Effects of adjunctive zonisamide treatment on weight and body mass index in children with partial epilepsy

Lagae, Lieven; Meshram, Chandrashekhar; Giorgi, Luigi; Patten, Anna

doi:10.1111/ane.12373

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…It has been reported that 24% (99% CI: 2-46%) of ZNS-treated patients develop weight loss, and losses may reach up to 8 kg [63,64]. In children, weight loss ≥5% has been observed in approximately 35% [65]. ZNS has been studied as an antiobesity drug but as yet it has not become an established treatment [24,66].…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

An evaluation of zonisamide, including its long-term efficacy, for the treatment of focal epilepsy

Reimers

Ljung

2019

Expert Opinion on Pharmacotherapy

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Introduction: About 70 million people worldwide are estimated to suffer from epilepsy. Despite a large variety of old and new antiepileptic drugs on the market, about 30% of people with epilepsy do not become seizure-free with medical treatment. This is a major individual and public health burden. Most of these difficult-to-treat patients are having focal seizures. Zonisamide is effective against focal seizures in adults and children and, thus, a therapeutic option for such patients. Its safety profile needs special attention. Areas covered: Herein, the authors discuss the pharmacology, clinical efficacy and the adverse effects of zonisamide. The article is derived from clinical trial data, long-term studies, meta-analyses, review articles, text books, webpages, and official license information. Expert opinion: Zonisamide has proven to be efficacious in focal epilepsy in children and adults, although it is not more effective than carbamazepine or other antiepileptic drugs. It is also effective in generalized epilepsy and in several other conditions of the CNS. Its safety profile may prevent it from becoming a first-line drug for focal epilepsy or any other indication.

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Section: Safety and Tolerabilitymentioning

confidence: 99%

An evaluation of zonisamide, including its long-term efficacy, for the treatment of focal epilepsy

Reimers

Ljung

2019

Expert Opinion on Pharmacotherapy

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“…Confounding conditions included congenital malformations, 23 brain injury, 24 seizure, 25 technology dependence, cancer, 21 eosinophilic esophagitis 26 or milk protein…”

Section: Confounding Health Conditionsmentioning

confidence: 99%

Body Mass Index and Associated Medical Expenditures in the US Among Privately Insured Individuals Aged 2 to 19 Years in 2018

et al. 2023

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ImportanceNearly 40% of US youth aged 2 to 19 years do not have a body mass index (BMI) in the healthy weight category. However, there are no recent estimates for BMI-associated expenditures using clinical or claims data.ObjectiveTo estimate medical expenditures among US youth across all BMI categories along with sex and age groups.Design, Setting, ParticipantsThis cross-sectional study used IQVIA’s ambulatory electronic medical records (AEMR) data set linked with IQVIA’s PharMetrics Plus Claims database from January 2018 through December 2018. Analysis was performed from March 25, 2022, through June 20, 2022. It included a convenience sample of a geographically diverse patient population from AEMR and PharMetrics Plus. The study sample included privately insured individuals with a BMI measurement in 2018 and excluded patients with pregnancy-related visits.ExposureBMI categories.Main Outcomes and MeasuresTotal medical expenditures were estimated using generalized linear model regression with γ distribution and log-link function. For out-of-pocket (OOP) expenditures, a 2-part model was used that included logistic regression to estimate the probability of positive expenditures followed by generalized linear model. Estimates were shown with and without accounting for sex, race and ethnicity, payer type, geographic region, age interacted with sex and BMI categories, and confounding conditions.ResultsThe sample included 205 876 individuals aged 2 to 19 years; 104 066 were male (50.5%) and the median age was 12 years. Compared with those with healthy weight, total and OOP expenditures were higher for all other BMI categories. Differences in total expenditures were highest for those with severe obesity ($909; 95% CI, $600-$1218) followed by underweight ($671; 95% CI, $286-$1055) compared with healthy weight. Differences in OOP expenditures were highest for those with severe obesity ($121; 95% CI, $86-$155) followed by underweight ($117; 95% CI, $78-$157) compared with healthy weight. Having underweight was associated with higher total expenditures at ages 2 to 5 years and 6 to 11 years by $679 (95% CI, $228-$1129) and $1166 (95% CI, $632-$1700), respectively; having severe obesity was associated with higher total expenditures at ages 2 to 5 years, 6 to 11 years, and 12 to 17 years by $1035 (95% CI, $208-$1863), $821 (95% CI, $414-$1227), and $1088 (95% CI, $594-$1582), respectively.Conclusions and RelevanceThe study team found medical expenditures to be higher for all BMI categories when compared with those with healthy weight. These findings may indicate potential economic value of interventions or treatments aimed at reducing BMI-associated health risks.

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“…The addition of zonisamide to treating a 15-year-old obese male admitted to the hospital for depression and anxiety symptoms resulted in appetite suppression by acting on the hypothalamus, weight loss and normalization of his triglyceride levels [ 101 ]. In addition, results from clinical trials investigating the effect of zonisamide as add-on therapy in children suffering from partial seizures on weight reduction showed that about 35.8% of the treated patients experienced significant weight reduction (≥5% reduction of body weight) [ 102 ].…”

Section: Treatmentmentioning

confidence: 99%

Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity

et al. 2022

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Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity.

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Effects of adjunctive zonisamide treatment on weight and body mass index in children with partial epilepsy

Abstract: Approximately one-third of children treated with zonisamide experienced ≥ 5% weight loss. Weight loss was most apparent in children with high baseline BMI values and did not appear to be associated with any consistent effects on growth and development.

Cited by 9 publications

References 13 publications

An evaluation of zonisamide, including its long-term efficacy, for the treatment of focal epilepsy

An evaluation of zonisamide, including its long-term efficacy, for the treatment of focal epilepsy

Body Mass Index and Associated Medical Expenditures in the US Among Privately Insured Individuals Aged 2 to 19 Years in 2018

Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity

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