Pharmacotherapy in pediatric epilepsy: rational drug and dose selection

Verrotti, Alberto; Piccorossi, Alessandra; Lasorella, Stefania; Tambucci, Renato

doi:10.1080/17425255.2016.1246536

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Compared with adults, children may have differences in pharmacokinetic and pharmacodynamic profiles. 11 In addition, as with many other medications, there is a lack of data on potentially efficacious antiepileptic drugs. A previous phase 1 study found that the doses tested in the current study were well tolerated and demonstrated a pharmacokinetic profile consistent with adults for children of ≥30 kg body weight.…”

Section: Discussionmentioning

confidence: 99%

Pregabalin as Adjunctive Treatment for Focal Onset Seizures in Pediatric Patients: A Randomized Controlled Trial

et al. 2019

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Efficacy and safety of pregabalin as adjunctive treatment for children (aged 4-16 years) with partial-onset seizures, hereafter termed focal onset seizures for this study, was evaluated. This double-blind, randomized, placebo-controlled, international study had 3 phases: 8-week baseline, 12-week double-blind treatment (2-week dose escalation; 10-week fixed dose), and 1-week taper. Selection criteria included experiencing focal onset seizures and receiving a stable regimen of 1 to 3 antiepileptic drugs. Study treatments were pregabalin 2.5 mg/kg/d, 10 mg/kg/d, or placebo; doses were increased to 3.5 or 14 mg/kg/d for subjects weighing <30 kg. The key endpoints were change in log e (28-day seizure rate), achieving a !50% seizure responder rate, safety, and tolerability during double-blind treatment. Subjects (n ¼ 295; mean age 10.2 years, 55% male, 69% white) were randomized to pregabalin 2.5 mg/kg/d (n ¼ 104), 10 mg/kg/d (n ¼ 97), or placebo (n ¼ 94). A statistically significant reduction in log e (28-day seizure rate) was demonstrated with pregabalin 10 mg/kg/d (a 19.9% improvement over placebo; P ¼ .0185). Seizure frequency was numerically improved (statistically nonsignificant) with pregabalin 2.5 mg/kg/d (P ¼ .2577). Responder rate significantly favored pregabalin 10 mg/kg/d (40.6%, P ¼ .0068) compared with placebo (22.6%) and was numerically improved with pregabalin 2.5 mg/kg/d (29.1%, P ¼ .2600). Common adverse events (!10% of any group) in 10 mg/kg/d, 2.5 mg/kg/d, and placebo groups, respectively, included somnolence (25.8%, 17.3%, 13.8%), increased weight (13.4%, 3.8%, 4.3%), and increased appetite (10.3%, 6.7%, 4.3%). Pregabalin 10 mg/kg/d demonstrated efficacy in seizure frequency reduction in children with focal onset seizures compared with placebo, and both pregabalin doses were generally safe and well tolerated. www.clinicialtrials.gov identifier NCT01389596; EudraCT #2010-020852-79

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Section: Discussionmentioning

confidence: 99%

Pregabalin as Adjunctive Treatment for Focal Onset Seizures in Pediatric Patients: A Randomized Controlled Trial

et al. 2019

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“…Efek farmakokinetik pada anak berbeda dengan dewasa, sehingga diperlukan pemahaman terkait pemakaian obat untuk memastikan keamanan pasien. Pada anak dan bayi mengalami metabolisme yang lebih cepat sehingga perlu obat dengan dosis (mg/kgBB) yang lebih besar dibandingkan orang dewasa (Prest,2003).Obat antiepilepsi yang dapat menginduksi enzim memerlukan hampir 2x lipat dosis dewasa karena memiliki tingkat eliminasi obat yang lebih cepat (Verroti, 2016). Penggunaan obat yang rasional diperlukan pada pasien epilepsi karena obat antiepilepsi digunakan dalam jangka waktu yang panjang, sehingga diharapkan terapi yang tepat dapat meminimalkan frekuensi kejang dan efek samping, mengatasi kondisi kesehatan dan sosial pasien, dan meningkatkan kualitas hidup (Nguyen et al, 2017), sebagai upaya untuk menurunkan angka kesakitan dan kematian (Perdossi, 2014).…”

