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Study Compares Drugs for Absence Epilepsy in Children

Ethosuximide, valproic acid found more effective than lamotrigine; editorial calls for deeper look

WEDNESDAY, March 3 (HealthDay News) -- Ethosuximide and valproic acid are more effective for treating childhood absence epilepsy than lamotrigine, and ethosuximide treatment results in fewer adverse attentional effects, according to research published in the March 4 issue of the New England Journal of Medicine.

Tracy A. Glauser, M.D., of the Cincinnati Children's Hospital, and colleagues analyzed data from 453 children, aged 2.5 to 13 years, with new-onset childhood absence epilepsy. Children were randomized to receive ethosuximide, valproic acid or lamotrigine, with doses increased until they were either free of seizures, reached the highest dose allowable or tolerable, or had treatment failure. The primary outcome was freedom from treatment failure at 16 or 20 weeks.

The researchers found that children treated with ethosuximide or valproic acid had higher freedom-from-failure rates compared to lamotrigine (53 and 58 percent, respectively, versus 29 percent). Ethosuximide had a smaller negative effect on attentional measures than valproic acid. The groups were similar in terms of discontinuation for intolerable adverse events.

"The fact that so many children (40 to 70 percent) continued to have seizures after four to five months of therapy is disconcerting," writes the author of an accompanying editorial. "Absence epilepsy may not be as benign as we have believed, and perhaps a more rigorous assessment should be used in determining whether children with this disorder actually are doing well."

Pfizer, Abbott Laboratories, and GlaxoSmithKline supplied medications free of charge. Several co-authors reported financial relationships with pharmaceutical companies or serving as expert witnesses.

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