Understanding the burden of focal epilepsy as a function of seizure frequency in the United States, Europe, and Brazil

Gupta, Shaloo; Ryvlin, Philippe; Faught, Edward; Tsong, Wan; Kwan, Patrick

doi:10.1002/epi4.12050

Cited by 28 publications

(8 citation statements)

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“…Even though the NHWS is a nationally representative general population survey that uses stratified random sampling to recruit respondents, most respondents are recruited online. Nonetheless, several studies have shown that disease prevalence estimates and health outcome results reported from studies using NHWS data align with studies using non‐NHWS data 3,38–43 . All data collected are cross‐sectional in nature, so associations can be measured, but causality cannot be assessed.…”

Section: Discussionmentioning

confidence: 94%

“…shown that disease prevalence estimates and health outcome results reported from studies using NHWS data align with studies using non-NHWS data. 3,[38][39][40][41][42][43] All data collected are cross-sectional in nature, so associations can be measured, but causality cannot be assessed. As is common in observational research, there is also the possibility of confounding by indication stemming from the selfreported nature of the survey.…”

Section: Discussionmentioning

confidence: 99%

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Impact of headache frequency and preventive treatment failure on quality of life, disability, and direct and indirect costs among individuals with episodic migraine in the United States

Dodick,

Reed,

Lee

et al. 2024

Headache

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ObjectiveTo evaluate unmet needs among individuals with episodic migraine (EM) in the United States (US).BackgroundData are limited on the impact of headache frequency (HF) and preventive treatment failure (TF) on the burden of migraine in the US.MethodsA retrospective, cross‐sectional analysis of 2019 National Health and Wellness Survey (NHWS) data was conducted from an opt‐in online survey that identified respondents (aged ≥18 years) in the US with self‐reported physician‐diagnosed migraine. Participants were stratified by HF (low: 0–3 days/month; moderate‐to‐high: 4–14 days/month) and prior preventive TF (preventive naive; 0–1 TF; ≥2 TFs). Comparisons were conducted between preventive TF groups using multivariable regression models controlling for patient demographic and health characteristics.ResultsAmong individuals with moderate‐to‐high frequency EM, the NHWS identified 397 with ≥2 TFs, 334 with 0–1 TF, and 356 as preventive naive. The 36‐item Short‐Form Health Survey (version 2) Physical Component Summary scores were significantly lower among those with ≥2 TFs, at a mean (standard error [SE]) of 41.4 [0.8] versus the preventive‐naive 46.8 [0.9] and 0–1 TF 44.5 [0.9] groups; p < 0.001 for both). Migraine Disability Assessment Scale scores were significantly higher in the ≥2 TFs, at a mean (SE) of 37.7 (3.9) versus preventive‐naive 26.8 (2.9) (p < 0.001) and 0–1 TF 30.1 (3.3) (p = 0.011) groups. The percentages of time that respondents experienced absenteeism (mean [SE] 21.6% [5.5%] vs. 13.4% [3.6%]; p = 0.022), presenteeism (mean [SE] 55.0% [8.3%] vs. 40.8% [6.5%]; p = 0.015), overall work impairment (mean [SE] 59.4% [5.6%] vs. 45.0% [4.4%]; p < 0.001), and activity impairment (mean [SE] 56.8% [1.0%] vs. 44.4% [0.9%]; p < 0.001) were significantly higher in the ≥2 TFs versus preventive‐naive group. Emergency department visits (preventive‐naive, p = 0.006; 0–1 TF, p = 0.008) and hospitalizations (p < 0.001 both) in the past 6 months were significantly higher in the ≥2 TFs group. Direct and indirect costs were significantly higher in the ≥2 TFs (mean [SE] $24,026 [3460]; $22,074 [20]) versus 0–1 TF ($10,897 [1636]; $17,965 [17]) and preventive‐naive ($11,497 [1715]; $17,167 [17]) groups (p < 0.001 for all). Results were similar in the low‐frequency EM group.ConclusionsIn this NHWS analysis, individuals with more prior preventive TFs experienced significantly higher humanistic and economic burden regardless of HF.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Impact of headache frequency and preventive treatment failure on quality of life, disability, and direct and indirect costs among individuals with episodic migraine in the United States

Dodick,

Reed,

Lee

et al. 2024

Headache

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“…Full details of the study design and methods, including the survey instrument used, are published elsewhere [ 23 ]. Briefly, participants registered in existing opt-in online survey panels [Kantar Profiles (Lightspeed) global panel and its partners] [ 24 ] were invited to participate in a health survey without knowledge of the specific health topic. This study was performed in accordance with the Helsinki Declaration of 1964 and its later amendments.…”

Section: Methodsmentioning

confidence: 99%

Acute Treatment Patterns, Migraine Burden, and Healthcare Resource Use in People With Migraine: Results From the OVERCOME (EU) Observational Study

