Evaluating the prescription pattern of newly diagnosed epilepsy patients in India - a real-world observational study

Abstract

Background: To determine the demographic details and management choices of anti-epileptic drugs (AEDs) for the newly diagnosed epilepsy patients in India.Methods: This was a retrospective, observational study conducted among newly diagnosed epilepsy patients in India between Apr 2021 and Mar 2022. The demographic parameters, treatment given, adherence to treatment, and clinician’s global assessment for effectiveness and safety of management options were evaluated.Results: Out of 20,343 patients, majority of the patients were aged between 31-50 years (54.5%), and 62.7% of them were males. Majority of the patients were diagnosed with focal epilepsy (72.2%). Migraine was the most common (28.3%) neuropsychiatric comorbidity among these patients followed by anxiety (19.7%), stroke (18.5%) and depression (11.2%); other commonly reported comorbidities were hypertension (38.27%), gastrointestinal disorders (25.39%), and diabetes (22.06%). Levetiracetam (49.6%) was the most commonly prescribed AED, followed by valproate (29.1%), oxcarbazepine (15.5%), clobazam (13.3%) and lacosamide (8%). With the prescribed AEDs, majority (91%) of the patients had decrease in seizure frequency, most (99.2%) patients had ‘good to excellent’ adherence to the therapy, and clinicians rated the efficacy and safety of prescribed drugs as ‘good to excellent’ in most (99.9%) patients.Conclusions: Epilepsy was common in patients aged 30-50 years with male preponderance. Focal epilepsy was more prevalent. Overall levetiracetam was the most prescribed AED. Levetiracetam and valproate were the most prescribed AEDs among focal and generalized epilepsy respectively. AEDs were well tolerated by most of the patients.

Prescribing Pattern of Levetiracetam in Epilepsy Patients: A Cross-Sectional Study in a Tertiary Care Centre in Manipur

“…In our study, GTCS is the most common type reported and male patients predominated females. These observations are in agreement with reports of various workers in India (10)(11)(12) . The mean age of 27.6 ± 14.5 years in this study is higher than the reported figures of 21.9 years (range 2-77) (10) and 21.64 ± 10.46 (11) .…”

“…However, polytherapy has an unquestionable role if monotherapy fails (15) . In recent studies carried out in India, levetiracetam was the most commonly prescribed AED (12,13,16) . In our study, GTCS was the most common epilepsy type treated with levetiracetam monotherapy.…”

Expert Opinion on the Prescription Practice of Levetiracetam for Different Types of Epilepsy in Indian Clinical Settings

“…Several clinical studies have shown that levetiracetam was safe and effective for epileptic childbearing patients and was the most effective medication in reducing seizure frequency [13,14]. Despite some studies assessing antiepileptic drug usage patterns in single-center settings, there was a dearth of consensus regarding usage patterns, drug choices for various seizure types, and the sociodemographic and clinical factors that influence treatment decisions in India.…”