Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy Report of the American Epilepsy Society Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology

被引：46

作者：

Kanner, Andres M. ^{[1
]}

Ashman, Eric ^{[2
]}

Gloss, David ^{[3
]}

Harden, Cynthia ^{[4
]}

Bourgeois, Blaise ^{[5
]}

Bautista, Jocelyn F. ^{[6
]}

Abou-Khalil, Bassel ^{[7
]}

Burakgazi-Dalkilic, Evren ^{[8
]}

Park, Esmeralda Llanas ^{[9
]}

Stern, John ^{[10
]}

Hirtz, Deborah ^{[11
]}

Nespeca, Mark ^{[12
]}

Gidal, Barry ^{[13
]}

Faught, Edward ^{[14
]}

French, Jacqueline ^{[15
]}

机构：

[1] Univ Miami, Miller Sch Med, Miami, FL 33136 USA

[2] Bronson Methodist Hosp, Bronson Neurosci Ctr, Kalamazoo, MI USA

[3] Charleston Area Med Ctr, Dept Neurol, Charleston, WV USA

[4] Mt Sinai Beth Israel, Dept Neurol, New York, NY USA

[5] Harvard Med Sch, Childrens Hosp, Boston, MA USA

[6] Cleveland Clin Fdn, Epilepsy Ctr, 9500 Euclid Ave, Cleveland, OH 44195 USA

[7] Vanderbilt Univ, Dept Neurol, Nashville, TN USA

[8] Rowan Univ, Cooper Med Sch, Dept Neurol, Cherry Hill, NJ USA

[9] AMITA Hlth Med Grp, Hoffman Estates, IL USA

[10] Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA

[11] Univ Vermont, Sch Med, Burlington, VT 05405 USA

[12] Univ Calif San Diego, Sch Med, Childrens Hosp, La Jolla, CA 92093 USA

[13] Univ Wisconsin, Sch Pharm, 425 N Charter St, Madison, WI 53706 USA

[14] Emory Univ, Sch Med, Atlanta, GA USA

[15] NYU, Dept Neurol, Langone Comprehens Epilepsy Ctr, New York, NY 10016 USA

来源：

EPILEPSY CURRENTS | 2018年 / 18卷 / 04期

关键词：

NEWLY-DIAGNOSED EPILEPSY; CONTROLLED-RELEASE CARBAMAZEPINE; QUALITY STANDARDS SUBCOMMITTEE; TECHNOLOGY-ASSESSMENT SUBCOMMITTEE; DOUBLE-BLIND; PARALLEL-GROUP; VALPROIC ACID; LAMOTRIGINE; MONOTHERAPY; TOPIRAMATE;

D O I：

10.5698/1535-7597.18.4.260

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To update the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy (GE) with second- and third-generation antiepileptic drugs (AEDs). Methods: The 2004 AAN criteria was used to systematically review literature (January 2003 to November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. Results: Several second-generation AEDs are effective for new-onset focal epilepsy. Data are lacking on efficacy in new-onset generalized tonic-clonic seizures, juvenile myoclonic epilepsy, or juvenile absence epilepsy, and on efficacy of third-generation AEDs in new-onset epilepsy. Recommendations: Lamotrigine (LTG) should (Level B) and levetiracetam (LEV) and zonisamide (ZNS) may (Level C) be considered in decreasing seizure frequency in adults with new-onset focal epilepsy. LTG should (Level B) and gabapentin (GBP) may (Level C) be considered in decreasing seizure frequency in patients >= 60 years with new-onset focal epilepsy. Unless there are compelling adverse-effect-related concerns, ethosuximide (ETS) or valproic acid (VPA) should be considered before LTG to decrease seizure frequency in treating absence seizures in childhood absence epilepsy (Level B). No high-quality studies suggest clobazam, eslicarbazepine, ezogabine, felbamate, GBP, lacosamide, LEV, LTG, oxcarbazepine, perampanel, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, or ZNS is effective in treating new-onset epilepsy because no high-quality studies exist in adults of various ages. A recent FDA strategy allows extrapolation of efficacy across populations; therefore, for focal epilepsy, eslicarbazepine and lacosamide (oral only for pediatric use) as add-on or monotherapy in persons >= 4 years old and perampanel as monotherapy received FDA approval.

引用

页码：260 / 268

页数：9

共 25 条

[1]

American Academy of Neurology, CLIN PRACT GUID PROC

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