Treatment of paediatric epilepsy in Germany: antiepileptic drug utilisation in children and adolescents with a focus on new antiepileptic drugs.
BACKGROUND
Treatment of paediatric epilepsy has advanced with the development of new antiepileptic drugs (AEDs). There are few data for Germany to which extent new AEDs are used in the treatment of childhood epilepsy.


OBJECTIVE
To characterise utilisation of antiepileptics in children and adolescents with a specific emphasis on new AEDs.


METHODS
Data were obtained from the German Pharmacoepidemiological Research Database for the period 2004-2006. Descriptive analyses were performed to assess prevalence and incidence of AED use stratified by age and sex. Mono- and combination therapy were considered as well as diagnoses and physician speciality.


RESULTS
We identified 13,197 children with AED use who received a total of 226,856 AED prescriptions. The majority of children treated with an AED were diagnosed with epilepsy (11,872; 89.96%). Of all AED prescriptions, 140,992 (62.15%) were for conventional and 85,864 (37.85%) were for new AEDs. One-year prescribing prevalence ranged between 4.10 and 4.11 per 1000 children. Incidence of AED use was 0.91 (95% CI: 0.87-0.95) per 1000 person-years in 2005 and 0.84 (95% CI: 0.81-0.89) per 1000 person-years in 2006. Monotherapy (9821; 74.42%) was more prevalent than combination therapy. Most AEDs were prescribed by paediatricians (147,150; 64.86%).


CONCLUSIONS
The introduction of the new AEDs had less impact on prescribing of AEDs in children than has been reported for adults. AED prescribing overall was in line with published guidelines.
University of Bremen, Bremen Institute for Prevention Research and Social Medicine (BIPS), Achterstr. 30, 28359 Bremen, Germany.
Michael
M
Dörks
Ingo
I
Langner
Antje
A
Timmer
Edeltraut
E
Garbe
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000639:trends; D015507:Drugs, Investigational / Q000627:therapeutic use*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome
D000927:Anticonvulsants; D015507:Drugs, Investigational