Adjunctive pregabalin for uncontrolled partial-onset seizures: findings from a prospective audit.

Abstract

AIMS:

Pregabalin (PGB) was licensed in Europe as an add-on antiepileptic drug (AED) for the treatment of partial-onset seizures in 2004. This audit assessed the response to adjunctive PGB in patients with uncontrolled seizures.

METHODS:

PGB was titrated in 135 patients [73 men; 62 women, aged 18-76 (median 44 years) until one of the following occurred: ≥ 6 months' seizure freedom, ≥ 50% or < 50% seizure reduction over 6 months; PGB withdrawal because of adverse effects, lack of efficacy or both.

RESULTS:

Of the 135 patients, 14 (10.4%) became seizure-free for ≥ 6 months (median PGB dose 300 mg/day; range 75-600 mg). A ≥ 50% seizure reduction occurred in 33 (24.4%) patients; 20 (14.8%) had < 50% reduction. PGB was withdrawn in 68 (50.4%) (40 adverse effects, seven lack of efficacy and 21 both). Commonest problems resulting in withdrawal were sedation (n = 18), weight gain (n = 14) and ataxia (n = 9). There was a positive correlation between increasing dose and weight gain (r = 0.42, P = 0.045).

CONCLUSIONS:

Add-on PGB benefited 50% of patients, but only 10% achieved 6 months' seizure freedom. Adverse effects, most commonly sedation, dose-related weight gain and ataxia, led to drug discontinuation by 45%. Prospective audits of novel AEDs are a useful adjunct to randomized, controlled trials in managing epilepsy.

• Authors: L J Stephen, P Parker, K Kelly, E A Wilson, V Leach, M J Brodie
• Journal: Acta neurologica Scandinavica (Acta Neurol Scand) Vol. 124 Issue 2 Pg. 142-5 (Aug 2011) ISSN: 1600-0404 [Electronic] Denmark
• PMID: 21434875 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 John Wiley & Sons A/S.

Chemical References

• Anticonvulsants
• Pregabalin
• gamma-Aminobutyric Acid

Topics

• Adolescent
• Adult
• Aged
• Anticonvulsants (therapeutic use)
• Body Weight (drug effects)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Pregabalin
• Prospective Studies
• Seizures (drug therapy)
• Substance Withdrawal Syndrome (diagnosis, physiopathology)
• Treatment Outcome
• Young Adult
• gamma-Aminobutyric Acid (adverse effects, analogs & derivatives, therapeutic use)