Three-Year Retention Rates of Levetiracetam, Topiramate, and Oxcarbazepine: A Retrospective Hospital-Based Study.

Abstract

OBJECTIVES:

We evaluated and compared the 3-year retention rates of levetiracetam (LEV), topiramate (TPM), and oxcarbazepine (OXC) in patients with epilepsy in routine clinical practice.

METHODS:

We retrospectively reviewed medical records of patients with epilepsy who were newly prescribed LEV, TPM, or OXC from 2006 to 2010. The retention rates were estimated by the Kaplan-Meier analysis, and independent risk factors for drug discontinuation were analyzed by the Cox regression method.

RESULTS:

A total of 588 patients were included: LEV (n = 345), TPM (n = 190), and OXC (n = 53). Among them, 82% had focal epilepsy, whereas 14.8% had generalized epilepsy. The 3-year retention rates for LEV, TPM, and OXC, were 81.2%, 78.3%, and 54.7%, respectively. Levetiracetam and TPM had equivalent retention rates, whereas patients remained on OXC for a significantly shorter amount of time (P < 0.001). A lower retention rate for OXC was also evident in the subgroup analysis of focal epilepsy (P < 0.001). In generalized epilepsy, LEV and TPM revealed comparable retention rates (P = 0.255). The seizure-freedom rate did not differ among groups, whereas the rate of adverse effects leading to drug withdrawal of OXC (87.5%) was higher than that of LEV (34.4%, P < 0.001) and TPM (52.5%, P = 0.012).

CONCLUSIONS:

The current study suggested that LEV and TPM had comparable retention profiles in the long-term treatment for both focal and generalized epilepsy. Meanwhile, OXC therapy seemed to be relatively less useful because of its poor tolerability.

• Authors: Jun-Sang Sunwoo, Byeong-Su Park, Seon Jae Ahn, Sungeun Hwang, Chan-Young Park, Jin-Sun Jun, Dong Wook Kim, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park, Kon Chu, Ki-Young Jung, Sang Kun Lee
• Journal: Clinical neuropharmacology (Clin Neuropharmacol) 2017 Mar/Apr Vol. 40 Issue 2 Pg. 56-62 ISSN: 1537-162X [Electronic] United States
• PMID: 28118167 (Publication Type: Journal Article)

Chemical References

• Anticonvulsants
• Topiramate
• Fructose
• Carbamazepine
• Levetiracetam
• Oxcarbazepine
• Piracetam

Topics

• Adult
• Anticonvulsants (adverse effects, therapeutic use)
• Carbamazepine (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Drug Utilization (statistics & numerical data)
• Epilepsy (drug therapy)
• Female
• Fructose (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Hospitals
• Humans
• Kaplan-Meier Estimate
• Levetiracetam
• Male
• Oxcarbazepine
• Piracetam (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Retrospective Studies
• Topiramate
• Young Adult