Topiramate as an adjunctive therapy in children with intractable epilepsy
Abstract
Background Epilepsy is a chronic disease that requires antiepileptic drugs (AEDs). Only 60-70% of new patients could be controlled effectively by standard AEDs and this stimulates the search for new, more effective and well-tolerated AEDs.
Objective To asses the efficacy and safety of topiramate, as an adjunctive therapy to standard AEDs for children with intractable epilepsy.
Methods This was an open label, parallel group study. Forty children with at least 4 seizures during a 4-week baseline period were randomly assigned to topiramate (n=20) or control group (n=20). In the topiramate group, the drug was given in adjunct to AEDs for 2-week titration dosage continued with a 12-week stabilization period, while the control group received only AEDs adjusted to their clinical responses.
Results Mean reduction from baseline in monthly seizures frequency was significantly greater in the topiramate group (88.6% vs. 25%; P=0.030). Other variable of efficacy was significantly different (e"50% reduction in seizures: 14/20 vs. 6 /20; P=0.049). Adverse effects of topiramate, such as decreased weight, paresthesia, somnolence, diarrhea, fever, aggressive reaction and flushing, were temporary and mild.
Conclusion Results of this trial strongly suggested that topiramate is effective and well tolerated in reducing seizures of intractable epilepsy.
References
2. Patsalos PN, Frösher W, Pisani F, Van Rijn CM. The importance of drug interactions in epilepsy therapy. Epilepsia. 2002;43:365-85.
3. Ritter F, Glauser T A, Elterman RD, Wyllie E. Topiramate YP Study Group. Etfectiveness, tolerability and safety of topiramate in children with partial onset seizures.
Epilepsia. 2000;41: S82-5.
4. Sharief M, Viteri C, Menchem EB, Weber M, Reiff. R, Pledger G. Karim R. Double.blind, placebo-controlled study of topiramate in patients with refractory partial epilepsy. Epilepsy Res. 1996;25:217-24.
5. Glauser TA. Topiramate. Epilepsia 1999;40 (Suppl 5): 571-80.
6. Elterman RD, Glauser TA, Reife R, Wu SC, Pledger G. The Topiramate YP Study Group: a double-blind randomized trial of topiramate as adjunctive therapy for partial onset seizures in children. Neurology. 1999; 52: 1338-44.
7. Reife RA, Pledger GW. Topramate as adjunctive therapy in refractory partial epilepsy: pooled analysis of data from double-blind, placebo controlled trials. Epilepsia.
1997;38:S31-3.
8. Commission on classification and terminology of International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia. 1981;22:489-501.
9. Commission on classificltion and terminology of International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1989;30:389-99.
10. Budiarto G. Patofisiologi epilepsi (kaitannya dengan pengobatan). Epilepsi. 1998;3:6.22.
11. Chadwick D. Epilepsy. J Neurol Neurosurg Psychiatry. 1994;57:264-77.
12. Coppola G, Caliendo G, Terraciano MM, Buono S, Pellegrino L, Pascoto A. Topiramate in reftactoy partial-onset seizures in children, adolescent and young adults: a multicentric open trial. Epilepsv Research. 2001 ;43:255-60.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-11-17
Published 2006-12-31
