been reported using various methods in different countries [15][16][17][18][19]. In our previous study, we have reported the prescribing patterns of AEDs in Southern Pakistan [13].…”

Section: Introductionmentioning

confidence: 98%

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Analysis of treatment adherence and cost among patients with epilepsy: a four‐year retrospective cohort study in Pakistan

Asghar

Rehman

Raza

et al. 2021

BMC Health Serv Res

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Background The adherence pattern of antiepileptic drugs (AEDs) among patients with epilepsy is relatively lower in the United States and different European countries. However, adherence and cost analysis of AEDs in Asian countries have not been thoroughly studied. Therefore, the present study aimed to analyze the cost and adherence of AEDs and its associated factors in patients followed in Pakistan. Methods Data from prescriptions collected from patients with epilepsy who have visited the Outpatient Department (OPD) of different tertiary care hospitals at the cosmopolitan city of Karachi, Pakistan from December 2015 to November 2019. The mean follow-up period for each participant was about 22 months. Pairwise comparisons from Cox regression/hazard ratios were used to assess the predictors of adherence. Direct costs of AEDs were calculated and presented as the annual cost of drugs. Results A total of 11,490 patients were included in this study, 51.2 % were male and 48.8 % were female with a mean age of 45.2 ± 15.8 y. Levetiracetam was found as the most prescribing AED in all study participants (32.9 %). Of them, 49.1 % of patients continued their initial recommended treatment. However, 31.3 % of patients have discontinued the therapy, while, 19.6 % were switched to other AED. Adherence with initial treatment was more profound in male (57.4 %) patients, compared to female with a mean age of 44.2 years. Lamotrigine users (60.6 %) showed a higher tendency to retain on initially prescribed drugs. The total cost of epilepsy treatment in the entire study cohort was 153280.5 PKR ($941.9). By applying the Cox regression analysis, it can be observed that the patients with increasing age (OR, 2.04), migraine (OR, 2.21), psychiatric disorders (OR, 4.28), other comorbidities (OR, 1.52) and users of other than top five prescribing AEDs (2.35) were at higher risk of treatment discontinuation. However, levetiracetam (OR, 0.69), valproic acid (OR, 0.52), carbamazepine (OR, 0.81), lamotrigine (OR, 0.80) or lacosamide (OR, 0.65) users have more chances to continue their initial therapy. Conclusions Similar to western countries, the majority of patients with epilepsy exhibited low adherence with AEDs. Various associated factors for improving adherence were identified in this study.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 66%

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Analysis of treatment adherence and cost among patients with epilepsy: a four‐year retrospective cohort study in Pakistan

Asghar

Rehman

Raza

et al. 2021

BMC Health Serv Res

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“…This is particularly apparent in comparison to the oldest, first generation ASMs. As was demonstrated in previous publications, second generation ASMs have higher rates of persistence than first generation ASMs particularly among new users [7,16].…”

Section: Discussionsupporting

confidence: 65%

The influence of demographics and comorbidity on persistence with anti-seizure medication

Marshall

Askarieh

et al. 2022

Seizure

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“…[18] These difference might be justified by larger study population in this study and variations in hepatic enzymes in different races. [1920]…”

Section: Discussionmentioning

confidence: 99%

Newer antiepileptic drugs discontinuation due to adverse effects: An observational study

Golpayegani¹,

Salari²,

Gharagozli³

2019

Ann Indian Acad Neurol

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Aims:Antiepileptic drugs are the main therapy for epilepsy. However, the incidence of adverse effects (AEs) results in treatment discontinuation. The aim of this study is evaluating the factors involved in discontinuation of antiepileptic drugs.Settings and Design:We studied 2797 epileptic patients who consumed levetiracetam (LEV), oxcarbazepine (OXC), topiramate (TPM), zonisamide (ZNS), rufinamide, and lacosamide to evaluate the discontinuation because of AEs.Statistical Analysis Used:Data were analyzed using descriptive statistics and Chi-square test.Results:This study showed the rate of discontinuation due to adverse reactions as follows: TPM (7.10%), OXC (4.5%), ZNS (1.8%), and LEV (1.6%) (Chi-square analysis, P < 0.0001). Our study also showed that 1.35% of the patients did not continue the therapy because of subjective experiences of the AEs. Furthermore, neurologic complications in TPM, skin rashes in OXC, and patients' subjective experiences in LEV prescription were the main reasons for nonadherence due to a AEs.Conclusions:AEs in newer antiepileptic drugs are extremely prevalent. Our observation revealed that skin rashes and paresthesia were the most probable causes of treatment discontinuation because of AEs.

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Comparative persistence of antiepileptic drugs in patients with epilepsy

Abstract: Supplemental Digital Content is available in the text

Cited by 12 publications

References 37 publications

Analysis of treatment adherence and cost among patients with epilepsy: a four‐year retrospective cohort study in Pakistan

Analysis of treatment adherence and cost among patients with epilepsy: a four‐year retrospective cohort study in Pakistan

The influence of demographics and comorbidity on persistence with anti-seizure medication

Newer antiepileptic drugs discontinuation due to adverse effects: An observational study

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