Evers,

Dell’Agnello,

Novick

et al. 2024

Pain Ther

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Introduction The ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (OVERCOME) European Union (EU) is part of an overarching population-based study program that also includes the United States and Japan. Here, we report data on the migraine/severe headache burden and the use of acute medication and healthcare resources in Spain and Germany. Methods OVERCOME (EU) was an online, non-interventional, cross-sectional survey conducted in adults in Spain and Germany between October 2020 and February 2021. A total migraine cohort was established based on health survey participants who reported headache/migraine in the last 12 months AND identified as having migraine based on modified International Classification of Headache Disorders, third edition criteria OR self-reported physician diagnosis. Data were analyzed for the total migraine cohort and the subcohort with moderate to severe headache attacks, with average pain severity ≥ 5 points, pain duration ≥ 4 h, and at least moderate disability due to migraine [Migraine Disability Assessment (MIDAS) score ≥ 11] over the past 3 months. Results Pain of moderate or severe intensity was the most frequent symptom in the total migraine cohort ( n = 19,103/20,756; 92.0%). Proportions of participants reporting severe disability (MIDAS Grade IV), poorer quality of life (QoL; Migraine-Specific QoL Questionnaire), and higher interictal burden (Migraine Interictal Burden Scale-4), generally increased with number of headache days (HDs)/month. Most participants (92.5%) reported current acute migraine/severe headache medication use, although only 39.0% were using triptans. In the moderate to severe attacks subcohort ( n = 5547), 48.4% were using triptans, with nonsteroidal anti-inflammatory drugs the most common acute medication. The moderate to severe attacks subcohort also reported poorer QoL and greater pain and disability with increasing HDs/month, although severe interictal burden was reported for ~ 60% of participants regardless of HDs/month. Treatment satisfaction (six-item migraine Treatment Optimization Questionnaire) in those using triptans was generally poor in both total and subcohorts. Conclusion High migraine-related burden levels were reported, despite use of acute medication. Although triptans are recommended for moderate to severe migraine attacks in Spanish and German guidelines, less than half of participants were using triptans; treatment satisfaction in those using triptans was generally poor. New tailored treatment options may help address unmet needs in current acute treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s40122-024-00589-3.

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“…Focal seizures (formerly known as partial seizures) constitute the most common seizure type, representing up to 61% of the epilepsy population (Gupta et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Epilepsy is one of the most common neurological conditions; it affects people of all ages, races, social classes, and geographical locations. Focal seizures (formerly known as partial seizures) constitute the most common seizure type, representing up to 61% of the epilepsy population (Gupta et al., 2017 ).…”

Section: Introductionmentioning

confidence: 99%

The burden of epilepsy and unmet need in people with focal seizures

et al. 2022

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Background: Epilepsy is one of the most common neurological conditions worldwide.As a chronic condition, epilepsy imposes a significant burden on people with epilepsy and society. We aimed to assess the burden and unmet need of individuals with epilepsy and their caregivers, focusing on focal seizures, the main type of seizure in adults and children. Methods:A targeted evidence review of the burden of epilepsy, focusing on focal seizures, was conducted to identify articles reporting: epidemiology, mortality, morbidity, quality of life (QoL), and costs. Results:Focal seizures affect up to ∼61% of people with epilepsy. They are associated with an increased risk of injury and premature death than the general population. People with epilepsy also have high comorbidity, particularly depression, anxiety, and cognitive impairments. Higher seizure frequency, adverse treatment events, and employment concerns reduce QoL. A reduction in caregivers' QoL is also often reported. Epilepsy requires long-term treatment accounting for high individual costs.Hospitalizations and antiseizure medications (ASMs) are the leading cost drivers of inpatient management and indirect costs with high unemployment rates, particularly in drug-resistant populations. Despite the advent of new treatments, a high unmet need remains unaddressed; approximately 40% of people with epilepsy are drug-resistant, further increasing the risks associated with epilepsy. Conclusions:Our findings highlight a substantial burden of illness and unmet needs in individuals with focal seizures, especially those with drug-resistant epilepsy. Suboptimal treatment options negatively impact QoL and, consequently, a sizeable economic burden indicating the need for new treatments and prioritizing this conditionantiseizure medication, caregivers, costs, drug-resistant epilepsy, quality of lifeThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Understanding the burden of focal epilepsy as a function of seizure frequency in the United States, Europe, and Brazil

Cited by 28 publications

References 30 publications

Impact of headache frequency and preventive treatment failure on quality of life, disability, and direct and indirect costs among individuals with episodic migraine in the United States

Impact of headache frequency and preventive treatment failure on quality of life, disability, and direct and indirect costs among individuals with episodic migraine in the United States

Acute Treatment Patterns, Migraine Burden, and Healthcare Resource Use in People With Migraine: Results From the OVERCOME (EU) Observational Study

The burden of epilepsy and unmet need in people with focal seizures

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