Guideline conform initial monotherapy increases in patients with focal epilepsy: A population-based study on German health insurance data

Abstract

Initial monotherapy for focal epilepsy is in line with current clinical practice guidelines and mainly implemented by prescription of levetiracetam. Further evaluations should address the question of whether patients treated in line with the guidelines have a favorable outcome, compared to patients not treated in line with current guidelines.

Real life pharmaceutical treatment patterns for adult patients with focal epilepsy in Germany: a longitudinal and cross-sectional analysis of recently approved anti-epileptic drugs

“…This study may in fact underestimate this situation as the observation started in 2007, but some of the prevalent FE patients may have received other AEDs before 2007. Thus, this study confirmed that German treatment guidelines are being strongly adhered to, with high prescription of established AEDs, and low prescription of novel AEDs [32]. …”

“…In our calendar year-based observation, the percentage of adult prevalent FE patients who did not receive any AED therapy ranged between 8.1% in 2007 to 15.4% in 2014; and it steadily increased over time. The generally lower percentage of the no-AED therapy group in comparison to the study by Ertl et al [32] can potentially be explained by our conservative sample definition which required at least one AED prescription in the whole observation period. Without knowledge about disease specifics of these patients, the pattern of the steadily increasing percentage of patients with no AED therapy may be explained by several factors: Firstly, epilepsy surgery or treatment with vagus nerve stimulation (VNS) are therapy options for drug-resistant epilepsy patients [33], [34].…”

“…A recent German study reported that between 32% and 69% of epilepsy patients did not received AED therapy in the first year upon epilepsy diagnosis [32]. In our calendar year-based observation, the percentage of adult prevalent FE patients who did not receive any AED therapy ranged between 8.1% in 2007 to 15.4% in 2014; and it steadily increased over time.…”

Burden and epidemiology of status epilepticus in infants, children, and adolescents: A population‐based study on German health insurance data

“…Entries contain inpatient diagnoses, outpatient diagnoses, costs, procedures, and demographics, and they are routinely inspected for outliers, data errors, and longitudinal changes. The database is continuously evaluated to ensure that it is representative of the German population by comparison to the annual publications of the German Federal Social Insurance Office (Bundesversicherungsamt [BVA]) and has been used previously for epidemiologic studies in epilepsy, SE, and multiple sclerosis . STROSA guidelines (Standardized Reporting Of Secondary data Analyses) were followed…”

Antiepileptic Drugs Impair Shortening of Isolated Cardiomyocytes

“…We have chosen CBZ as it is considered the prototype of sodium channel blockers used in the treatment of people with epilepsy. LEV and LTG were selected, because they are nowadays the most widely used AEDs in the developed countries (16). Furthermore, CBZ and LTG were discussed as potential risk factors for SUDEP in previous studies (17).…”