Section: Pendahuluanunclassified

EVALUASI RASIONALITAS ANTIEPILEPSI PADA PASIEN EPILEPSI PEDIATRI DI INSTALASI RAWAT JALAN RSUPdr. SOERADJI TIRTONEGORO KLATEN TAHUN 2018

Nisak,

Nugraheni

2022

ujp

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Penggunaan obat yang rasional diperlukan pada pasien epilepsi karena obat antiepilepsi digunakan dalam jangka panjang. Terapi epilepsi yang tepat dapat meminimalkan frekuensi kejang dan efek samping, mengatasi kondisi kesehatan dan sosial pasien, meningkatkan kualitas hidup, sebagai upaya menurunkan angka kesakitan dan kematian. Tujuan penelitian ini adalah untuk mengevaluasi rasionalitas antiepilepsi pada pasien epilepsi anak di instalasi rawat jalan RSUP dr. Soeradji Tirtonegoro Klaten tahun 2018 berdasarkan parameter tepat indikasi, tepat pasien, tepat obat dan tepat dosis. Penelitian ini merupakan penelitian non-eksperimental dengan metode deskriptif. Pengambilandata dilakukan secara retrospektif menggunakan data rekam medik pasien epilepsi anak di instalasi rawat jalan tahun 2018 secara purposive sampling yang memenuhi kriteria inklusi yaitu usia pasien ≤ 17 tahun yang terdiagnosa epilepsi dan mempunyai data rekam medik lengkap. Evaluasi kategori pemilihan obat menggunakan Panduan Praktik Klinik Tata Laksana Kasus Epilepsi RSUP dr. Soeradji Tirtonegoro Klaten dan Pharmacotherapy a Pathophysiologic Approach 10th Edition, sedangkan pemilihan dosis obat mengacu pada Pedoman Nasional Pelayanan Kedokteran Tata Laksana Epilepsi Pada Anak 2017, Panduan Praktik KlinikTata Laksana Kasus Epilepsi RSUP dr. Soeradji Tirtonegoro Klatendan BNFfor Children2016 - 2017.Sampel yang memenuhi kriteria inklusi sebanyak 155 pasien. Monoterapi yang sering digunakan adalah asam valproat (58,71%) sedangkan politerapinyaasam valproat dengan fenitoin (9,68%). Ketepatan penggunaan antiepilepsi yang didapatkan sebanyak 100% tepat indikasi, 100% tepat pasien, 100% tepat obat, dan 55,48% tepat dosis. Rasionalitas antiepilepsi pada pasien epilepsi pediatri di instalasi rawat jalan RSUP dr. Soeradji Tirtonegoro Klaten tahun 2018 yaitu 55,48%.

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High incidence of persistent subtherapeutic levels of the most common AEDs in children with epilepsy receiving polytherapy

Czornyj

Guido

Bramuglia³

et al. 2018

Epilepsy Research

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Pharmacotherapy in pediatric epilepsy: rational drug and dose selection

Cited by 3 publications

References 15 publications

Pregabalin as Adjunctive Treatment for Focal Onset Seizures in Pediatric Patients: A Randomized Controlled Trial

Pregabalin as Adjunctive Treatment for Focal Onset Seizures in Pediatric Patients: A Randomized Controlled Trial

EVALUASI RASIONALITAS ANTIEPILEPSI PADA PASIEN EPILEPSI PEDIATRI DI INSTALASI RAWAT JALAN RSUPdr. SOERADJI TIRTONEGORO KLATEN TAHUN 2018

High incidence of persistent subtherapeutic levels of the most common AEDs in children with epilepsy receiving polytherapy

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