Impacto económico y en calidad de vida de la epilepsia resistente en España: estudio ESPERA

Villanueva, Vicente; Girón, Jesús Martínez; Martín, Javier; Hernández-Pastor, L.J.; Lahuerta, Juan José; Doz, M.; Cuesta, M.; Lévy-Bachelot, L.

doi:10.1016/j.nrl.2012.04.012

Cited by 40 publications

(6 citation statements)

References 17 publications

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“… What this study adds to the field This is the first study using perampanel in Asian population for patients with epilepsy, which revealed the 50% responder rate (45.8%) and treatment emergency adverse event (39.5%) similar to the studies of Europe and North American. Uncontrolled seizures reduce patients' quality of life [1] and increase mortality [2] . Although several antiepileptic drugs (AEDs) have been developed in the past 20 years, the proportion of patients that have achieved seizure-free status is suboptimal, and high drug resistance rates persist.…”

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confidence: 99%

Preliminary Asian experience of using perampanel in clinical practice

et al. 2017

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BackgroundTo analyze the efficacy and safety of perampanel over a 3-month period in a sample of Asian people with epilepsy.MethodsThe efficacy and safety of perampanel as an adjunctive therapy for patients with epilepsy were retrospectively reviewed and analyzed. Patients were categorized according to seizure type, concomitant antiepileptic drug usage, and perampanel dosage.ResultsA total of 210 patients were included in the study and 131 patients completed 3 months of perampanel treatment. The average dosage of perampanel was 5.31 mg/day, and the 50% responder rate (≥50% seizure frequency reduction) in all patients was 45.8%, with a 27.5% seizure-free rate. For focal seizures, focal to bilateral tonic-clonic seizures, and primary generalized seizures, the 50% responder rates were respectively 29.4%, 49.5%, and 36.4%. In total, 39.5% of patients experienced adverse events within 3 months of observation period, and the rate of drug withdrawal due to adverse events was 8.6%. Dizziness, ataxia, irritability/aggression were the most common adverse events.ConclusionsThe efficacy and safety of perampanel in a real-world setting with Asian patients is comparable to that in clinical trials that have included fewer Asian patients.

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confidence: 99%

Preliminary Asian experience of using perampanel in clinical practice

et al. 2017

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“…Emotional distress, social isolation and stigmatization, dependence on family, poor employment opportunities, and personal injury add to the suffering of PWE [38,39]. A number of studies, including data from Spain, have demonstrated the negative impact of DRE in patients' healthrelated quality of life (HRQOL) [40][41][42][43]. Its association with high unemployment rates and occupational incapacity has also been reported [41,44,45].…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies, including data from Spain, have demonstrated the negative impact of DRE in patients' healthrelated quality of life (HRQOL) [40][41][42][43]. Its association with high unemployment rates and occupational incapacity has also been reported [41,44,45]. More than one-third of patients need a caregiver for day life activities [44] and caregivers' quality of life is also negatively impacted both physically and mentally [46].…”

Section: Discussionmentioning

confidence: 99%

Identifying key unmet needs and value drivers in the treatment of focal-onset seizures (FOS) in patients with drug-resistant epilepsy (DRE) in Spain through Multi-Criteria Decision Analysis (MCDA)

