Prescription patterns of antiseizure drugs in tuberous sclerosis complex (TSC)-associated epilepsy: a multicenter cohort study from Germany and review of the literature.
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Strzelczyk Adam, Grau Janina, Bast Thomas, Bertsche Astrid, Bettendorf Ulrich, Hahn Andreas, Hartmann Hans, Hertzberg Christoph, Hornemann Frauke, Immisch Ilka, Jacobs Julia, Klotz Kerstin A, Kluger Gerhard, Knake Susanne, Knuf Markus, Kurlemann Gerhard, Marquard Klaus, Mayer Thomas, Meyer Sascha, Muhle Hiltrud, Müller-Schlüter Karen, von Podewils Felix, Rosenow Felix, Ruf Susanne, Sauter Matthias, Schäfer Hannah, Schlump Jan-Ulrich, Schubert-Bast Susanne, Syrbe Steffen, Thiels Charlotte, Trollmann Regina, Wiemer-Kruel Adelheid, Wilken Bernd, Zukunft Bianca, Zöllner Johann Philipp
Аннотация
METHODS: We evaluated the pattern of routine ASD use and everolimus prescriptions based on a 2019 multicenter survey of 268 individuals with TSC-associated epilepsy. We contextualized the results with a structured review of real-world and clinical study evidence.
RESULTS: TSC-associated epilepsy treatment comprises a wide variety of ASDs. In this German sample, the majority of patients were treated with polytherapy, and lamotrigine (34.7%), valproate (32.8%), oxcarbazepine (28.7%), vigabatrin (19.0%), and levetiracetam (17.9%) were identified as the most-commonly used ASDs. In addition, everolimus was used by 32.5% of patients. In adherence to current TSC guidelines, the disease-modifying ASD vigabatrin was widely used in children (58% below the age of 5 years), whereas treatment in adults did not necessarily reflect guideline preference for (partial) GABAergic ASDs.
CONCLUSIONS: The selection of ASDs for patients with TSC-associated epilepsy follows well-evaluated recommendations, including the guidelines regarding vigabatrin use in children. Several characteristics, such as the comparatively high frequency of valproate use and polytherapy, reflect the severity of TSC-associated epilepsy.