Epilepsy Patients' Response to New Drugs Can Be Predicted
Past treatment history strongly determines future response
WEDNESDAY, Jan. 2 (HealthDay News) -- Among patients with epilepsy, the number of failed prior treatments, the type and duration of epilepsy, and recent seizure frequency all help predict their response to a new antiepileptic medication, according to an article published in the Jan. 1 issue of Neurology.
Yitzhak Schiller, M.D., Ph.D., of Rambam Medical Center in Haifa, Israel, and colleagues followed 478 consecutive epilepsy clinic patients who received newly administered antiepileptic drug treatments for a mean of 1.5 to 7.5 years, in order to investigate factors predicting response to therapy.
The response of patients to newly administered antiepileptic drugs strongly depended on their past treatment history. The seizure-free rate for a first antiepileptic drug was 61.8 percent, compared to 41.7 percent, 16.6 percent and 0.0 percent after one, two to five, and six to seven failed prior drug treatments, with a response curve corresponding mathematically to a mono-exponential function. In addition, the type of epilepsy, duration of epilepsy, and number of seizures in the prior three months also predicted response to treatment.
"Early diagnosis of drug resistance is of key importance both for estimating the expected prognosis of patients and for early referral of patients to non-pharmacologic treatments such as epilepsy surgery and vagal nerve stimulation," the authors write.