Villanueva

Carreño

Gil‐Nagel

et al. 2021

Epilepsy & Behavior

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Introduction: Epilepsy is a serious neurological disease, ranking high in the top causes of disability. Approximately 40% of patients with epilepsy are pharmacoresistant after their seizures failed at least two antiseizure medications (ASMs). Adult patients experiencing focal-onset seizures (FOS) account for approximately 60% of all patients with epilepsy and they are more likely to become drug-resistant epilepsy (DRE) than those with generalized onset. Drug-resistant epilepsy is associated with mortality, morbidity, and reduced quality of life. The information available on the clinical management, health outcomes, and unmet needs of the disease within the Spanish healthcare environment is very limited. Multi-Criteria Decision Analysis (MCDA) allows determination of what represents value in a given indication considering all relevant criteria for healthcare decision-making in a transparent and systematic manner and from the perspective of relevant stakeholders. Purpose: The aim of this study was to identify the burden of DRE (clinical, quality of life, and economic) and the unmet needs in Spain and to determine what represents value in the treatment of FOS in DRE patients from the perspective of Spanish epileptologists. Methods: The steps taken to carry out the MCDA were based on previously published good methodological practices. A systematic literature review (combining biomedical databases and gray literature sources) was performed between March and April 2020. Results were reviewed and validated with three epileptologists in June 2020 and used to develop a MCDA value framework, adapted for FOS in DRE, composed of 12 quantitative criteria and 3 contextual criteria. A group of six Spanish epileptologists from four Spanish regions were trained in MCDA methodology before individually validating value criteria (and their definitions based on literature review findings) and assigned relative weights using an ordinal 6points scale. Results were analyzed and discussed in a group meeting through reflective MCDA discussion methodology. Results: Drug-resistant epilepsy is considered a very severe health problem with important unmet needs affecting a considerably sized population. While safety and impact on quality of life of available ASMs are considered adequate, efficacy remains insufficient for patients to achieve seizure freedom and maintain it over time. Hence, the therapeutic benefit of pharmacological treatments currently used is regarded as suboptimal. Drug-resistant epilepsy management is associated with moderate pharmacological, relevant direct medical and high indirect costs. Quality of evidence available for current treatments is moderate. It is considered that DRE does not currently stand as a key priority for the Spanish healthcare system.

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“…• The psychosocial burden of epilepsy. Epilepsy may lead to decreased quality of life, which is associated with occurrence of depression 9 . In a study by Novy et al 10 , high social burden in epilepsy cases explained the association with psychiatric comorbidities.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of psychiatric comorbidities in children and adolescents at a tertiary epilepsy center

Serra-Pinheiro

D’Andrea-Meira

Angelim

et al. 2021

Arq. Neuro-Psiquiatr.

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Background: Epilepsy is highly comorbid with psychiatric disorders and a significant amount of the morbidity related to epilepsy is in fact a result of psychiatric comorbidities. Objective: To investigate the frequency of different psychiatric comorbidities in children with refractory epilepsy. Methods: We present preliminary observational data from a series of patients (n=82) examined in the psychiatric branch of a tertiary epilepsy center in Rio de Janeiro, Brazil. Patients were classified as presenting autism spectrum disorders, mood disorders, anxiety disorders, disruptive disorders, attention deficit hyperactivity disorder (ADHD), intellectual development disorder, psychotic episode, dissociative/conversive disorders or others. We determined the frequency of each disorder, along with demographic data, medications prescribed, electroencephalogram findings and additional medical examinations and consultations. Results: The most common comorbidities in our sample were autism spectrum disorders and ADHD. Antipsychotics and selective serotonin uptake inhibitors were the most commonly prescribed psychiatric medications. Conclusions: Knowledge about the prevalence of such comorbidities may provide more targeted interventions in Psychiatry and Psychology services linked to epilepsy centers.

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Impacto económico y en calidad de vida de la epilepsia resistente en España: estudio ESPERA

Abstract: Results suggest that DRE is associated with increased use of healthcare resources and consequently with higher costs, poorer quality of life and higher incidence of major depression compared to seizure-free patients, thus representing a considerable burden to the SNS and society.

Cited by 40 publications

References 17 publications

Preliminary Asian experience of using perampanel in clinical practice

Preliminary Asian experience of using perampanel in clinical practice

Identifying key unmet needs and value drivers in the treatment of focal-onset seizures (FOS) in patients with drug-resistant epilepsy (DRE) in Spain through Multi-Criteria Decision Analysis (MCDA)

High prevalence of psychiatric comorbidities in children and adolescents at a tertiary epilepsy center

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