title: Retention rates of rufinamide in pediatric epilepsy patients with and without Lennox-Gastaut Syndrome.
abstract: OBJECTIVE
  To evaluate the effectiveness of rufinamide (RFM) in patients with Lennox-Gastaut Syndrome (LGS) compared to those with other epilepsy syndromes using time to treatment failure (retention rate) as the outcome measure.
  
  
  METHODS
  In this retrospective cohort study, characteristics and outcomes of all patients receiving RFM in 2009 and 2010 were recorded. The primary outcome measure was RFM failure, defined as discontinuation of RFM or initiation of an additional antiepileptic therapy. The secondary outcome measure was discontinuation of RFM. Kaplan-Meier method survival curves were generated for time to RFM failure, for all patients and by the presence or absence of Lennox Gastaut Syndrome (LGS). The impact of age, seizure type, fast or slow drug titration, and concomitant therapy with valproate on retention rate were evaluated using Cox regression models.
  
  
  RESULTS
  One hundred thirty-three patients were included, 39 (30%) of whom had LGS. For all patients, the probability of remaining on RFM without additional therapy was 45% at 12 months and 30% at 24 months. LGS diagnosis was an independent predictor of time to RFM failure (HR 0.51, 95% CI 0.31-0.83), with a median time to failure of 18 months in LGS compared to 6 months in all others (p=0.006).
  
  
  CONCLUSIONS
  In a broad population of children with refractory epilepsy, around half will continue taking the medication for at least a year without additional therapy. Patients with LGS are two times more likely to continue RFM without additional therapy compared to those without LGS.
authors.affiliation: Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, United States. Electronic address: kesslers@email.chop.edu.
authors.forename: Sudha Kilaru
authors.initials: SK
authors.lastname: Kessler
authors.affiliation: Temple University School of Medicine, United States.
authors.forename: Ann
authors.initials: A
authors.lastname: McCarthy
authors.affiliation: Departments of Pediatrics and Epidemiology and Biostatistics, George Washington University and Children's National Medical Center, United States.
authors.forename: Avital
authors.initials: A
authors.lastname: Cnaan
authors.affiliation: Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, United States.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Dlugos
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D065768:Lennox Gastaut Syndrome / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014230:Triazoles; C079703:rufinamide
keywords: Antiepileptic drug; Effectiveness; Efficacy; Refractory epilepsy; Retention rate; Tolerability
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