he purpose of this report was to update the 2006 International League Against Epilepsy (ILAE) report and identify the level of evidence for long-term efficacy or effectiveness for antiepileptic drugs (AEDs) as initial monotherapy for patients with newly diagnosed or untreated epilepsy. All applicable articles from July 2005 until March 2012 were identified, evaluated, and combined with the previous ysis (Glauser et al., 2006) to provide a comprehensive update.
The prior ysis methodology was utilized with three modifications: (1) the detectable noninferiority boundary approach was dropped and both failed superiority studies and prespecified noninferiority studies were yzed using a noninferiority approach, (2) the definition of an adequate comparator was clarified and now includes an absolute minimum point estimate for efficacy/effectiveness, and (3) the relationship table between clinical trial ratings, level of evidence, and conclusions no longer includes a recommendation column to reinforce that this review of efficacy/evidence for specific seizure types does not imply treatment recommendations.
This evidence review contains one clarification: The commission has determined that class I superiority studies can be designed to detect up to a 20% absolute (rather than relative) difference in the point estimate of efficacy/effectiveness between study treatment and comparator using an intent-to-treat ysis. Since July, 2005, three class I randomized controlled trials (RCT) and 11 class III RCTs he been published. The combined ysis (1940-2012) now includes a total of 64 RCTs (7 with class I evidence, 2 with class II evidence) and 11 meta-yses.
New efficacy/effectiveness findings include the following: levetiracetam and zonisamide he level A evidence in s with partial onset seizures and both ethosuximide and valproic acid he level A evidence in children with childhood absence epilepsy.
There are no major changes in the level of evidence for any other subgroup. Levetiracetam and zonisamide join carbamazepine and phenytoin with level A efficacy/effectiveness evidence as initial monotherapy for s with partial onset seizures. Although ethosuximide and valproic acid now he level A efficacy/effectiveness evidence as initial monotherapy for children with absence seizures, there continues to be an alarming lack of well designed, properly conducted epilepsy RCTs for patients with generalized seizures/epilepsies and in children in general.
These findings reinforce the need for multicenter, multinational efforts to design, conduct, and yze future clinically relevant adequately designed RCTs. When selecting a patient's AED, all relevant variables and not just efficacy and effectiveness should be considered.
察看信源地址
下一页:小孩子脑瘫的病人方法是什么呢?
- 2022-05-02癫痫病在蔬果方面应该注意什么
- 2022-04-25儿童时期是癫痫的高发期,为什么母亲会患上癫痫?家长要如何预防
- 2022-04-202013年国际抗癫痫联合会抗癫痫药剂使用指南
- 2022-01-10哪家癫痫病治疗最难
- 2021-11-09国家救人癫痫病治疗吗
- 2019-04-18癫痫病在发作时如何进行急救
- 治疗阳痿五食疗方
- 在转移机制研究方面取得了重大进展
- 争吵和压力会影响夫妻的生活!瑜伽或冥想可以缓解美国健康
- 癫痫治疗障碍仍难以克服
- 全国妇科内分泌培训项目
- Cell重磅:解决了近百年的问题!研究发现了闪过记忆的潜在机制
- 癫痫猝死:凶手是谁?
- Autoimmun Rev:心肌炎是一种系统性免疫介导性疾病:发病率、特征和预后
- 精囊恶性预防 五大保健措施
- 治疗脑炎后遗症的方法有哪些?
- 你在中国当医生的五少痛点?
- 第一次同房失败,怎么治疗?
- 每个女人都是江湖……
- 情产生性对性健康更有益
- 手术学习:颅内脊索瘤内镜下三脑室入路治疗
- 癫痫的治疗方法 中医拔罐治疗癫痫的小方法(2)
- J Cell Physiol:草莓对子宫肌瘤患者有益
- 【预约直播】铿锵的论道 不炎,越来越多--「郁金香论坛」学术沙龙即将举行
- 奥硝唑、甲硝唑和替硝唑有什么区别?
- 20白癜风是由人民军医出版社出版的!
- 【用药问答】癫痫发作和局限性发作的首选治疗是什么?
- BJOG:口服补充剂对孕期微生物群的影响
- JAMA Neurology:左乙拉西坦对阿尔茨海默病患者的认知功能有影响,不伴有癫痫活动
- 女性月经保健 如何避免月经期间对身体的伤害?
- BMJ:血浆置换对ANCA相关性血管炎患者的影响
- 男性不育的罪魁祸首:精囊炎
- 体检报告中的结节、钙化和囊肿是什么意思?教你手拉手理解
- 水果虽貌似可能更健康
- 癫痫病的发病状况有哪些
- EOTT:GDF15: 1型高血压的潜在治疗靶点
- 青少年癫痫病怎么疗法最彻底
- 女性癫痫的成因都有哪些
- 20年来首款慢性肾脏病放射治疗药物Forxiga获得NICE推荐
- 癫痫病能治好吗,先详细了解情况?
- 西兰花的做法多心 凉拌西兰花
- 20130301烟台卫视养生节目:安晓光谈癫痫病病因
- Neurology:功能图片呈现神经语言网络可塑性证据,癫痫儿童存在静息状态功能连接性(FC)差异
- 中医学应该怎么治疗癫痫病
- PM2.5危害极大 铲除室内PM2.5专家有妙招
- 瘙痒症严寒预防措施 瘙痒症患者严寒洗浴要点