Efficacy and safety of a smartphone application‐based treatment of ketogenic diet in pediatric refractory epilepsy

Abstract

ObjectiveWe aimed to find predictors for smartphone application based Ketogenic Diet (KD) treatment effectiveness and safety.MethodsThe efficacy was evaluated according to the reduction of seizure frequency after the intervention of KD, safety was evaluated based on adverse effects. The ordinal logistic regression analysis was used to explore the influencing factors of efficacy.ResultsThe study sample included 116 males and 65 females with a median age of 2.27 years. The baseline frequency of seizure was more than 5 times/day in 123 children, 50.83% of them received 3 or more AEDs. 72 patients’ KD initiation mode was outpatient, 73 completed the 12‐month follow‐up. A total of 88 (48.62%) patients had reported a reduction of seizure ≥ 50%. Compared with 12 months, those who had received KD therapy for only 3 (P=0.009) and 6 months (P=0.005) were more likely to show negative outcomes. Outpatient initiation had better outcomes (P=0.029) than inpatient initiation. For the number of antiepileptic drugs (AEDs) applied, patients on 2 AEDs were more likely to achieve better outcomes (P=0.001). Adverse events had been noted among 77 patients, BMI Z‐score at KD initiation was associated with adverse effects (P=0.003).SignificanceOur study suggested that outpatient initiation and long‐term treatment of KD should be encouraged.