[Topiramate in clinical practice (part 1). Multicentric retrospective analysis of the efficacy of topiramate as add-on therapy according to the topographic form of focal epilepsy].
Randomized, controlled studies of new antiepileptic drugs do not always highlight their best utilization in clinical practice. The authors gathered 361 cases of focal epilepsies treated with topiramate (TPM) as an add-on to other anti epileptic drugs prior to marketing. Among these, only 237 were treated for at least 3 months and analyzed here. These patients were treated by neurologists in a clinical setting, with free choice of associated drugs, titration and final daily doses. Compared with controlled studies, TPM was titrated slowly (mean rate: 43 mg/week, vs 100 to 200), and was given at a lower final dose (346 mg/d, vs 200 to 1000). This analysis confirmed the efficacy of TPM as add-on therapy in focal epilepsies (9.3p.100 totally controlled, 19 p.100 with reduction of seizures=90 p. 100, 52.7 p.100 responders at=50 p.100). It showed that there was a striking response in epilepsies originating from the central areas, which are often drug-resistant (19 p.100 totally controlled, 33.33 p. 100 with reduction of seizures=90 p.100). There were responders in all topographic groups. There was however no specific response according to etiology.
Biraben
A
A
Clinique Neurologique, CHRU Pontchaillou, 35033 Rennes cedex 09. Arnaud.Biraben@univ-rennes1.fr
Genton
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004334:Drug Administration Schedule; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012189:Retrospective Studies; D013223:Statistics as Topic; D000077236:Topiramate; D016896:Treatment Outcome
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose